Intergenerational Caregiving to At-Risk Youth

对高危青少年的代际照顾

• 批准号: 6733541
• 负责人: Carol M. Musil
• 金额: $ 26.78万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-01 至 2005-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6733541
• 关键词: behavioral /social science research tag; caregivers; child care; clinical research; coping; family structure /dynamics; female; grandparent; human subject; interview; longitudinal human study; psychological stressor; quality of life; questionnaires; racial /ethnic difference; social support network; women' s health

Nearly 2.3 million grandmothers have a grandchild under 18 years of age living in their home (Bryson and Casper, 1998). Most of these grandmothers are caregivers for their grandchildren either as the primary, custodial caregiver or as a supplemental caregiver. In both cases, the expected duration of caregiving is often indefinite, although many primary caregivers can expect to raise their grandchildren until adulthood. The health of these grandmothers is important because of their central role in the family. In addition, grandmother-headed families are at greater risk because many such grandmothers report high stress, 22 percent are over 65 years, 23 percent are poor, and about half are minorities, increasing their likelihood of experiencing various health problems and associated social, role and functional limitations that affect family well-being. Indeed, the limited data on the health of grandmother caregivers suggest that primary caregiver grandmothers in particular have more problems with depressive symptoms and physical health than non- caregivers or caregivers of other types, although much less is known about the well-being of the 1.4 million grandmothers who provide supplemental care to children in multi-generational homes (Musil, in press; Szinovacz, 1999). In addition, the links between the grandmother and family in terms of stress, health and family well-being have not been previously studied in families of grandmother caregivers. Therefore, the purpose of this study is to describe the longitudinal effects of grandmother caregiver status, family stress, resources and coping on grandmother and family will-being. Research questions for this study are: 1. Are there differences between primary caregiver, supplemental caregiver and non-caregiver grandmothers in (a) family stress, (b) general health, (c) physical health, (d) mental health, and (e) family well being at each of three times one year apart, T1, T2, and T3? 2. Do these differences remain after controlling for partner status and race? 3. Do social support and learned resourcefulness moderate the relationship between appraised stress and individual and family well-being? 4. Does the model adequately represent the relationships among the major study variables with individual and family health at each of the three time points? And 5. How do grandmothers who experience changes in family composition perceive these changes for themselves and their families? Answers to these questions will be sought in a four and one half year longitudinal study of grandmothers using a random sample of 375 women from urban, rural and suburban areas in Ohio. Data will be collected by mailed questionnaire each year for three time points. A theoretical model based on the Resiliency Model of Family Stress, Adjustment and Adaptation (McCubbin and McCubbin, 1993) will be tested using structural equation modeling to describe relationships among the major study variables, thereby allowing nurses and other health care professionals to identify factors that may moderate the effects of stress on grandmother and family will-being. In addition, narrative interviews with grandmothers who experience changes in their family composition over the study period will illuminate how these changes affect the grandmother and family. The innovations of this study are that it includes a comparison group of non-care giver grandmothers in a longitudinal design using a probability sample, it considers the functioning of both the grandmother and family, and it examines the moderating effects of support and learned resourcefulness on the stress-health relationship.

近230万的祖母有一个18岁以下的孙子住在家里（Bryson和Casper， 1998）。这些祖母中的大多数都是孙辈的照顾者，要么是主要的、监护的照顾者，要么是辅助的照顾者。在这两种情况下，预期的照顾时间通常是不确定的，尽管许多主要的照顾者可以期望抚养他们的孙辈直到成年。这些祖母的健康很重要，因为她们在家庭中起着核心作用。此外，祖母为户主的家庭面临更大的风险，因为许多这样的祖母报告压力很大，22%的祖母超过65岁，23%的祖母很穷，大约一半是少数民族，增加了她们遇到各种健康问题以及影响家庭福祉的相关社会、角色和功能限制的可能性。事实上，关于祖母照顾者健康的有限数据表明，主要照顾者祖母比非照顾者或其他类型的照顾者有更多的抑郁症状和身体健康问题，尽管对在多代家庭中为儿童提供补充照顾的140万祖母的健康知之甚少（Musil, in press; Szinovacz, 1999）。此外，祖母和家庭在压力、健康和家庭幸福方面的联系以前没有在照顾祖母的家庭中进行过研究。因此，本研究旨在探讨外祖母照顾者地位、家庭压力、资源和应对对外祖母和家庭意愿存在的纵向影响。本研究的研究问题是：1。主要照顾者、辅助照顾者和非照顾者的祖母在(a)家庭压力、(b)一般健康、(c)身体健康、(d)心理健康和(e)家庭幸福方面，在间隔一年的T1、T2和T3三次中的每一次，是否存在差异？2. 在控制了伴侣地位和种族之后，这些差异还存在吗？3. 社会支持和习得的机智是否调节了评估压力与个人和家庭幸福之间的关系？4. 该模型是否充分代表了三个时间点上主要研究变量与个人和家庭健康之间的关系？和5。经历过家庭构成变化的祖母们如何看待自己和家庭的这些变化？这些问题的答案将在对俄亥俄州城市、农村和郊区的375名女性进行为期四年半的纵向研究中寻求。以邮寄问卷的方式收集数据，每年三个时间点。基于家庭压力、调整和适应弹性模型（McCubbin and McCubbin, 1993）的理论模型将使用结构方程模型来描述主要研究变量之间的关系，从而使护士和其他卫生保健专业人员能够确定可能缓和压力对祖母和家庭意愿的影响的因素。此外，对在研究期间经历家庭组成变化的祖母进行叙述性访谈将阐明这些变化如何影响祖母和家庭。本研究的创新之处在于采用概率样本的纵向设计，将无照护者祖母作为对照组，同时考虑了祖母和家庭的功能，并考察了支持和习得机智对压力-健康关系的调节作用。