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Combining informal care with paid work: An exploration of working carers’ situation with regards to their health status, gendered patterns of care, support and the impact of the COVID-19 pandemic
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0003-1037-4682
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Working carers (WKCs) combine paid work with informal care. Little is known about this important group of carers, which is expected to increase in number due topopulation ageing and economic trends. WKCs are beneficial for society but thecombination of work and care roles has consequences for their social and financialcircumstances as well as their health. This thesis explores the caregiving situation ofWKCs.

Study I was a scoping review of research on the challenges of and solutions for thecombination of paid work and care and the role of technologies in supportingWKCs. Results included a conceptual framework which identified high and/orcompeting demands as a key challenge solved by formal support. Web-based andcommunication technologies were seen to be a potential beneficial solution tosupport WKCs. Nevertheless, barriers existed in some instances, preventing theiroptimal use.

Studies II and III were based on data from a 2018 survey of a stratified randomsample of the Swedish population. Study II described informal care provision andreceived support among Swedish female and male WKCs. Female compared tomale WKCs cared more often alone, with more intensity, experienced care as moredemanding while their ability to work was reduced to a greater extent. Study III determined the caregiving-related factors associated with WKCs’ reducedability to work and experience of caregiving as demanding. A key finding was thatpsychological stress and financial problems due to caregiving increased the odds ofboth experiencing caregiving as demanding and a reduced ability to work, whilefinding caregiving satisfying decreased the odds of both.

Study IV was an interview study of WKCs’ experiences during the COVID-19pandemic. WKCs’ positive experiences included the delivery of support by distancevia digital technologies and more time with the care-recipient. Negative experiencesincluded the fear of becoming sick, new challenges at work, and the cancellation ofhome and community-based services for the care recipient.

This thesis contributes new knowledge on the situation of WKCs in Sweden. Itsfindings have implications for how policy can more appropriately and effectivelyaddress WKCs’ needs and preferences for support and their combination of workand care roles.

Abstract [sv]

Yrkesverksamma anhöriga (YVA) kombinerar förvärvsarbete med att geanhörigomsorg. Idag vet man ganska lite om denna viktiga grupp avomsorgsgivare som förväntas öka i antal på grund av en åldrande befolkningoch den ekonomiska utvecklingen. YVA gör stora insatser för samhället menkombinationen av förvärvsarbete och att ge anhörigomsorg får konsekvensersåväl för deras sociala och ekonomiska förhållanden som för deras hälsa. Dennaavhandling undersöker hur anhörigskapet påverkar YVA.

Studie I var en scoping review över forskning om utmaningar och lösningar vidkombinationen av att yrkesarbeta och ge anhörigomsorg och vilket stödinformations- och kommunikationstekniska lösningar kan innebära för YVA.Resultaten inkluderade ett begreppsmässigt ramverk som identifierade högaoch/eller konkurrerande krav som en avgörande utmaning som kan lösas medformellt stöd. Webbaserad teknik och kommunikationsteknik ansågs vara enpotentiell fördelaktig lösning för att stödja YVA. Likväl fanns det hinder som ivissa fall förhindrade att det användes optimalt.

Studie II och III baserades på data från en undersökning som genomfördes 2018på ett stratifierat slumpmässigt urval av Sveriges befolkning. Studie II beskrevinformella omsorgsåtaganden och erhållet stöd bland kvinnliga och manligaYVA. Kvinnor utförde oftare anhörigomsorg ensamma, med högre intensitetoch upplevde omsorgen mer krävande samtidigt som deras arbetsförmågaminskade i större utsträckning vid jämförelse med männen. Studie III fastställde de omsorgsrelaterade faktorer som associerades medYVAs minskade arbetsförmåga och att det är krävande att ge anhörigomsorg.Ett viktigt resultat var att psykisk stress och ekonomiska problem på grund avatt ge anhörigomsorg ökade risken att både uppleva omsorgen som krävandeoch gav upphov till minskad arbetsförmåga, medan upplevd tillfredställelse avatt ge anhörigomsorg minskade risken för detta.

Studie IV var en intervjustudie om YVAs erfarenheter under COVID-19pandemin. YVAs positiva erfarenheter inkluderade stöd på distans via digitalteknik och mer tid med omsorgstagaren. Negativa erfarenheter inkluderaderädslan för att bli sjuk, nya utmaningar på arbetsplatsen och inställtkommunbaserat stöd till omsorgstagaren.

Denna avhandling bidrar med ny kunskap om YVAs situation i Sverige.Resultaten har betydelse för hur policyer mer effektivt och lämpligt kan hanterastödbehovet hos YVA som kombinerar yrkesarbete med anhörigomsorg.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2023. , p. 101
Series
Linnaeus University Dissertations ; 476
Keywords [en]
working carers, informal care, family care, support, employment, gender, health, COVID-19 pandemic
Keywords [sv]
yrkesverksamma anhöriga, informell vård, anhörigomsorg, stöd, anställning, kön, hälsa, COVID-19 pandemi
National Category
Health Sciences
Research subject
Health and Caring Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-118187DOI: 10.15626/LUD.476.2023ISBN: 9789189709799 (print)ISBN: 9789189709805 (electronic)OAI: oai:DiVA.org:lnu-118187DiVA, id: diva2:1724785
Public defence
2023-01-20, Sal Lapis, Hus Vita 391 82, Kalmar, 13:46 (English)
Opponent
Supervisors
Available from: 2023-01-13 Created: 2023-01-09 Last updated: 2025-03-18Bibliographically approved
List of papers
1. Challenges of combining work and unpaid care, and solutions: A scoping review
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2020 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 28, no 3, p. 699-715Article in journal (Refereed) Published
Abstract [en]

The number of people who combine work and unpaid care is increasing rapidly as more people need care, public and private care systems are progressively under pressure and more people are required to work for longer. Without adequate support, these working carers may experience detrimental effects on their well-being. To adequately support working carers, it is important to first understand the challenges they face. A scoping review was carried out, using Arksey and O'Malley's framework, to map the challenges of combining work and care and solutions described in the literature to address these challenges. The search included academic and grey literature between 2008 and 2018 and was conducted in April 2018, using electronic academic databases and reference list checks. Ninety-two publications were mapped, and the content analysed thematically. A conceptual framework was derived from the analysis which identified primary challenges (C1), directly resulting from combining work and care, primary solutions (S1) aiming to address these, secondary challenges (C2) resulting from solutions and secondary solutions (S2) aiming to address secondary challenges. Primary challenges were: (a) high and/or competing demands; (b) psychosocial/-emotional stressors; (c) distance; (d) carer's health; (e) returning to work; and (f) financial pressure. This framework serves to help those aiming to support working carers to better understand the challenges they face and those developing solutions for the challenges of combining work and care to consider potential consequences or barriers. Gaps in the literature have been identified and discussed.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
challenges, support and solutions, conceptual framework, scoping review, international, unpaid care, working carers
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-90919 (URN)10.1111/hsc.12912 (DOI)000502858300001 ()31845451 (PubMedID)2-s2.0-85076724822 (Scopus ID)
Available from: 2020-01-15 Created: 2020-01-15 Last updated: 2023-01-09Bibliographically approved
2. Benefits and barriers of technologies supporting working carers - A scoping review
Open this publication in new window or tab >>Benefits and barriers of technologies supporting working carers - A scoping review
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2022 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 30, no 1, p. e1-e15Article, review/survey (Refereed) Published
Abstract [en]

Combining work and care can be very challenging. If not adequately supported, carers' employment, well-being and relationships may be at risk. Technologies can be potential solutions. We carried out a scoping review to find out what is already known about technologies used by working carers. The search included academic and grey literature published between January 2000 and June 2020. Sixteen relevant publications were analysed and discussed in the context of the broader discourse on work-care reconciliation. Technologies discussed can be classified as: (a) web-based technologies; (b) technologies for direct communication; (c) monitoring technologies; and (d) task-sharing tools. Technologies can help to make work-care reconciliation more manageable and alleviate psychosocial and emotional stress. General barriers to using technology include limited digital skills, depending on others to use technologies, privacy and data protection, cost, limited technological capabilities, and limited awareness regarding available technologies. Barriers specific to some technologies include work disruptions, limited perceived usefulness, and lacking time and energy to use technologies. More research into technologies that can address the needs of working carers and how they are able to use them at work is needed.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
barriers, benefits, employment, scoping review, technology, working carers
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-105798 (URN)10.1111/hsc.13421 (DOI)000654041000001 ()34036665 (PubMedID)2-s2.0-85106414940 (Scopus ID)2021 (Local ID)2021 (Archive number)2021 (OAI)
Available from: 2021-07-08 Created: 2021-07-08 Last updated: 2023-01-09Bibliographically approved
3. Informal care provision among male and female working carers: Findings from a Swedish national survey
Open this publication in new window or tab >>Informal care provision among male and female working carers: Findings from a Swedish national survey
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2022 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 17, no 3, article id e0263396Article in journal (Refereed) Published
Abstract [en]

Introduction

Informal carers in paid employment–working carers (WKCs)—have complex support needs. However, little is known about WKCs’ pattern of informal care provision, the support they receive, the impact providing care has on their employment, and how these vary between male and female WKCs. This study describes the pattern of informal care provision and received support among Swedish WKCs.

Research method/Design

The study was a cross-sectional questionnaire-based survey of a stratified random sample of the Swedish population aged 18 or over. The questionnaire addressed the type and extent of informal care provided, support received and the impact of care provision on employment. Of the 30,009 people who received the questionnaire, 11,168 (37.3%) responded, providing an analytic sample of 818 (7.32% of respondents) employed or self-employed informal carers.

Findings

A typical Swedish WKC was a middle-aged female, providing weekly or daily care to a non-cohabitant parent, who experiences care as sometimes demanding and receives no formal support as a carer. Female WKCs were more likely than males to care alone and with higher intensity, to report a need for help in meeting their care-recipient’s needs, and to experience care as demanding. Approximately 17% of WKCs reported their employment had been affected due to caring, 40% their ability to work, and 31% their career development opportunities. Female WKCs’ ability to work was affected more than males’, and they were more commonly prevented from applying for work.

Conclusion

Swedish female WKCs compared to males provide more hours of informal care, across more care domains, more often alone. This places them in a challenging situation when combining paid work and care. Greater recognition of the challenges faced by WKCs is required in Sweden and other countries, as are policies to reduce gender inequalities in informal care provision in this group.

Place, publisher, year, edition, pages
Public Library of Science, 2022
National Category
Nursing Gender Studies
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-110748 (URN)10.1371/journal.pone.0263396 (DOI)001143684900004 ()2-s2.0-85125974596 (Scopus ID)
Available from: 2022-03-09 Created: 2022-03-09 Last updated: 2024-03-13Bibliographically approved

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Vicente, Joana

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  • nn-NB
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