关键词: 抑郁, 老年人隔代抚养, 元分析

Abstract:

Granpareting is that grandparents take care of grandchildren and assume some or all of the responsibility for upbringing and education. Older parents often become caregivers when young couples are unable to care for their children for some reasons. Based on the researches available, effectiveness of grandparenting on grandparents' depression levels remains unclear. In addition, previous studies have ignored the influence of cultural backgrounds on the relationship between grandparenting and grandparents' depression levels. And differences of cultural background may explain why grandparents take care of their grandchildren and the consequence of grandparenting. Therefore, meta-analysis was used in this paper to explore the relationship between grandparenting and grandparents' depression levels in eastern cultures and western cultures respectively.

We identified cross-sectional studies and case-control studies through Web of Science, EBSCO, PubMed, CNKI and Wangfang (from inception to June 29, 2021). Through literature retrieval, 22 articles met the inclusion criteria of this meta-analysis were selected and 22 independent effect sizes were synthesized. CMA3.0 software was used for the meta-analysis. We also applied the Effective Public Health Practice Project's (EPHPP) Quality Assessment Tool for Quantitative Studies to evaluate the quality of primary studies included in the meta-analysis. What's more, publication bias analysis showed that there was no publication bias. And the results of heterogeneity test suggested the use of random-effects model. Evidence from cross-sectional studies and case-control studies was synthesized as standardized mean differences which were used to compare the depression levels of grandparents who did and did not take care of grandchildren. The main-effect analysis showed that standardized mean differences (d) were -2.44 (95%CI: [-3.22, -1.67]) and 0.22 (95%CI: [0.04, 0.40]) in eastern cultures and western cultures respectively. Sensitivity analysis excluded one study with the greatest influence of heterogeneity in the two cultural backgrounds respectively and the effect size was no longer significant in eastern cultures (d= -0.05, 95%CI: [-0.18, 0.08]) and the effect size of western cultures had no significant change. In order to prevent the reliability of meta-analysis from being interfered by this abnormal study of eastern cultures, it was excluded in subsequent analysis. Because of the high level of heterogeneity, we used subgroup analysis and meta-regression to explore whether measurement tools of depression, study design, gender and marriage were potential moderators. Subgroup and meta-regression results showed that in eastern cultures, the type of depression measurement tools, the type of study design, gender and marriage had significant moderating effects. But in western cultures, the results showed that only measurement tools and study design do moderate.

In conclusion, it is found that in eastern cultures, grandparenting has no significant effect on the depression levels of the elderly. However, it has a noteworthy negative effect on the depression levels of grandparents in the West. One possible explanation is the weakening of traditional cultural values in the context of eastern cultures and the role strain experienced by the elderly in the context of western cultures. The results of this meta-analysis contribute to a better understanding of the relationship between grandparenting and depression levels of the elderly. They also provide future empirical studies with a reference to explain depression levels of the elderly with grandparenting. However, eastern and western cultures can not represent all cultures, so further researches can focus on using more appropriate coding methods to explore the more precise and more detailed relationships between grandparenting and depression levels of the elderly.

Key words: depression, grandparenting, meta-analysis