Mental and physical health changes around transitions into unpaid caregiving in the UK: a longitudinal, propensity score analysis
Mental and physical health changes around transitions into unpaid caregiving in the UK: a longitudinal, propensity score analysis
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DOI：
10.1016/s2468-2667(23)00206-2
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发表时间：
2024-01-02
影响因子：
50
通讯作者：
McMunn，Anne
中科院分区：
文献类型：
--
作者：
Lacey，Rebecca E.;Xue，Baowen;McMunn，Anne
背景：无报酬照顾者的健康状况平均而言比非照顾者差。很少有人关注成为照顾者时健康如何变化，以及这是否因年龄，性别和照顾强度而异。我们的目的是调查的心理和身体健康的变化，成为一个照顾者，以及这些协会是否不同的性别，habitiving强度，或age.MethodsThis研究使用的数据从英国家庭纵向研究（2009-20），以检查周围的过渡到成为一个照顾者在16岁及以上的成年人的心理和身体健康的变化。我们纳入了具有护理信息的成年人，匹配所需的完整协变量，以及在成为护理人员之前或之后（或匹配的非护理人员）的至少一项健康指标。通过一般健康问卷-12（GHQ-12，心理困扰）和12项简表调查（SF-12，身心功能）测量健康状况。我们采用分段增长曲线模型与倾向得分匹配的模式轨迹的精神和身体健康的照顾者和匹配的非照顾者。按年龄组、性别和生育强度进行分层分析。调查结果样本量从3025（成年早期的GHQ-12分析）到5785（成年中期早期的SF-12分析）不等。心理困扰增加过渡到所有年龄段的老年人，特别是在那些年龄小于64岁，那些每周提供20小时或以上的照顾，并为生活在家里的人。对于那些年龄在30-64岁，每周提供20小时或更多时间的人，以及那些在家庭中照顾某人的人，心理健康功能在生育过渡期间恶化。身体健康功能没有改变，但有证据表明，在康复前功能水平较低。在心理和身体健康的变化后过渡到adulving没有不同的性别。InterpretationOur的研究结果强调了早期识别和支持的照顾者，包括年轻的照顾者的重要性。这对于打破生育和未来护理需求的循环至关重要。保健服务工作人员，包括全科医生和医院出院小组，完全有能力及早查明提供照料者。我们还鼓励特别支持照顾者的心理健康，特别是那些在年轻时成为照顾者的人。
BackgroundThe health of unpaid caregivers is poorer, on average, than in non-caregivers. There has been little focus on how health changes when becoming a caregiver and whether this varies by age, gender, and caregiving intensity. We aimed to investigate the mental and physical health changes involved with becoming a caregiver and whether these associations varied by gender, caregiving intensity, or age.MethodsThis study used data from the UK Household Longitudinal Study (2009–20) to examine mental and physical health changes around the transition to becoming a caregiver in adults aged 16 years and older. We included adults with information on care, complete covariates needed for matching, and at least one measure of health before or after becoming a caregiver (or matched non-caregiver). Health was measured via General Health Questionnaire-12 (GHQ-12, psychological distress) and 12-item Short Form Survey (SF-12, physical and mental functioning). We applied piecewise growth curve modelling with propensity score matching to model trajectories of mental and physical health for caregivers and matched non-caregivers. Analyses were stratified by age group, gender, and caregiving intensity.FindingsSample sizes varied from 3025 (GHQ-12 analyses in early adulthood) to 5785 (SF-12 analyses in early mid-adulthood). Psychological distress increased during transition to caregiving for all ages, particularly in those younger than 64 years, those providing care for 20 h or more per week, and for someone living within the household. Mental health functioning worsened during caregiving transition for those aged 30–64 years, those providing 20 h or more per week, and for those caring for someone within the household. Physical health functioning did not change but there was evidence of lower levels of functioning before caregiving. Changes in mental and physical health upon transition to caregiving did not differ by gender.InterpretationOur findings highlight the importance of early identification of and support for caregivers, including younger caregivers. This is important to break the cycle of caregiving and future care need. Health services staff, including general practitioners and hospital discharge teams, are well positioned for early identification of caregivers. We also encourage particular support for the mental health of caregivers and particularly those who become caregivers at a younger age.FundingThe UK Economic and Social Research Council.