Características sociodemográficas, de salud y utilización de recursos sanitarios de cuidadores de ancianos atendidos en domicilio

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Abstract

La población de mayores es susceptible de padecer enfermedades crónicas e invalidantes que los confinan en su domicilio. Atención Primaria, desde sus programas específicos para estos pacientes, atiende sus necesidades. Sin embargo, la mayor parte de los cuidados son asumidos por las familias, generalmente por un cuidador principal, al que el hecho de cuidar repercute física y psíquicamente. Interesa conocer las características sociodemográficas y de salud, así como los factores que determinan el estado de salud y utilización de recursos sanitarios de estos cuidadores en el desempeño del rol de cuidadores de ancianos incapacitados atendidos en domicilio. Se realizó un estudio de corte transversal en estos cuidadores. Se estudiaron variables sociodemográficas, clínicas, de relación con el cuidado, percepción del estado de salud, estado psicopatológico, nivel de sobrecarga y utilización de recursos sanitarios. El perfil demográfico del cuidador de nuestra área es mujer casada, que no trabaja, hija de la persona incapacitada, con estudios primarios, de una edad media de 56 años y la mayoría tiene su edad comprendida entre 47 y 63. Se mostraron determinantes de la percepción del estado de salud la edad y la relación de parentesco con la persona cuidada. También se obtuvo asociación significativa entre las variables Índices de Katz y Lawton y Brody con puntuación de la Escala de Zarit. Respecto a la utilización de los recursos sanitarios, se encontró significación estadística entre diagnóstico médico de depresión con las variables utilización de los servicios de urgencia y consulta médica por parte del cuidador.

Translated abstract

The population of old people may suffer of chronic diseases , with increasing incapacity and high level of dependency, which keep them at home. The Health Care Services offer them attention through its specific programs, adapted to their true needs. Although, most of the care is given by the families, in general by a main caregiver, who supports the effects of it, physically and psychically. It's important to know the sociodemographic and clinical characteristics, as well as the factors which determine the health condition, and the use of health care resources of these caregivers when attending elderly with high level of dependence at home. A cross-sectional study of these caregivers was undertaken. The sociodemographic and clinical variables were studied, in relation to the care, perception of the health condition, psychopathologic status, overload, and use of the health care resources. The demographic profile of a caregiver in our area is a woman, married, unemployed, daughter of the impaired old person, with Primary Education, with an average age of 56 years old -the majority is between 47 and 63 years old-. Factors as the perception of the health condition, the age, and the family relation to the patient were shown as determinant. It was also obtained a significant relation between the Index variables of Katz, Lawton and Brody with Zarit's scale punctuation. Concerning the use of the health care resources, the statistics revealed prevailing the medical diagnosis of depression with its variables of using the emergency services and medical consultation from the caregiver.

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[The system of informal caregiving as inequality].

Ana Eguiguren, Inmaculada Rodríguez, María del Mar García Calvente (2004)

In our setting, it is families, not the health and social services, who play the greatest role in providing continuous care to persons in need of such services. Informal health care poses two key questions with regard to the issue of equity: differences in the burdens borne by men and women, which contribute to gender inequality and, depending on their educational and socio-economic level, inequities in their ability to choose and gain access to needed resources and support services, thus contributing to social class inequalities. Distributing the burden of caregiving between men and women, and between the family and the state, constitutes a crucial debate in public health. This study analyzes the concept and characteristics of informal care, provides data on its dimensions in our setting, and analyzes the profile of caregivers, as well as the work they do and the impact it has on their lives. Finally, it presents currently existing models and support strategies for informal caregivers. It is largely women who assume the principal role of providing informal care, undertaking the most difficult and demanding tasks and dedicating the largest share of their time to them. As a result, women bear an elevated cost in their lives in terms of health, quality of life, access to employment and professional development, social relations, availability of time for themselves, and economic repercussions. Unemployed, under-educated women from the least privileged social classes constitute the largest group of informal caregivers in our country. Any policies aimed at supporting those who provide such care should keep in mind the unequal point from which they start and be evaluated in terms of their impact on gender and social class inequality.