The Health of Aging Parents of Adult Children with Serious Conditions

摘要 平均而言，患有严重疾病的儿童的母亲（例如，精神疾病，残疾，发展 疾病，慢性病）面临健康风险，由于负担，压力和其他因素，往往 与他们养育子女的许多有益方面相反。这些健康影响似乎被放大， 孩子们长大成人，母亲们则到了中年晚期及以后。现代医疗 进步使处于这种弱势地位的母亲人数增加，她们需要得到支持。这 该项目将通过采用一个 创新的生命过程方法和混合方法战略，以解决这一重大的公共卫生问题。 具体而言，该项目扩展和丰富了关于怀孕母亲身心健康的文献， 孩子们问了三个问题。第一个问题（“为什么？”）涉及复杂的 社会和心理的回报和养育孩子的压力与严重的条件， 在中年后期影响母亲的健康。第二个问题（“什么时候？”）涉及 风险和复原力的累积期与敏感期的潜力 从出生到成年都有严重的疾病第三个问题（“在哪里？”）关系到 在非正式生态系统中，家庭支持哪一种，在正式生态系统中，社区卫生和人类服务支持哪一种 缓和回报和压力的交换，以缓冲年轻成年人的中年晚期母亲的健康风险 病情严重的儿童。这些问题将得到解决与顺序解释混合 方法策略，其中定量结果由定性见解和定性见解来解释 指导后续的定量分析。这一战略整合了对现有人口的统计分析 数据库，对新收集的定性数据进行文本/扎根理论分析，均以母亲为重点 在生命的第六个十年。第一个项目涉及大约3 100名有年轻成年子女的母亲（其中420名 在1979年全国青年纵向调查中，有严重的情况）。第二 涉及80名有或没有严重疾病的年轻成年子女的母亲。这种混合方法序列 已经通过了对高影响力的定量数据的初步分析， 期刊和由国家影响评估试点机制供资的小规模定性数据收集。所进行 一个由资深和初级学者组成的跨学科小组，在家庭研究方面具有互补专长， 健康，这个项目将提出和完善一个健康和福祉的生命过程框架， 强化养育的无限责任，可以指导这一领域的未来研究，并帮助调整 旨在为这一日益增长的老龄化人口提供服务的政策和计划。最终目标是， 然后，基础知识将有助于设计今后关于这一问题的人口研究，供公众使用。

Abstract On average, the mothers of children with serious conditions (e.g., mental illnesses, disabilities, developmental disorders, chronic conditions) face health risks due to caregiving burdens, stress, and other factors that often counter the many rewarding aspects of their parenting. These health implications appear to be magnified when children reach adulthood and mothers reach late midlife and beyond. Modern medical and therapeutic advances have increased the number of mothers in this vulnerable position, and they need support. This project will further build the theoretically grounded empirical foundation for that support by employing an innovative life course approach and mixed methods strategy to address this significant public health issue. Specifically, this project extends and enriches the literature on the physical and mental health of mothers of children with serious conditions by asking three questions. The first question (“why?”) concerns the complex ways that the social and psychological rewards and strains of parenting children with serious conditions into adulthood converge to shape mothers’ health in late midlife. The second question (“when?”) concerns the potential for cumulative vs. sensitive periods of risk and resilience across years of caring for children with serious conditions from their births into their adulthoods. The third question (“where?”) concerns the degree to which family supports in the informal ecology and community health and human services in the formal ecology moderate the exchange of rewards and strains to buffer health risks among late-midlife mothers of young adult children with serious conditions. These questions will be addressed with a sequential explanatory mixed methods strategy in which quantitative results are unpacked by qualitative insights and qualitative insights guide subsequent quantitative analyses. This strategy integrates statistical analyses of an extant population database with textual/grounded theory analyses of newly collected qualitative data, both focusing on mothers in the sixth decade of life. The first involves approximately 3,100 mothers of young adult children (420 of whom had serious conditions) in the geocoded, multilevel National Longitudinal Survey of Youth 1979. The second involves 80 mothers of young adult children with and without serious conditions. This mixed methods sequence is already vetted and supported by preliminary analyses of the quantitative data published in a high-impact journal and a smaller-scale qualitative data collection funded by an NIA pilot mechanism. Conducted by an interdisciplinary team of senior and junior scholars with complementary expertise in the study of families and health, this project will put forward and refine a life course framework of health and wellbeing in the context of the indefinite responsibilities of intensive parenting that can guide future research in this area and help to tailor policies and programs aiming to serve this growing slice of the aging population. The ultimate goal is that this foundational knowledge will then support the design of a future population study of this issue for public use.