Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA.
Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA.
West J Nurs Res. 2024 Nov;46(11):928-940. doi: 10.1177/01939459241278453. Epub 2024 Sep 9.
Caregiving in the African American community is informed by strong cultural expectations but may be associated with negative experiences and poor mental health outcomes.
The purpose of this convergent mixed-methods study is to understand the relationship between caregiving experiences and mental health and explore stress management strategies in African American family caregivers of adults with chronic or disabling conditions.
African American family caregivers (N = 100) were recruited using community-engaged methods and completed a sociodemographic questionnaire, the Caregiver Reaction Assessment scale, and the Center for Epidemiologic Studies Depression (CES-D-10) Scale. A subsample (n = 24) participated in semi-structured interviews. Data were analyzed using linear regression and content analysis. A matrix was developed to integrate quantitative and qualitative results.
Participants were on average 59 years old. Most were women and provided care to a parent. Lack of family support ( = 1.37, = .03) and impact of caregiving on caregivers' finances ( = 1.74, = .004), schedule ( = 2.92, < .001), and health ( = 3.26, < .001) were associated with depressive symptoms and were reported as stressful experiences. Negative interactions with the care recipient and caring for multiple people emerged as other sources of stress. Participants used independent and interpersonal coping strategies, as well as strategies to facilitate their caregiving role to reduce their stress. Values of reciprocity, limited use of community-based resources, and mental health stigma emerged as important cultural considerations.
Our findings suggest the need for culturally-sensitive interventions to improve communication and care coordination within African American family caregiving networks and educational programs about mental health and caregiving resources endorsed by trusted community sources.
非裔美国人社区的护理工作受到强烈文化期望的影响，但可能与负面体验和心理健康不良结局有关。
本汇聚式混合方法研究的目的是了解护理经验与心理健康之间的关系，并探索患有慢性或致残疾病的成年非裔美国家庭照顾者的压力管理策略。
采用社区参与的方法招募了非裔美国家庭照顾者（N=100），他们完成了社会人口学问卷、照顾者反应评估量表和流行病学研究中心抑郁量表（CES-D-10）。一个亚样本（n=24）参加了半结构式访谈。使用线性回归和内容分析进行数据分析。开发了一个矩阵来整合定量和定性结果。
参与者的平均年龄为 59 岁。大多数是女性，照顾的是父母。缺乏家庭支持（ = 1.37， = .03）和照顾对照顾者财务（ = 1.74， = .004）、日程安排（ = 2.92， < .001）和健康（ = 3.26， < .001）的影响与抑郁症状相关，并被报告为有压力的经历。与照顾对象的负面互动和照顾多个人是其他压力源。参与者使用独立和人际应对策略，以及促进他们的照顾角色的策略来减轻他们的压力。互惠、有限使用基于社区的资源以及心理健康耻辱感等价值观是非裔美国家庭照顾者的重要文化考虑因素。
我们的研究结果表明，需要采取文化敏感的干预措施，以改善非裔美国家庭照顾者网络中的沟通和护理协调，并提供关于心理健康和照顾资源的教育计划，这些计划得到了可信赖的社区来源的认可。
