Overwhelming odds: caregiving and the risk of institutionalization.
Overwhelming odds: caregiving and the risk of institutionalization.
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压倒性的可能性：护理和收容的风险。
DOI：
10.1093/geronj/45.5.s173
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Rice,M
中科院分区：
文献类型：
--
作者：
Newman,SJ;Struyk,R;Wright,P;Rice,M
在这项研究中，我们探讨了是否非正式或正式提供的长期护理服务，以减少机构中受损的老年人和支持和风险之间的关系的性质的风险。我们主要依赖于1982年的全国长期护理调查（NLTC）与1984年NLTC和美国全国住房调查的补充数据。五种具体类型的影响进行了测试：直接影响的正式和非正式的护理机构的风险;缓冲效应的支持缓和风险因素;补充效应的正式支持的风险降低的影响，非正式的护理;促进影响的住房环境，使支持继续;和中介的直接影响的干预效果。每种支持的效果有很大不同。这些分析并没有证实正规的有偿护理可以减少机构风险的观点。事实上，在其他条件相同的情况下，使用有偿照顾者与更大的机构化风险有关。非正式护理的结果更为复杂。一个一般性的措施，占所有类型的非正式支持没有影响的机构风险，在任何测试的配方。但是，在直接效应模型中，质量和直接支持的边际显著性效应与银行化降低制度风险的假设一致。研究结果还表明，少量的住房或位置的功能是正式支持和特定类型的非正式支持的促进因素。
In this study we explored whether informally or formally provided long-term care services reduce the risk of institutionalization among the impaired elderly and the nature of the relationship between support and risk. We relied principally on the 1982 National Long-Term Care Survey (NLTC) with supplementary data from the 1984 NLTC and the national american housing survey. Five specific types of effects were tested: direct effects of formal and informal care on institutional risk; buffering effects of support moderating risk factors; supplementation effects of formal support on the risk-reducing impact of informal care; facilitating effects of the housing environment in enabling support to continue; and intervening effects mediating the direct effects. The effects of each type of support differ substantially. The analyses do not confirm the notion that formal, paid care reduces institutional risk. In fact, the use of paid caregivers is associated with greater risk of institutionalization, other things equal. The results for informal care are more mixed. A general measure that accounts for all types of informal support has no effect on institutional risk in any of the formulations tested. But the marginally significant effects of quality and proximate support in the direct effects model are consistent with the hypothesis that caregiving reduces institutional risk. The findings also indicate that a small number of housing or locational features are facilitators of formal support and particular types of informal support.