海南省琼中县农村居民生活质量状况及影响因素分析

目的了解海南省琼中县农村居民生活质量状况及其影响因素。方法采用整群随机抽样方法,采用自行设计的调查问卷对海南省琼中县19个村6127名农村居民进行生活质量的问卷调查并分析其影响因素。结果琼中县农村居民生理功能得分为(64.34±27.08)分,生理职能得分为(62.71±26.14)分,肌体疼痛得分为(78.14±28.33)分,总体健康得分为(59.22±23.46)分;活力得分为(64.90±24.85)分,社会功能得分为(76.39±27.20)分,情感功能得分为(71.47±22.39)分,心理健康得分为(66.05±23.08)分。多因素分析显示,琼中县农村居民生理健康的影响因素为文化程度、年龄、是否患有慢性病、职业状态、家庭月收入等;琼中县农村居民心理健康的影响因素为年龄、性别、文化程度、是否患有慢性病、职业状态、家庭月收入等。结论海南省琼中县农村居民的生活质量较差,需根据其影响因素采取针对性的干预措施。     

城市育龄妇女生命质量评价及相关因素分析

目的:应用EQ-5D量表评价城市育龄妇女生命质量状况,分析影响其生命质量的相关因素。方法:采用多阶段分层整群随机抽样方法确定调查对象。应用欧洲五维度健康量表EQ-5D对城市育龄妇女的生命质量进行问卷调查,并对影响其生命质量的相关因素进行分析。结果:城市育龄妇女EQ-5D指数和EQ-VAS平均得分分别为(0.981±0.085)分、(86.290±11.735)分。在量表的五个维度测量中,维度2(自我照顾)方面没有困难的人最多,占98.8%,困难报告率较高的是维度4(疼痛/不舒服)和维度5(焦虑/抑郁),分别为3.8%和4.1%。单因素分析表明,不同年龄、婚姻状况、文化程度、就业状况以及患慢性病情况的城市育龄妇女在EQ-5D指数和EQ-VAS得分方面差异有统计学意义(P<0.05)。多因素Logistic回归分析表明,行动能力维度影响因素是患慢性病情况;自我照顾维度影响因素是婚姻状况和患慢性病情况;日常活动维度影响因素是文化程度和患慢性病情况;疼痛/不舒服维度影响因素主要为年龄、婚姻状况以及患慢性病情况;焦虑/抑郁维度影响因素主要为年龄、婚姻状况、就业状况以及患慢性病情况。结论:年龄、婚姻状态、文化程度、就业状况以及是否患有慢性病可影响城市育龄妇女的生命质量。     

中老年艾滋病感染者生命质量及其影响因素研究

目的 调查四川省中老年艾滋病高流行区泸县50岁以上的HIV/AIDS患者的生命质量,并分析不同因素对生命质量的影响,为今后提高HIV/AIDS患者的生命质量提供参考依据。方法 截至2018年6月,根据纳入和排除标准在四川省泸县共纳入50岁以上的HIV/AIDS患者共计228例。采用自行设计的问卷收集一般人口学信息、艾滋病抗病毒治疗信息,采用SF - 12调查患者的生命质量,采用多元线性回归方法分析生命质量的影响因素。结果 中老年HIV/AIDS患者的躯体健康总评（PCS）和心理健康总评（MCS）分别为（45.60±11.88）分和（54.17±11.70）分。通过多元线性回归分析发现,经济收入（β = 1.49）、现在正在接受治疗（β = 8.62）与患者PCS评分呈现正相关,而是否患有慢性病（β = - 10.55）与患者PCS评分呈现负相关。年龄与MCS评分呈正相关（β = 0.35）,而分居/离异/丧偶（β = - 3.91）,是否患有慢性病（β = - 4.79）、现在正在接受治疗（β = - 19.12）与患者的MCS评分呈现负相关。结论 中老年HIV/AIDS患者PCS评分较低,而MCS评分较高。低收入、未接受抗病毒治疗、患有慢性病、婚姻状况为分居、离异或丧偶的患者,生命质量较低,应积极采取措施提高中老年HIV/AIDS的生命质量。     

宁夏五县农村居民两周患病率及影响因素分析

目的了解宁夏农村居民两周患病率及其影响因素,为针对农村居民卫生政策的制定提供依据。方法采用多阶段整群抽样方法随机抽取宁夏五县63个乡镇29083名农村居民作为调查对象,获取2015年五县入户横断面调查数据,运用logistic回归分析影响因素。结果调查地区农村居民两周患病率为11.50%,低于2008年全国平均水平18.90%。单因素检验不同性别、民族、年龄、婚姻状况、文化程度、职业、慢病史间差别具有统计学意义(均P0.05)。多因素logistic回归分析显示性别、年龄、婚姻状况、文化程度、职业、慢病史是两周患病率的主要影响因素(均P0.05)。结论宁夏五县农村居民两周患病率受到多种因素的影响,患有慢性病、文化程度低、特殊人群(女性、儿童、老年人)是两周患病的危险因素。合理配置卫生资源、针对特殊人群制定卫生政策,是保障居民健康需求,提高卫生效益的关键。     

宁夏四县农村居民健康相关生命质量影响因素研究

目的测量宁夏四县农村居民的健康相关生命质量并分析其影响因素。方法数据来源于宁夏"创新支付制度,提高卫生效益"项目2011年、2012年和2015年的随访调查,采用我国EQ-5D-3L效用值积分体系计算健康效用值来评价农村居民的健康相关生命质量,并通过Tobit回归模型分析其影响因素。结果 2011年、2012年和2015年的3次随访调查中,宁夏四县农村居民的健康效用值分别为0.92、0.92和0.91,其置信区间分别为(0.92～0.93)、(0.92～0.93)和(0.91～0.92)。结论宁夏四县农村居民的健康相关生命质量与其他地区的农村居民相近,居民经济收入、性别、年龄、文化程度以及是否患有慢性病等对健康相关生命质量有显著影响。     

晚期肺癌患者生命意义和生活质量现状及相关因素分析

目的 调查晚期肺癌患者生命意义和生活质量现状,并探讨晚期肺癌患者生命意义和生活质量的影响因素。 方法 采取便利抽样选取某三甲肿瘤医院324例晚期肺癌患者为研究对象,使用癌症治疗功能评价-通用量表和晚期癌症患者生命意义量表进行调查,并采用多元线性逐步回归分析其影响晚期肺癌患者生命意义和生活质量因素。 结果 共调查了324位肺癌晚期患者,其中男性260例(80.2%),女性64例(19.8%)。生命意义得分为(96.22±11.87),患者生活质量总分为(68.79±14.89)。多元线性回归分析得出,文化程度(P=0.001)、宗教信仰(P=0.022)、婚姻状况(P=0.011)、家庭平均收入(P=0.016)和合并慢性病情况(P=0.001)对生命意义有影响;受教育程度(P=0.010)、婚姻状况(P=0.001)、家庭平均收入(P=0.040)和合并慢性病情况(P=0.014)对生活质量有影响。 结论 文化程度、宗教信仰、婚姻状况、家庭平均收入和合并慢性病情况是肺癌患者生命意义的独立影响因素。在临床实践中,应综合考虑患者的基本情况,实施个性化的精神照护是提高晚期癌症患者生命意义水平和生活质量的关键。     

桂西地区老年人生命质量影响因素分析

目的 探讨桂西地区老年人生命质量状况及其相关的影响因素,为进一步提高老年人的生命质量提供依据。方法 采用多阶段随机整群抽样方法在桂西地区抽取60岁及以上的老年人2 000名作为研究对象。使用自行设计的一般情况调查问卷、健康状况调查简表（SF - 36）、健康促进生活方式量表（HPLP - C）进行问卷调查。运用t检验、方差分析、秩和检验和多元线性回归分析数据。结果 桂西地区老年人生命质量的情感职能维度得分高于中国常模,其他维度的得分均显著低于中国常模（t = - 4.287,P＜0.05）。健康生活方式的老年人生命质量总分高于不健康生活方式的老年人（t = - 7.439,P＜0.001）。多元线性回归分析显示,影响老年人生命质量的主要因素有慢性病（β = 0.340,P＜0.001）、婚姻状况（β = - 0.040,P = 0.049）、健康促进生活方式（β = 0.131,P＜0.001）、年龄（β = - 0.110,P＜0.001）、文化程度（β = 0.046,P = 0.033）。结论 桂西地区老年人生命质量水平还有待提高,相关部门应从老年人慢性病防治、医疗养老保障、健康教育、培养健康生活方式等多方面采取相关措施,改善桂西地区老年人的生命质量。     

山东省居民家庭医疗费用支出占比定量分析

目的了解山东省居民家庭医疗保健费用支出结构,探讨居民家庭医疗费用支出的影响因素。方法基于山东省第五次卫生服务调查数据,利用SPSS对居民家庭卫生费用支出比例进行聚类分析,利用卡方检验对影响居民卫生费用支出的因素进行单因素分析,有序多分类logistic回归进行多因素分析。结果年龄、婚姻状况、文化程度、就业状况、家庭总收入、居住地、是否患慢性病、是否住院和家庭规模对家庭卫生费用支出比例有影响。结论年龄和家庭规模是影响医疗费用支出比例的重要因素,患有慢性病和住院的居民医疗费用支出比例较高;高收入家庭和城镇家庭的医疗费支出比重更低;婚姻状况、文化程度和工作状况影响家庭医疗费支出比例。     

昆明四城区参加农村合作医疗农民慢性病患病情况分析

目的了解昆明四城区参加新型农村合作医疗(参合)农民慢性病的影响因素。方法用分层随机抽样的方法 ,在昆明市对4个城区抽取589户2 123人进行入户调查。结果参合农民主要的慢性病包括高血压、消化系统疾病、支气管炎、心脏病、风湿等。单因素分析的结果显示不同婚姻状况、职业、文化程度、年龄的参合农民慢性病患病率不同。非条件logistic回归分析结果显示,影响慢性病患病的因素有民族和年龄。结论昆明四个区参合农民总的慢性病患病率为4.5%,影响昆明四个区参合农民患慢性病的主要因素有民族和年龄等。     

基于欧洲五维健康量表的浙川冀甘4省慢性病患者的健康相关生命质量现状及影响因素研究

目的调查浙川冀甘4省的慢性病患者健康相关生命质量并分析其影响因素,为提高慢性病患者健康相关生命质量提供科学依据。方法于2017年4、8和10月对甘肃省、河北省和四川省进行调研,于2018年5月对浙江省进行调研,对符合慢性病特征的患者进行个人情况调查和欧洲五维健康(EQ-5D)-5L量表调查,运用EQ-5D-5L的英国积分体系计算得到浙川冀甘4省的慢性病患者的健康效用值。运用SPSS 22.0和Stata 14.1统计软件进行t检验、方差分析和Tobit回归模型分析。结果浙川冀甘4省慢性病患者在5个维度按有困难者占比排序为:疼痛或不舒服(69.37%)、焦虑或沮丧(58.76%)、日常活动(37.91%)、行动能力(36.86%)和自我照顾(34.58%)。Tobit回归分析结果显示,户口性质(农村β=0.254)、年龄(40～50岁β=0.391,51～60岁β=0.391,61～70岁β=0.286)、婚姻状况(已婚β=0.189)和慢性病种(消化系统疾病β=0.272,心脑血管疾病β=0.186)是浙江省慢性病患者健康相关生命质量的影响因素;年龄(40～50岁β=0.323,51～60岁β=0.295,61～70岁β=0.286,71～80岁β=0.322)、婚姻状况(离异β=-0.256)和医保类型(城镇职工基本医疗保险β=0.149)是四川省慢性病患者健康相关生命质量的影响因素;年龄(40～50岁β=0.279,51～60岁β=0.278,61～70岁β=0.208,71～80岁β=0.201)、文化程度(小学β=0.304)、收入水平(1 000元β=-0.504,1 000～1 999元β=-0.504,2 000～2 999元β=-0.482)和慢性病种(呼吸系统疾病β=-0.239)是河北省慢性病患者健康相关生命质量的影响因素;性别(男性β=0.090)、年龄(51～60岁β=0.209,61～70岁β=0.122)和慢性病种(消化系统疾病β=0.224,心脑血管疾病β=0.233)是甘肃省慢性病患者健康相关生命质量的影响因素,均有统计学意义(P0.05,P0.01)。结论慢性病对患者心理上的影响程度大于生理上,应当加强对患者心理的关注;地理位置的不同,慢性病患者的影响因素也各不相同,需要政府部门根据实际情况采取防治措施。     

Inter-rater and test-retest reliability of the Danish version of the everyday technology use questionnaire

Background: Everyday technologies are naturally integrated in people’s daily life. For older adults and adults living with a chronic disease like chronic obstructive pulmonary disease (COPD), the ability to use technologies for health management has become increasingly important. The aim of this study was to investigate inter-rater and test-retest reliability of the Danish version of the Everyday Technology Use Questionnaire (ETUQ) in a sample of older adults with (n?=?23) and without (n?=?24) COPD.

Material and method: The ETUQ was initially translated in accordance with the dual panel approach and then administered to a sample of 47 participants. Svensson’s method for paired ordinal data was utilized to calculate and analyze reliability.

Results: Overall, inter-rater and test-retest reliability of the Danish version of the ETUQ demonstrated excellent percentage agreement (PA) (>75%), although for test-retest reliability, nine items demonstrated fair (53%) to good (73%) agreement.

Conclusion: This study supports the use of the Danish version of the ETUQ in a sample of older adults with or without COPD.

Application to practice: The Danish version of the ETUQ is an evidence-based evaluation that can reliably contribute to clinical occupational therapy and research in Denmark focusing on everyday technology use.     

Spontaneous dissection of the celiac artery in the young: a case report and systematic review of the literature

Introduction: The spontaneous isolated celiac artery dissection (siCAD) represents a challenging cause of abdominal pain and complete information regarding incidence, etiology and risk factors in the young is still lacking. In this study, we report a case of siCAD occurred in a young woman and we systematically searched for information on siCADs in literature databases.

Methods: PubMed/Embase and Cochrane were searched for, using the following terms: Isolated celiac trunk dissection, isolated celiac artery dissection, celiac artery dissection, celiac trunk dissection, spontaneous isolated visceral artery dissection, spontaneous isolated dissection of visceral arteries, isolated celiac artery dissection in the young, isolated celiac trunk dissection in the young. Patients were included if they were younger than 50 years, if they had a spontaneous etiology and a selective involvement of the celiac artery (with or without involvement of its branches).

Results: 180 studies were found, and 18 remained after screening. Twenty-one patients (male = 19, female = 2) with siCADs were included. Mean age was 44.71 ± 3.61 years. Hypertension was the most prevalent comorbidity. All patients presented with abdominal pain, more often located in the epigastrium (n = 11). Almost all patients underwent CT to confirm the diagnosis. A conservative treatment was adopted in 13 patients while an invasive approach was adopted in 8 patients (endovascular approach in 7).

Discussion: siCADs represent a rare but important cause of vascular dissection in the young. Uncomplicated cases can be safely treated with conservative strategies. The surgical or endovascular repair is indicated when dissections complicate or symptoms persist despite an adequate conservative treatment.     

Effect of the application of the new diagnostic criteria of diabetes mellitus in the prevalence estimates and diagnostic level in the general population

Background: The objective was to study the effect of the applicationof the new diagnostic criteria for diabetes mellitus on itsprevalence in Galicia (northwest Spain). Methods: Analysis using‘old’ and ‘new’ criteria (diabetes undertreatment and/or fasting glycaemia 140 mg/dl or 126 mg/dl respectively)was performed in a cross-sectional study (1,275 participants)in the general population aged 40–69 years. Results: Prevalenceof diabetes rose from 7.5 (95% Cl: 6.1–9.1) to 10.4% (95%Cl: 8.8–12.2) with the new criteria. The proportion ofnon diagnosed diabetes rose from 22.2 to 37.8%. Conclusions:The new diagnostic criteria for diabetes mellitus make it necessaryto increase previous prevalence estimates by 30–35% Inmiddle age (40–69 years).     

Diet and nutrients in the modulation of infant sleep: A review of the literature

Objectives: The establishment of organized sleep patterns is an important developmental process during infancy. Little is known about the role of nutrition in sleep maturation. This review focuses on exploring the link between infant sleep and nutrition with the aim to provide an overview of existing literature on the impact of diet and specific nutrients on sleep modulation in infants.

Methods: An exploratory literature search was performed on the topic in Medline, Scopus and Cochrane Library databases, with a focus on publications in English.

Results: Both the type of nutrients consumed and the timing at which they were consumed, relative to sleeping time, have been reported to influence infant sleep. Some nutrients have been shown to naturally fluctuate in maternal breast milk with circadian rhythm, and nutrients such as tryptophan, nucleotides, essential fatty acids and Omega-3 long-chain fatty acids have been suggested to impact infant sleep.

Discussion: In summary, little is known about the nutritional impact on infant sleep and sleep maturation, particularly with regard to specific nutrients. While nutrients like tryptophan and nucleotides seem to impact sleep at the level of brain activity, some fatty acids may affect sleep as a result of their role in supporting the maturity of the central nervous system. In our view, the existing literature indicates that the link between nutrition and infant sleep may be a promising concept to support this crucial phase of early development.     

少数民族流动人口的流动特征、社会融合对基本公共卫生服务利用的影响

目的 了解少数民族流动人口的流动特征、社会融合对基本公共卫生服务利用的影响。方法 基于2017年全国流动人口动态监测调查数据,采用两水平logistic回归模型分析少数民族流动人口的流动特征、社会融合与建立居民健康档案、接受健康教育和慢性病健康管理之间的关联性。结果 少数民族流动人口中,36.54% 建立了居民健康档案,以及分别有76.48%和42.49%接受过健康教育和慢性病健康管理。多因素分析结果显示,家庭化流动（OR=1.25;95%CI:1.04~1.49）、跨省流动（OR=1.12;95%CI:1.01~1.25）、流入城市（OR=1.34;95%CI:1.23~1.47）、有社会保障（OR=1.98;95%CI:1.82~2.15）、办理了居住证（OR=1.33;95%CI:1.22~1.46）、有落户意愿（OR=1.13;95%CI:1.02~1.24）以及心理融合（OR=1.07;95%CI:1.05~1.09）与社会参与（OR=1.17;95%CI:1.14~1.21）程度越高,是建档的正向影响因素。而流动城市数在2~3个内相对于1个以内是建档的负向影响因素（OR=0.87;95%CI:0.79~0.95）。有社会保障（OR=1.23;95%CI:1.12~1.35）、居住证（OR=1.45;95%CI:1.32~1.60）及社会参与（OR=1.31;95%CI:1.26~1.37）和心理融合（OR=1.03;95%CI:1.01~1.04）越高,是接受健康教育的正向影响因素,而流动城市数在4个及以上相对于1个以内是接受健康教育的负向影响因素（OR=0.82;95%CI:0.69~0.98）。此外,有居住证（OR=1.54;95%CI:1.07~2.20）和落户意愿（OR=1.66;95%CI:1.11~2.48）对接受慢性病健康管理具有显著的正向效应。 结论 少数民族流动人口对基本公共卫生服务的利用水平总体较低。需要格外关注独自流动、省内流动、流动稳定性较差的人群,促进地区和城乡间基本公共卫生服务的均等化、均衡化发展;通过提高社会融合程度提高基本公共卫生服务的利用水平。     

Are the school version of the assessment of motor and process skills measures valid for German-speaking children?

Background: There are no validated assessment tools for evaluating quality of schoolwork task performance of children living in German-speaking Europe (GSE).

Objective: To determine whether the international age-normative means of the School Version of the Assessment of Motor and Process Skills (School AMPS) are valid for use in GSE.

Methods: The participants were 159 typically-developing children, 3-12 years, from GSE. We examined the proportions of School AMPS measures falling within?±2 standard deviation (SD) of the international age-normative means, and evaluated for significant group differences (p?<?0.05) in mean School AMPS measures between the GSE sample and the international age-normative sample using one-sample Z tests. When significant mean differences were found, we evaluated if the differences were clinically meaningful.

Results: At least 95% of the GSE School AMPS measures fell within?±2 SD of the international age-normative means for the School AMPS. The only significant mean differences were for 6- (p?<?0.01) and 8-year-olds (p?=?0.02), and only the 6-year-old school process mean difference was clinically meaningful.

Conclusions: Because the only identified clinically meaningful difference was associated with likely scoring error of one rater, the international age-normative means of the School AMPS appear to be valid for use with children in GSE.     

Effect of the Interaction between Dietary Patterns and the Gastric Microbiome on the Risk of Gastric Cancer

We aimed to observe the combined effects of Gaussian graphical model (GGM)-derived dietary patterns and the gastric microbiome on the risk of gastric cancer (GC) in a Korean population. The study included 268 patients with GC and 288 healthy controls. Food intake was assessed using a 106-item semiquantitative food frequency questionnaire. GGMs were applied to derive dietary pattern networks. 16S rRNA gene sequencing was performed using DNA extracted from gastric biopsy samples. The fruit pattern network was inversely associated with the risk of GC for the highest vs. lowest tertiles in the total population (odds ratio (OR): 0.47; 95% confidence interval (CI): 0.28–0.77; p for trend = 0.003) and in females (OR: 0.38; 95% CI: 0.17–0.83; p for trend = 0.021). Males who had a low microbial dysbiosis index (MDI) and high vegetable and seafood pattern score showed a significantly reduced risk of GC (OR: 0.44; 95% CI: 0.22–0.91; p-interaction = 0.021). Females who had a low MDI and high dairy pattern score showed a significantly reduced risk of GC (OR: 0.23; 95% CI: 0.07–0.76; p-interaction = 0.018). Our novel findings revealed that vegetable and seafood pattern might interact with dysbiosis to attenuate the risk of GC in males, whereas the dairy pattern might interact with dysbiosis to reduce the GC risk in females.     

Gender differentials of abdominal obesity among the adults in the district of Colombo, Sri Lanka

OBJECTIVE: To assess the gender-specific prevalence and determinants of abdominal obesity (AO) within the population and lifestyle diversity of an urban district in Sri Lanka. METHODS: Prevalence of AO (defined by waist circumference) was estimated in a cross-sectional study of 1400 adults aged 20-64, residing in the district of Colombo in 2004. Demographic, socio-economic and lifestyle factors were assessed in gender-specific logistic regression models to identify determinants of AO. RESULTS: Prevalence of AO was 44.7% (95% confidence interval (CI): 41.0, 48.5) in females and 25.7% (95% CI: 22.6, 29.0) in males. Significant determinants of AO were age 35-49 (adjusted odds ratio: 1.7; 95% CI: 1.2, 2.5), moderately urban sector (1.9; 1.3, 2.9) and insufficient level of physical activity (1.7; 1.1, 2.4) among females in contrast to household income >Rupees 10,000 (6.1; 2.7, 13.5), increased alcohol (medium: 1.9; 1.2, 2.9; high: 2.1; 1.2, 3.5), low-fiber diet (1.6; 1.1, 2.4) and frequent large meals (1.7; 1.0, 2.8) among males. Determinants common to males (M) and females (F) were age >or=50 years (M: 2.5; 1.5, 4.2 and F: 2.9; 1.9, 4.4), most urban sector (M: 2.0; 1.3, 3.1 and F: 1.8; 1.2, 2.7) and married status (M: 2.2; 1.3, 3.6 and F: 2.4; 1.6, 3.6). CONCLUSIONS: A distinct gender differential was observed in the prevalence and determinants of AO. It appears vital that preventive strategies of AO be developed to be more 'gender-sensitive' in urban districts.     

Prevalence and correlates of everyday discrimination among black Caribbeans in the United States: the impact of nativity and country of origin

Objectives: Black Caribbeans in the United States have been the victims of major discrimination (e.g. unfairly fired, denied a promotion, denied housing). What is not known is the degree to which they also experience more routine forms of everyday discrimination such as receiving poor restaurant service, being perceived as dishonest, and being followed in stores. This paper investigates the distribution and correlates of everyday discrimination among a national sample of black Caribbeans in the U.S.

Design: This analysis used the black Caribbean sub-sample (n?=?1,621) of the National Survey of American Life. Demographic and immigration status correlates of ten items from the Everyday Discrimination Scale were investigated: being treated with less courtesy, treated with less respect, receiving poor restaurant service, being perceived as not smart, being perceived as dishonest, being perceived as not as good as others, and being feared, insulted, harassed, or followed in stores.

Results: Roughly one out of ten black Caribbeans reported that, on a weekly basis, they were treated with less courtesy and other people acted as if they were better than them, were afraid of them, and as if they were not as smart. Everyday discrimination was more frequent for black Caribbeans who were male, never married, divorced/separated, earned higher incomes, and who were second or third generation immigrants. Black Caribbeans attributed the majority of the discrimination they experienced to their race.

Conclusion: To our knowledge, this is the first study to provide an in-depth investigation of everyday discrimination among the black Caribbean population. It provides the frequency, types and correlates of everyday discrimination reported by black Caribbeans in the United States. Understanding the frequency and types of discrimination is important because of the documented negative impacts of everyday discrimination on physical and mental health.     

Caregiving outside of the home: the effects of race on depression

Objective . This research examines the conditions that determine whether Blacks experience lower or higher levels of depression while caregiving outside of the home, as compared to Whites. Some prior literature has found that African Americans report a lesser caregiver burden despite an increased likelihood that they will acquire this role, and decreased resources to do so. Others have found that African Americans experience the same caregiver burden and distress as Whites. Given these mixed findings, we use the stress process model to examine whether African American caregivers experience lower or higher levels of depression when they provide care outside of the home.

Design . A sample of care workers who provide care to others outside of the home was drawn from the 1992–4 National Survey of Families and Households. The final sample included 275 (11%) Blacks, and 2,218 (89%) Whites (not of Hispanic origin). The primary statistical method for predicting differences in caregivers’ depressive symptomatology was OLS regression analysis with progressive adjustment.

Results . We examined sociodemographics, family structure, resources, and stressors and found that African Americans, those with lower socioeconomic status, the unmarried, spending more weeks caregiving, having a physical impairment, and surprisingly receiving more help from parents are associated with higher depressive symptomatology. Stronger religious beliefs decreased depressive symptomatology for Blacks. The race effect was, in part, explained by family structure, amount of caregiving, and impairment of care worker.

Conclusion . Contrary to prior literature, we found that Blacks are more depressed than White caregivers in large part because of lower socioeconomic status and greater stressors, and higher levels of physical impairment. Yet, strength in religious belief has a stress-buffering effect for African Americans. We suggest that policies that attempt to eliminate racial disparities in socioeconomic status and health could benefit these caregivers.