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健康相关生活质量的恶化:非正式照料的隐性健康负担。

Deterioration of health-related quality of life: the hidden health burden of informal caregiving.

作者信息

Keramat Syed Afroz, Sarker Prianka Maria, Comans Tracy, Brooks Deborah, Dissanayaka Nadeeka N

机构信息

Centre for Health Services Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia.

Margaret Chase Smith Policy Center, University of Maine, Orono, ME, USA.

出版信息

Eur J Health Econ. 2025 Apr 17. doi: 10.1007/s10198-025-01776-5.

Abstract

Informal caregiving is physically and mentally demanding and may lead to poor health and impaired well-being. We aim to check the effects of informal caregiving on health-related quality of life (HRQoL). We utilised longitudinal data from the most recent sixteen waves of the Household, Income and Labour Dynamics in Australia (HILDA) Survey. We measured HRQoL through the physical component summary (PCS), the mental component summary (MCS), the short-form six-dimension (SF-6D) utility index, and the eight dimensions of the SF-36 health survey. The primary exposure variable is informal caregiving. The variable was categorised into not a caregiver, lighter (< 5 hours [h]/week), moderate (5-19 h/week), and intensive (≥ 20 h/week) caregiving based on the hours of providing informal care per week. We have found that informal caregiving negatively affects HRQoL. We found that moderate (β = -0.0035, standard error [SE] = 0.0012) and intensive caregiving (β = -0.0074, SE = 0.0020) reduced SF-6D utility value. We also found that lighter (β = -0.29, SE = 0.07), moderate (β = -0.55, SE = 0.12), and intensive (β = -1.53, SE = 0.19) caregiving lowered MCS scores. Moreover, our results revealed that lighter, moderate and intensive caregiving decreases the scores of mental health-related dimensions (e.g., role emotional, social functioning, and mental health) of the SF-36 health survey. Our study findings have significant policy implications for improving the HRQoL and well-being of caregivers. To effectively support the health and well-being of informal carers, it is crucial to implement strategies that address their diverse needs, including supporting work-life balance, providing financial assistance and social security measures, ensuring access to community-based services, providing access to relevant information and training, and offering respite care options.

摘要

非正式照料对身体和精神都有很高要求,可能导致健康状况不佳和幸福感受损。我们旨在研究非正式照料对健康相关生活质量(HRQoL)的影响。我们使用了澳大利亚家庭、收入与劳动力动态调查(HILDA)最新十六轮的纵向数据。我们通过身体成分汇总(PCS)、精神成分汇总(MCS)、简短六维度(SF - 6D)效用指数以及SF - 36健康调查的八个维度来衡量HRQoL。主要暴露变量是非正式照料。根据每周提供非正式照料的时长,该变量被分为非照料者、轻度(<5小时/周)、中度(5 - 19小时/周)和重度(≥20小时/周)照料。我们发现非正式照料对HRQoL有负面影响。我们发现中度(β = -0.0035,标准误[SE]=0.0012)和重度照料(β = -0.0074,SE = 0.0020)会降低SF - 6D效用值。我们还发现轻度(β = -0.29,SE = 0.07)、中度(β = -0.55,SE = 0.12)和重度(β = -1.53,SE = 0.19)照料会降低MCS得分。此外,我们的结果显示,轻度、中度和重度照料会降低SF - 36健康调查中与心理健康相关维度(如角色情感、社会功能和心理健康)的得分。我们的研究结果对改善照料者的HRQoL和幸福感具有重要的政策意义。为了有效支持非正式照料者的健康和幸福感,实施能够满足他们多样化需求的策略至关重要,这些策略包括支持工作与生活的平衡、提供经济援助和社会保障措施、确保获得社区服务、提供相关信息和培训以及提供喘息照料选择。

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