Involvement in caregiving and adjustment to death of a spouse - Findings from the caregiver health effects study
Involvement in caregiving and adjustment to death of a spouse - Findings from the caregiver health effects study
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DOI：
10.1001/jama.285.24.3123
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发表时间：
2001-06-27
影响因子：
120.7
通讯作者：
Burton, L
中科院分区：
文献类型：
--
作者：
Schulz, R;Beach, SR;Burton, L
在美国，大多数死亡发生在有一种或多种残疾状况的老年人中。因此，许多死亡之前，在此期间，家庭成员提供照顾他们的残疾relations. ObjectiveTo更好地了解丧亲之痛对家庭照顾者的影响，通过检查死亡前与死亡后的变化，自我报告和客观的健康结果之间的老年人提供不同程度的照顾之前，他们的配偶的死亡。1993年至1998年在美国4个社区进行的基于人群的队列研究。参与者129名年龄在66至96岁之间的个体，其配偶在平均4年的随访期间死亡。个体被分类为非照顾者（n=40）、报告没有紧张的照顾者（n=37）或紧张的照顾者（n=52）。（采用流行病学中心抑郁量表（CES-D）评定）、抗抑郁药物使用、6种健康危险行为和体重。受教育程度、基线时心血管疾病患病率以及死亡前和死亡后评估的间隔时间，CES-D评分仍然较高，但在紧张的照顾者中没有变化（9.44 vs 9.19; P= 0.76），而这些评分在非照顾者中增加（4.74 vs 8.25; F-1，F-116=14.33; P
Context Most deaths in the United States occur among older persons who have 1 or more disabling conditions. As a result, many deaths are preceded by an extended period during which family members provide care to their disabled relative.Objective To better understand the effect of bereavement on family caregivers by examining predeath vs postdeath changes in self-reported and objective health outcomes among elderly persons providing varying levels of care prior to their spouse's death.Design and Setting Prospective, population-based cohort study conducted in 4 US communities between 1993 and 1998.Participants One hundred twenty-nine individuals aged 66 to 96 years whose spouse died during an average 4-year follow-up. Individuals were classified as noncaregivers (n=40), caregivers who reported no strain (n=37), or strained caregivers (n=52).Main Outcome Measures Changes in depression symptoms (assessed by the 10-item Center for Epidemiological Studies-Depression [CES-D] scale), antidepressant medication use, 6 health risk behaviors, and weight among the 3 groups of participants.Results Controlling for age, sex, race, education, prevalent cardiovascular disease at baseline, and interval between predeath and postdeath assessments, CES-D scores remained high but did not change among strained caregivers (9.44 vs 9.19; P=.76), while these scores increased for both noncaregivers (4.74 vs 8.25; F-1,F-116=14.33; P