The Effect of Intergenerational Care on Chinese Elderly’ s Mental Health from the Perspective of Social Role: The Moderating Effect of Care Intensity

doi:10.21203/rs.3.rs-4912504/v1

Objectives: This study examines the influence of caring for grandchildren on Chinese elderly’s life satisfaction to elucidate the informal cultural institutions.

Background: Intergenerational care is an important mean for ensuring family security in China in the face of deficient childcare services. However, the impact of caregiving on grandparents’ quality of life is uncertain. This study bridged the role tension and role enhancement theories which were a pair of competitive hypothesesto explain the impact of intergenerational care.

Methods: This study used the China Longitudinal Aging Social Survey(http://class.ruc.edu.cn/) 2018 database obtained by probability sampling method and sorted out 5,773 eligible elderly samples. Multiple linear regressions and polynomial models were used to analyze the data. Endogeneity was solved through propensity score matching.

Results: The grandparents caring for grandchildren scored significantly high for life satisfaction. The relationship between the duration of care and the life satisfaction of grandparents was inversely U-shaped. Caring for grandchildren and advanced age elderly, such as respondents’ parents, inhibited the benefits of intergenerational care.

Conclusions: Caring for grandchildren moderately improves Chinese elderly’s quality of life. The intensity of care is an important factor determining the direction of the influence of intergenerational care on grandparents’ quality of life.

Implications: For the sake of the mental health of the elderly and family unity, the older adults should be ensured to care for their grandchildren under conditions of low care intensity and high care willingness.

intergenerational care

life satisfaction

social role theory

aging

informal institution

Chinese culture

Population aging will be a basic national condition in China for a long period in the future [1]. The elderly and the government hope to tap the human resources of the aging population [2]. Therefore, the Chinese government encourages the elderly to play a role in family education and cultural inheritance. Enjoying with grandchildren is a typical picture of the life of senior citizens in traditional Chinese culture. To date, approximately 40% of grandparents in China care for their grandchildren as an informal institution in urban and rural areas [3, 4], which exerts a positive effect on total household utility.

Intergenerational care is defined as the personal participation of grandparents in any aspect of the daily care of grandchildren regardless of whether or not the grandparents have custody of or live with the grandchildren [5]. It also pertains to the degree to which the care of grandparents for their grandchildren replaces the duties of the parents [6]. After decades of the family core trend in urban areas of China, a large number of grandparents live separately from their grandchildren, but they still care for their grandchildren. Therefore, this study focuses on care behavior when defining intergenerational care rather than limiting the definition to living arrangements.

However, intergenerational care is not simple household work, which may exert a complex impact on the quality of life of senior citizens [7]. On the one hand, the role of caregiver may cause pressure on the elderly, such as worrying about failure in their role as caregiver, which, thus, reduces the quality of life. This kind of view can be attributed to role tension theory [8]. On the other hand, intergenerational care may enable the elderly to gain self-worth from caring for their grandchildren and strengthen their relationship with their families, which can improve their quality of life. This kind of view can be attributed to role enhancement theory [9]. Thus far, scholars have endeavored to determine the key factors that can determine the direction of the influence of intergenerational care on the elderly to conduct the main mechanism.

Multiple dimensions can be used to describe the quality of life of the old population. Life satisfaction is an indicator that can comprehensively reflect the subjective cognition of the elderly on the quality of life, which belongs to the category of psychological health research [10]. In addition, social role theory is closely connected with the cognition of actors, which can play an important role in the study of the mechanism of the influence of intergenerational care on the life satisfaction of grandparents.

Differences exist in opinions regarding the impact of intergenerational care on the life satisfaction ofthe elderly. Many studies found that caring for grandchildren could weaken the life satisfaction of grandparents [11, 12, 13]. A study designed for female grandparents found a significant correlation between participation in intergenerational care and low levels of life satisfaction of grandmothers [14].The major explanation is as follows: The senior citizens who participate in care are under pressure from the role of a caregiver. When time is tight, they will give up activities that play an important role in maintaining their quality of life, such as entertainment, exercise, and medical treatment [15, 16].

Most grandparents who take care of their grandchildren are aged between 60–70 years and have not completely withdrawn from the labor market. Intergenerational care enables them to give up work or retire early, which results in loneliness, anxiety, and other negative emotions [17, 18, 19]. For the elderly who have left the role of childcare for a long time, re-entering the role is very challenging [20], which may make them nervous. Research that aims to verify role tension theory focuses on societies in which caring for grandchildren is associated with negative situations, such as the lack of education and material resources [21], such that the social evaluation of intergenerational care is likely negative.

Many pieces of evidence confirm that intergenerational care can improve the life satisfaction of grandparents [22, 23]. The interpretation reflects the purport of role enhancement theory. For the elderly who are gradually withdrawing from the labor market, the family sector has occupied an increasingly long time in their lives, and “being grandparents” has become an important part of their lives [24]. Intergenerational care can provide a new meaning to life for many grandparents who feel empty and lonely [25], enrich their later life, and promote their personal growth [26]. In addition, taking care of grandchildren can make grandparents feel needed [27].

Studies that aim to verify role enhancement theory compared with role tension theory are few, and many studies on role enhancement theory focus on societies whose culture emphasizes family responsibility [28]. Parents have the moral obligation to help their children for a long time in China. Thus, caring for grandchildren has been natural for senior citizens from ancient times up to now. The Chinese elderly do not associate intergenerational care with negative social evaluation and disadvantaged socio-economic status. Instead, they consider it as a reflection of good parents, which may improve family relations. Therefore, this culture can prevent or reduce the negative effects of their being caregivers for their grandchildren from caregivers.

Therefore, the current study poses the following research questions:

First, what is the impact of caring for grandchildren on the life satisfaction of grandparents?

Second, does the direction of this influence vary with which factors?

Research Hypothesis

This study focuses on social role theory to explain the mechanism and heterogeneity of intergenerational care on grandparents' mental health. The multiple roles of grandparents and the characteristics of their intergenerational care behavior under the domination of social culture have produced a series of corresponding concepts of social roles, the most important of which is how grandparents define their social roles. Social culture determines how grandparents perceive their social role and thus influences their self-evaluation. The interaction between intergenerational care behavior and grandparents' cognitive and practical social roles determines whether intergenerational care behavior will eventually point to a role tension mechanism or a role enhancement mechanism, and ultimately determines whether intergenerational care will improve grandparents' mental health or reduce their mental health.

H1 Chinese grandparents who take care of their grandchildren score higher on life satisfaction than those who do not.

The differences in the conclusions of previous research may have stemmed from differences in the cultural environment, which is a key factor that influences the direction of the effect of intergenerational care on the life satisfaction of grandparents at the macro level. In China, taking care of grandchildren is regarded as one of the most important contributions of grandparents to the family, which is likely to improve life satisfaction. At the same time, under the situation of the retirement system in China and the continuous postponement of the first time of birth, the degree of work–care conflict among grandparents is relatively low. In general, role enhancement theory has more space to play its role than role tension theory.

H2 The intensity of care significantly influences the direction of the relationship between intergenerational care and the life satisfaction of Chinese grandparents.

Heterogeneity analysis can help in establishing the connection between the different conclusions of the previous research at the micro level. The intensity of care is an important factor. For example, Jin and Liu [29] found that an inverse U-shaped relationship exists between the intensity of intergenerational care and the life satisfaction of grandparents. The intensity of care is quantified into care duration and double care roles, which are detailed in the following two sub-hypotheses.

H2.1 The relationship between care duration and the life satisfaction of grandparents is inversely U-shaped.

On the one hand, the higher the intensity of the intergenerational care provided by grandparents, the more interaction they may have with their adult children, which will strengthen their solidarity. A good family relationship and social support network will improve the life satisfaction of grandparents. On the other hand, when the care duration is too long, the positive effects may not offset the negative effects, such as psychological pressure and time conflict, faced by grandparents. Therefore, the life satisfaction of grandparents may first increase and then decreases with the increase in care duration.

H2.2 Playing multiple care roles will hinder the improvement of the life satisfaction of grandparents through intergenerational care.

The majority of seniors who care for grandchildren are not very old, such that they also have to care for their parents, who are mainly octogenarians. This study defines grandparents who care for grandchildren and their own parents at the same time as playing multiple care roles. Many differences exist between caring for minors and octogenarians. Thus, role cultivation cannot be shared. The social support obtained is more likely to come from the same family, which indicates that help is limited, but the role pressure is double.

Data Source

This study uses data from the China Longitudinal Aging Social Survey (CLASS) for 2018. CLASS is a national and continuous large-scale social survey project. It collects data on the health, intergenerational relations, economy, social participation, and other aspects of the elderly in China, which is one of the important infrastructures for examining the problem of aging in China. The samples without grandchildren or whose grandchildren were adults were excluded to avoid the confusing factors caused by systematic differences.

An elderly person who is not involved in the care of grandchildren can be divided into having grandchildren but not caring for them and having no children or grandchildren and not having the opportunity to care for them. These two groups of people have huge differences in social and economic status, cultural identity, life experience and other aspects, so it will cause large errors to consider the two groups of people as the same group to be included in the study. This study mainly focuses on the impact of intergenerational care on the health of the elderly. In order to avoid the negative impact on the conclusion caused by the difficult confusing factors caused by the differences between the two groups of people, this study decides to exclude the samples of the elderly who have never had children and grandchildren, and only focus on the elderly who are grandparents. In addition, because the minimum age of the sample in the CLASS2018 data is 60 years old, the right deletion caused by delayed childbearing is less and has almost no impact.

At the same time, the objects of intergenerational care are generally minor grandchildren, and the explanation paths of many theories are also based on the reality of taking care of minor grandchildren. Therefore, this study finally decided to limit the sample scope to the elderly who currently have minor grandchildren, and the elderly whose youngest grandchild has become an adult were further excluded from the sample. On the one hand, the behavioral logic of grandparents taking care of adult grandchildren and taking care of minor grandchildren is quite different, so it is not suitable to be analyzed together. On the other hand, when the youngest grandchild reached adulthood, it had been several years since the grandparents' intergenerational care behavior. The dependent variable of this study was the grandparents' mental health status at the time of the visit and its changes in the past two years, and the independent variable measured the intergenerational care behavior should be similar to the time of the visit.

To sum up, only the samples with current minor grandchildren were included in the analysis to improve the reliability of the conclusion. This study excluded 5670 cases and finally obtained 5773 samples.

Variable Measurement

The study measured the life satisfaction of grandparents using the question, “In general, are you satisfied with your current life?” Responses were rated from 1 to 5, with 1 indicating “very dissatisfied” and 5 indicating “very satisfied.”

This study used a dichotomous variable care to first measure intergenerational care as the behavior of grandparents. When the answer to the question “How long have you spent caring for this child in the past 12 months?” is completely not, then the value of care is 0; otherwise, it takes a value of 1. We then used the ordering variable “care duration” to measure the duration of time that grandparents spent caring for one grandchild per day on average. The same question was used, and the values were 0, 0.5, 1.5, 3, 6, and 9 h. To maximize the use of data information and reduce the error caused by a situation in which one grandparent takes care of two or more grandchildren, this study converted the data format from a wide format that one grandparent case corresponds to five grandchildren to a long format in which one case just records one grandchild when we use the variable care duration (N = 9586).

Multiple care roles are measured by the question, “Do you need to take care of your own (or your spouse’s) parents?”. If the answer is yes, then it takes a value of 1; otherwise, it takes a value of 0.

According to the previous literature [30, 31], this study took gender (female = 0), age, marital status (not in marriage, such as divorced, widowed or unmarried = 0), education, pension (no pension = 0), smoking (never smoke = 0), and activity of daily living (ADL, which is a continuous variable: the greater the value, the worse the physical health of the respondents) as control variables.

Table 1 displays the sample characteristics of the 2018 survey.

Table 1｜Descriptive statistics of the variables (N = 5773)

Variables	Mean or %	SD	Range
Life satisfaction	3.81	0.86	1–5
Care
Yes	49.97
No	50.03
Care duration (hours/child/day; N = 9586)	1.10	2.08	0–9
Multiple care roles
Yes	7.45
No	92.55
Gender
Male	53.18
Female	46.82
Age	68.48	5.68	60–98
Marital status
In marriage	77.76
Not in marriage	22.24
Education
Illiterate	21.29
Primary	39.70
Junior high school	28.23
Senior high school or above	10.77
Pension
Yes	77.59
No	22.41
Smoking
Yes	27.78
No	72.22
ADL	9.68	1.96	9-25

This study uses multiple linear and polynomial regression models to verify the hypotheses. To control for the nonlinear effect of age, the quadratic and cubic powers of the age of grandparents were added to the model to test the robustness of the results. The study used propensity score matching (PSM) and greedy matching (GM) to alleviate endogeneity.

Table 2 presents the results of the linear regression model in which caring for grandchildren in the past year is significantly positive for Models 1 and 2. This result indicated that grandparents who participated in intergenerational care exhibited higher levels of life satisfaction than those who did not. The elderly who cared for their grandchildren reported a 0.123 higher score for life satisfaction than those who did not, given that the level of the control variables was consistent. Intergenerational care exerted a significant positive impact on the life satisfaction of grandparents, which supports H1.

Table 2｜Effect of intergenerational care on the life satisfaction of grandparents

	Model 1	Model 2
Care	0.121***	0.123***
	(0.0225)	(0.0223)
Gender		−0.00944
		(0.0266)
Age		0.00979***
		(0.00208)
Marital status		0.0853**
		(0.0280)
Primary (illiterate = 0)		−0.0982**
		(0.0302)
Junior high school (illiterate = 0)		−0.0102
		(0.0329)
Senior high school or above (illiterate = 0)		0.252***
		(0.0426)
Pension		0.0851**
		(0.0269)
Smoking		−0.0261
		(0.0291)
ADL		−0.0446***
		(0.00587)
Intercept	3.745***	3.400***
	(0.0159)	(0.154)
N	5773	5773
R²[1]	0.01	0.03

*p < 0.05.

**p < 0.01.

***p < 0.001

Table 3 presents the results of the relationship between life satisfaction and duration of care. The variable duration of care and the control variables were input into the linear regression model in this order to obtain Models 3 and 4 after converting the data to the long format. The square of the duration of care was input into Models 3 and 4 to obtain Models 5 and 6, respectively.

Table 3｜Effect of care duration on the life satisfaction of grandparents

	Model 3	Model 4	Model 5	Model 6
Care duration	0.0231***	0.0233***	0.0819***	0.0782***
	(0.00424)	(0.00419)	(0.0127)	(0.0126)
Care duration’s square			-0.0084***	−0.0078***
			(0.00171)	(0.00170)
Gender		−0.0324		−0.0295
		(0.0208)		(0.0208)
Age		0.0116***		0.0115***
		(0.00164)		(0.00164)
Marital status		0.0593**		0.0617**
		(0.0219)		(0.0219)
Primary (illiterate = 0)		−0.097***		−0.0964***
		(0.0232)		(0.0232)
Junior high school (illiterate = 0)		−0.0102		−0.00972
		(0.0256)		(0.0255)
Senior high school or above		0.224***		0.222***
(illiterate = 0)		(0.0344)		(0.0343)
Pension		0.0894***		0.0875***
		(0.0206)		(0.0206)
Smoking		−0.00290		−0.00323
		(0.0226)		(0.0226)
ADL		−0.044***		−0.044***
		(0.00474)		(0.00473)
Intercept	3.767***	3.326***	3.703***	3.269***
	(0.00996)	(0.121)	(0.0164)	(0.121)
N	9586	9586	9586	9586
R²	0.003	0.03	0.01	0.03

*p < 0.05.

**p < 0.01.

***p < 0.001

As shown in Table 3, the duration of care is significantly positive in all models. The life satisfaction of grandparents increased by 0.0233 for every increase in the amount of time spent caring for one grandchild of one hour per day, given that the level of the control variables was consistent. The benefit increased to 0.0782 when controlling for the quadratic term of duration of care.

The square of the duration of care is significantly negative in Models 5 and 6, which indicates that the life satisfaction of grandparents first increases and then decreases with the increase in the duration of care. The inflection point was calculated to be 5.4 h, which confirms H2.1.

The respondents were divided into two groups. The first takes a value of 1 for multiple care roles; the second takes a value of 0 for multiple care roles. In other words, the former is caring for their advanced-aged parents, whereas the latter is not. The linear regression models, as in Models 1 and 2, were performed on the samples of the first group to obtain Models 7 and 8. The same operations were performed on the samples of the second group to obtain Models 9 and 10. Table 4 presents the results.

Table 4｜Effect of multiple care roles on the relationship between care and life satisfaction

	Multiple care roles		Not multiple care roles
	Model 7	Model 8	Model 9	Model 10
Care	−0.0222	0.0162	0.128***	0.130***
	(0.0798)	(0.0771)	(0.0235)	(0.0233)
Gender		0.00539		−0.00466
		(0.0905)		(0.0277)
Age		0.00828		0.0106***
		(0.00773)		(0.00216)
Marital status		0.329**		0.0674*
		(0.125)		(0.0288)
Primary (illiterate = 0)		−0.386**		−0.0775*
		(0.121)		(0.0312)
Junior high school (illiterate = 0)		−0.132		−0.00966
		(0.119)		(0.0344)
Senior high school or above		−0.0653		0.276***
(illiterate = 0)		(0.139)		(0.0449)
Pension		0.0239		0.0908**
		(0.0894)		(0.0282)
Smoking		0.0362		−0.0341
		(0.0970)		(0.0304)
ADL		−0.094***		−0.040***
		(0.0195)		(0.00615)
Intercept	3.953***	4.148***	3.732***	3.282***
	(0.0621)	(0.547)	(0.0165)	(0.160)
N	430	430	5343	5343
R²	0.0002	0.09	0.01	0.03

*p < 0.1.

**p < 0.05.

***p < 0.01

As shown in Models 7 and 8, the coefficient of care is nonsignificant, which indicates that the life satisfaction of respondents caring for their own advance-aged parents and minor grandchildren was not statistically significantly different from those who did not care for grandchildren. In contrast, as shown in Models 9 and 10, among the respondents who did not care for their advance-aged parents, caring for grandchildren still exerted a significant positive effect on life satisfaction. This finding suggests that playing multiple care roles diminishes the benefits of intergenerational care to older adults. In summary, H2.2 is confirmed.

Combining the results that confirmed H2.1 and H2.2, we can assume that the intensity of care is a key factor for bridging role enhancement and role tension theories. The total benefit of intergenerational care on the life satisfaction of older adults is positive when the intensity is low, and the added stress renders the total benefit negative when the intensity is extremely high. Thus, H2 was confirmed.

The abovementioned multiple linear and polynomial regression models only controlled for the linear influence of age, but age may have a nonlinear influence. To test the robustness of our results, the quadratic and cubic powers of age are added to Models 2, 4, 6, 8, and 10 to obtain Models 2a, 4a, 6a, 8a, and 10a. All results were significant. In general, the conclusions of this study are valid.

A certain endogeneity between care for grandchildren and the life satisfaction of grandparents. Specifically, grandparents who tend to participate in intergenerational care may have other characteristics that are difficult to measure, such as an optimistic personality and outstanding ability, which can also increase their level of life satisfaction. This study used PSM to overcome endogeneity due to selective bias to enhance the robustness of the results and employed GM to test for robustness.

This study calculated the average treatment effect (ATT) for the treatment group and selected the control variables (i.e., age, marital status, education, and ADL) that influence the dependent and independent variables when constructing the propensity score. The treatment group is composed of grandparents who participated in intergenerational care, while the control group is made up of grandparents who did not participate. The closest propensity score was found for matching. The Mahalanovis distance was used for GM. The full sample, the sample playing multiple care roles, and the sample not playing multiple care roles were matched separately. Table 5 presents the results.

Table 5｜Results of PSM

	Coefficient	SD	t-Value	p-Value
PSM (full sample)	0.128	0.026	5	0
GM (full sample)	0.133	0.025	5.36	0
PSM (multiple care roles)	0.023	0.102	0.23	0.82
GM (multiple care roles)	0.103	0.106	0.98	0.328
PSM (not multiple care roles)	0.129	0.026	4.89	0
GM (not multiple care roles)	0.133	0.026	5.19	0

The table indicates that the ATT of the full sample and the sample not playing multiple care roles were significant, and that of the sample playing multiple care roles was nonsignificant, which was the same as the results of the linear and polynomial regression models. The life satisfaction of grandparents who took care of their grandchildren increased by 0.128 compared with those who did not. The conclusion that moderately participating in intergenerational care can improve the life satisfaction of grandparents and that these benefits will disappear when the intensity becomes extremely high has a certain causal inference significance. The results of GM led to the same conclusion.

The study checked the balance of the abovementioned PSM. Figure 1 depicts the results, which indicated that the matching effect was good.

[1] For the univariate regression model is R² and for the multiple regression model is the adjusted R². The models reported below are the same.

This study explored the mechanism and heterogeneity of the impact of intergenerational care on the life satisfaction of the aging population in China, which compensated for the limitations of previous studies on the analysis of multiple roles and bridged role enhancement and role tension theories. Moreover, the study used PSM to test the results of models, such that the conclusions have a certain significance of causal inference. This study found that, first, intergenerational care can improve the life satisfaction of grandparents as a whole. The culture that encourages grandparents to pay for the family may have played an important role. Second, the study observed an inverse U-shaped relationship between the duration of care and the life satisfaction of grandparents. Third, playing multiple care roles will inhibit the benefits of intergenerational care, which is consistent with the inverse U-shaped relationship between the duration of care and the life satisfaction of grandparents. When the support resources are insufficient to resist the double pressure, then the situation will change from a mechanism dominated by role enhancement theory to one dominated by role tension theory.

In the existing literature, there are also studies to bridge the inconsistent conclusions by examining the different effects of intergenerational care on the health outcomes of the elderly under different care duration. For example, Han and Wang analyzed the favorable and unfavorable characteristics of the time spent taking care of grandchildren on the health of the elderly in China, and found that the total impact of taking care of grandchildren on the health of them presents an inverted U-shaped relationship of first favorable and then unfavorable [32]. The marginal contribution of our study is that it adopts the perspective of social role theory to explain the mechanism between care intensity and mental health of the elderly in China. Moreover, from the perspective of theory, the operation of care intensity is more abundant, and multiple role variables are added in addition to care duration.

The policy implication of the conclusions is that tapping into the informal institutions of culture can compensate for the deficiencies of public services. In China, the reason why the role enhancement theory plays a leading role is that the Chinese culture has shaped the recognition of senior citizens about family; that is, caring for grandchildren is an obligation. The ubiquity of this type of culture has contributed to a long-practiced informal institution that compensates for the lack of public services in childrearing. However, for the health of the elderly, we should advocate that senior citizens should act within their means when caring for grandchildren. In addition, we should respect the diversified choices of each grandparent [33].

The limitation of this study is the lack of longitudinal data analysis. PSM only solves partial endogeneity. Although the reverse causal problem between intergenerational care and the life satisfaction of the elderly is not very serious, using longitudinal data will render our conclusions more reliable.

Author Contribution

RL. W. analyzed data and wrote original draft, YF.L and K.Z revised the manuscript. All authors have read and agreed to the published version of the manuscript.

Data Availability

Data is provided within the manuscript or supplementary information files.

Smith, JP., Strauss, J., & Zhao, Y. Healthy aging in China. The Journal of the Economics of Ageing, (2014) 4, 37-43. https://doi.org/10.1016/j.jeoa.2014.08.006.
Bai, C., & Lei, X. New trends in population aging and challenges for China’s sustainable development. China Economic Journal, (2019) 13(1), 3–23. https://doi.org/10.1080/17538963.2019.1700608
Huang, G., Du, P., & Chen, G. The impacts of the children care on grandparent’s health among the Chinese old people. Population and Development, (2016) 06, 93–100 + 109.
Ko, P.-C., & Hank, K. Grandparents caring for grandchildren in China and Korea: Foundings from CHARLS and KLoSA. Journals of Gerontology Series B, (2014) 69:4, 646–651. https://doi.org/10.1093/geronb/gbt129
Zheng, J. Intergenerational exchange: The essence and challenges of intergenerational upbringing. Journal of Jishou University(Social Sciences), (2019) 01, 113-119. doi:10.13438/j.cnki.jdxb.2019.01.014.
Kleiner, H. S., & Hertzog, J. Grandparents acting as parents. National Satellite Video Conference. Purdue University. (1998)
Wu, P. The impacts of caring for grandchildren on physical and mental health of middle and old-aged persons: An empirical study based on CHARLS data. China Rural Survey, (2018) 04, 117–131.
Goode, W.J. A Theory of Role Strain. AmericanSociologicalReview, (1960) 25（4）:483-496.
Sieber, S. D. Toward a theory of role accumulation. American Sociological Review, (1974) 39:4, 567–578. https://doi.org/10.2307/2094422
Proctor, C., Linley, P. A., Maltby, J., & Port, G. Life satisfaction. Encyclopedia of adolescence, (2017) 2(1), 2165-2176.
Gerard, J. M., Landry-Meyer, L., & Roe, J. G.. Grandparents raising grandchildren: The role of social support in coping with caregiving challenges. International Journal of Aging and Human Development, (2006) 62:4, 359–383. https://doi.org/10.2190/3796-DMB2-546Q-Y4AQ
Jendrek, M. P. Grandparents who parent their grandchildren: Effects on lifestyle. Journal of Marriage and the Family, (1993) 55:3, 609–621. https://doi.org/10.2307/353342
Zarit, S. H., Reever, K. E., & Bach-Peterson, J. Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist, (1980) 20:6, 649–655. https://doi.org/10.1093/geront/20.6.649
Baydar, N., & Brooks-Gunn, J. Profiles of grandmothers who help care for their grandchildren in the United States. Family Relations,(1998) 47:4, 385–393. https://doi.org/10.2307/585269
Baker, L. A., & Silverstein, M. Depressive symptoms among grandparents raising grandchildren: The impact of participation in multiple roles. Journal of Intergenerational Relationships, (2008) 6:3, 285–304. https://doi.org/10.1080/15350770802157802
Winefield, H., & Air, T. Grandparenting: Diversity in grandparent experiences and needs for healthcare and support. International Journal of Evidence-Based Healthcare, (2010) 8:4, 277–283. https://doi.org/10.1111/j.1744-1609.2010.00187.x
Hooyman, N. R., & Kiyak, H. A. Social gerontology: A multidisciplinary perspective. Allyn & Bacon. (2011)
Lumsdaine, R. L., & Vermeer, S. J. Retirement timing of women and the role of care responsibilities for grandchildren. Demography, (2015) 52:2, 433–454. https://doi.org/10.1007/s13524-015-0382-5
Silverstein, M., Conroy, S. J., Wang, H., Giarrusso, R., & Bengtson, V. L Reciprocity in parent–child relations over the adult life course. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, (2002) 57:1, Suppl. 3, S3–S13. https://doi.org/10.1093/geronb/57.1.s3
Guo, B., Pickard, J. G., & Huang, J. A cultural perspective on health outcomes of caregiving grandparents February. Journal of Intergenerational Relationships, (2008) 5:4, 25–40. https://doi.org/10.1300/J194v05n04_03
Minkler, M., & Fuller-Thomson, E. African American grandparents raising grandchildren: A national study using the Census 2000 American Community Survey. Journals of Gerontology: Series B, (2005) 60:2, S82–S92. https://doi.org/10.1093/geronb/60.2.S82
Bowers, B. F., & Myers, B. J. Grandmothers providing care for grandchildren: Consequences of various levels of caregiving. Family Relations, (1999). 48:3, 303–311. https://doi.org/10.2307/585641
Young, C., & Denson, L. A. Psychological health and provision of grandchild care in noncustodial “baby boomer” grandparents. Journal of Family Studies, (2014) 20:1, 88–100. https://doi.org/10.5172/jfs.2014.20.1.88
Burn, K., & Szoeke, C. Grandparenting predicts late-life cognition: Results from the women’s healthy ageing project. Maturitas, (2015) 81:2, 317–322. https://doi.org/10.1016/j.maturitas.2015.03.013
Emick, M. A., & Hayslip, B. Custodial grandparenting: Stresses, coping skills, and relationships with grandchildren. International Journal of Aging and Human Development, (1999) 48:1, 35–61. https://doi.org/10.2190/1FH2-AHWT-1Q3J-PC1K
Moore, S. M., & Rosenthal, D. A.. Personal growth, grandmother engagement and satisfaction among non-custodial grandmothers. Aging and Mental Health, 19(2), 136–143. https://doi.org/10.1080/13607863.2014.920302
Goodfellow, J., & Laverty, J. Grandparents supporting working families. Family Matters, (2003) 66, 14–19.
Lo, M., & Liu, Y. H. Quality of life among Older Grandparent Caregivers: A Pilot Study. Journal of Advanced Nursing,(2009) 65:7, 1475–1484. https://doi.org/10.1111/j.1365-2648.2009.05000.x
Jin, X., & Liu, Y. The impact of caring for grandchildren on life satisfaction of the elderly: Based on the study of floating elderly and non-floating elderly. Journal of Southeast University (Philosophy and Social Science), (2017) 02, 119–129 + 148. https://doi.org/10.13916/j.cnki.issn1671-511x.2017.02.016
Shen, L., & Zhang, Z. The grandparenting and mental health of middle aged and elderly people: The mediating effect of family cohesion. Studies of Psychology and Behavior, (2020) 02, 234–240.
Borrell LN. The role of social class on health behaviors and psychosocial factors: the United States experience. Soz Praventivmed, (2005) 50:4:193-4. doi: 10.1007/s00038-005-5019-9. PMID: 16167502.
Han, B., Wang, S. The Effect of Caring for Grandchildren on the Health of Middle and Old-Aged People. Population Research, (2019) 43 (04): 85-96.
Luo, L., Kong, F. Studying on the Self－rated Health Status of The Elderly Taking Care of Their Grandchildren and Its Influencing Factors Based on Empirical Analysis of CFPS Database in 2016. Chinese Health Service Management, (2021) 38 (06): 462-467.

No competing interests reported.

The Effect of Intergenerational Care on Chinese Elderly’ s Mental Health from the Perspective of Social Role: The Moderating Effect of Care Intensity

Status:

Version 1

Abstract

Figures

Introduction

Methods

Research Hypothesis

H1 Chinese grandparents who take care of their grandchildren score higher on life satisfaction than those who do not.

H2 The intensity of care significantly influences the direction of the relationship between intergenerational care and the life satisfaction of Chinese grandparents.

Data Source

Variable Measurement

Results

Discussions

Declarations

Author Contribution

Data Availability

References

Additional Declarations

Status:

Version 1