| Titre : | Involvement in caregiving and adjustment to death of a spouse : Findings from the caregiver health effects study. (2001) |
| Auteurs : | Richard SCHULZ ; Scott-R BEACH ; Lynda BURTON ; Calvin Hirsch ; Sharon JACKSON ; Bonnie LIND ; Lynn-M MARTIRE ; Bozena ZDANIUK ; Department of Psychiatry University of Pittsburgh. Pittsburgh. PA. USA ; University Center for Social and Urban Research University of Pittsburgh. Pittsburgh. PA. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 285, n° 24, 2001) |
| Pagination : | 3123-3129 |
| Langues: | Anglais |
| Mots-clés : | Mort ; Conjoint ; Personne âgée ; Homme ; Risque ; Etat santé ; Etat dépressif ; Amaigrissement ; Epidémiologie ; Etats Unis ; Amérique ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST-CNRS 88dR0xRU. Diffusion soumise à autorisation]. 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 ; F1.116=14.33 ; P<. 001) and nonstrained caregivers (4.94 vs 7.13 ; F1.116=4.35 ; P=04). Noncaregivers were significantly more likely to be using nontricyclic antidepressant medications following the death than the nonstrained caregiver group (odds ratio [OR], 12.85 ; 95% confidence interval [Cl], 1.02-162.13 ; P=05). The strained caregiver group experienced significant improvement in health risk behaviors following the death of their spouse (1.47 vs 0.66 behaviors ; F1.118=20.23 ; P<. 001), while the noncaregiver |
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