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      Desigualdades de género en los impactos del cuidado informal de mayores dependientes en Gipuzkoa: Estudio CUIDAR-SE Translated title: Gender inequalities in the impacts of informal elderly caregiving in Gipuzkoa: CUIDAR-SE Study

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          Abstract

          RESUMEN Fundamentos: La prestación de cuidados informales determina la existencia de desigualdades en salud, a las cuales se suman las desigualdades de género por el papel mayoritario de las mujeres en dicha prestación. Los objetivos de este estudio fueron caracterizar a la población cuidadora informal de mayores dependientes en Gipuzkoa, conocer los impactos de cuidar sobre la salud y la calidad de vida relacionada con la salud (CVRS), y explicar la relación entre el sexo y las consecuencias atribuibles al cuidado. Métodos: Estudio transversal en el que se analizaron datos de salud (salud percibida y GHQ-12) y CVRS (EQ-5D-5L) de 123 mujeres y 103 hombres cuidadores de mayores dependientes que participaron en la primera oleada del estudio CUIDAR-SE en Gipuzkoa. Se realizó un estudio descriptivo, y un análisis de regresión logística para examinar la asociación entre el sexo y las consecuencias del cuidado. Resultados: Mujeres y hombres tenían más de 60 años, estaban casadas/os, tenían educación primaria o inferior, y cuidaban a sus progenitores fundamentalmente. Las mujeres presentaban peor salud percibida (46,3% vs 32,0%) y mental (23,3% vs 13,9%), y más problemas en las dimensiones de ansiedad/depresión (35,0% vs 21,4%) y dolor/malestar (52,8% vs 31,1%) de laEQ-5D-5L. El modelo de regresión mostró mayor riesgo de cansancio (OR=2,83; IC95%:1,53-5,24) y sobrecarga (OR=1,87; IC95%:1,06-3,29) en mujeres que en hombres. Conclusiones: Existen desigualdades de género en la provisión de cuidados informales a mayores dependientes en Gipuzkoa, mostrando las mujeres un mayor impacto en su salud y CVRS que los hombres. Considerando la organización del cuidado en esta provincia, será necesario el diseño de acciones de mejora más adecuadas a las necesidades de las personas cuidadoras.

          Translated abstract

          ABSTRACT Background: The provision of informal care determines the existence of health inequalities, as well as gender inequalities, because of women being the most frequent caregivers. The objectives of this study were to characterize the informal caregivers of elderly dependents in Gipuzkoa, to know the impact of caring on health and health related quality of life (HRQoL), and to explain the relationship between sex and consequences attributable to care. Methods: Cross-sectional study analyzing health (self-perceived health and GHQ-12) and HRQoL (EQ-5D-5L) data of 123 women and 103 men who took care of a dependent elderly and participated in the first wave of the CUIDAR-SE study in Gipuzkoa. A descriptive study was performed, and a logistic regression analysis was carried out to examine the association between sex and the consequences attributable to care. Results: Women and men were over 60 years old, married, with primary education or less, and took care of their parents mainly. Women presented worse perceived health (46.3% vs 32.0%) and mental health (23.3% vs 13.9%), and more problems in the dimensions of anxiety/depression (35.0% vs 21.4%) and pain/discomfort (52.8% vs 31.1%) of EQ-5D-5L.The regression model showed greater risk of fatigue (OR = 2.83; 95% CI:1.53-5.24) and burden (OR = 1.87; 95% CI: 1.06-3.29) among women than among men. Conclusions: There are gender inequalities in the provision of informal care to dependent elderly people in Gipuzkoa, with women having a greater impact on their health and HRQoL than men. Considering the organization of care in this province, it will be necessary to design improvement actions more suited to the needs of caregivers.

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          Most cited references26

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          Gender Differences in Caregiver Stressors, Social Resources, and Health: An Updated Meta-Analysis

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            Gender differences in health: results from SHARE, ELSA and HRS.

            We examine gender differences in health at ages 50 years and older in 11 European countries, England and the USA. We use the Survey of Health, Ageing and Retirement (SHARE) for 11 Continental European countries; the English Longitudinal Study of Ageing (ELSA) and the Health and Retirement Study (HRS) for the USA to examine gender differences in health behaviours, functioning problems, disability, disease prevalence and self-rated health. Women in all countries are more likely than men to have disabling, non-lethal conditions including functioning problems [odds ratio (OR) indicating the effect of female is 1.57-2.43], IADL difficulties (OR 1.45-2.94), arthritis (OR 1.46-2.90) and depressive symptoms (OR 1.45-3.35). On the other hand, self-reported heart disease is more common among men (OR indicating effect of female ranges from 0.43 to 0.86). These differences are not eliminated by controlling for smoking behaviour and weight. Self-reported hypertension (OR 0.72-1.53) is generally more common among women; stroke and diabetes do not show consistent sex differences. While subjective assessment of health is poorer among women, this is not true when indicators of functioning, disability and diseases are controlled. There is remarkable consistency in direction of gender differences in health across these 13 countries. The size of the differences is affected in many cases by the similarity in behaviours of men and women.
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              Predictors of caregiver burden in caregivers of individuals with dementia.

              This article is a report on a study of the multidimensional predictors of caregiver burden in caregivers of individuals with dementia using nationally representative data. Caregiver burden affects the health of both caregivers and their care-recipients. Although previous studies identified various predictors of caregiver burden, these predictors have not been confirmed in nationally representative population. Data for this secondary analysis was provided by the National Alliance for Caregiving, American Association of Retired Persons. The data were collected through a telephone survey of randomly selected adults in seven states in 2003 (weight adjusted n = 302). Descriptive statistics, inter-correlation analysis and a hierarchical multiple regression analysis were performed. Disease-related factors were the most significant predictors, explaining 16% of caregiver burden; these were followed by caregiver socio-demographical factors and caregiving-related factors (F = 21·28, P < 0·01). Significant individual predictors were impairment of activities of daily living or instrumental activities of daily living, the number of hours of caregiving, use of coping strategies, co-residence, spousal status and caregiver gender (P < 0·05). Impaired function in care-recipients predicts caregiver burden, and also interacts with demographical- and caregiving-related factors. Thus, it will be beneficial to both care-recipients and caregivers to target nursing interventions and community services to improve the functional abilities of individuals with dementia. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
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                Author and article information

                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad, Consumo y Bienestar social (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                2019
                : 93
                : e201901002
                Affiliations
                [3] San Sebastián orgnameGobierno Vasco orgdiv1Departamento de Salud España
                [6] San Sebastián orgnameOsakidetza-Servicio Vasco de Salud orgdiv1Centro de salud de Alza España
                [9] San Sebastián orgnameInstituto de Investigación Sanitaria Biodonostia España
                [4] Granada orgnameEscuela Andaluza de Salud Pública España
                [1] Leioa Bizkaia orgnameUniversidad del País Vasco / Euskal Herriko Unibertsitatea orgdiv1Facultad de Ciencias Sociales y de la Comunicación orgdiv2Dpto de Sociología 2 España
                [7] San Sebastián orgnameOsakidetza-Servicio Vasco de Salud orgdiv1Unidad de Investigación de Atención Primaria-OSIs Gipuzkoa España
                [8] Barakaldo orgnameRed de Investigación en Servicios de Salud en Enfermedades Crónicas España
                [10] Barakaldo orgnameKronikgune - Centro de Investigación en Cronicidad España
                [2] Leioa Bizkaia orgnameUniversidad del País Vasco / Euskal Herriko Unibertsitatea orgdiv1OPIK - Grupo de Investigación en Determinantes Sociales de la Salud y Cambio Demográfico España
                [5] Granada Granada orgnameInstituto de Investigación Biosanitaria ibs España
                Article
                S1135-57272019000100401 S1135-5727(19)09300000401
                d0caff32-5771-43b2-8cdc-665339b9b191

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 16 May 2018
                : 17 November 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 0
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                SciELO Public Health

                Categories
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                Spain,España,Desigualdades en salud,Género,Dependencia,Personas mayores,Cuidado informal,Cuidadores,Calidad de vida,Salud,Health inequalities,Gender,Dependence,Aged,Informal care,Caregivers,Quality of life,Health

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