Longitudinal associations between chronic condition discordance and perceived control among older couples.
Longitudinal associations between chronic condition discordance and perceived control among older couples.
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DOI：
10.1037/pag0000679
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发表时间：
2022-05
影响因子：
3.7
通讯作者：
Kales, Helen C
中科院分区：
文献类型：
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作者：
Polenick, Courtney A;Birditt, Kira S;Turkelson, Angela;Shattuck, Sadie M;Kales, Helen C
个人及其伴侣的慢性健康状况可能会削弱他们的控制感，特别是当这些状况非常复杂时。我们考虑了个人层面和夫妻层面（即配偶之间）的慢性疾病不协调（即两种或两种以上的疾病具有不重叠的自我管理要求的程度）如何与8年期间的健康控制和个人掌握相关联，以及这些联系是否因年龄而异。美国的样本包括879名妻子（M = 53.81岁）和丈夫（M = 57.19岁），来自三波（2006年、2010年和2014年）的健康与退休研究。二元增长曲线模型控制了年龄、少数民族地位、教育程度、自己和伴侣的基线负面婚姻质量，以及自己和伴侣随时间变化的抑郁症状和慢性健康状况的数量。总体而言，个人水平和夫妻水平的慢性疾病不协调程度与感知控制的初始水平和变化率有关。当妻子在个人层面上的不和谐更大时，她们最初的个人掌控能力就会降低。当丈夫有更大的个人层面的不协调时，他们报告了较低的初始健康相关控制和更快的健康相关控制和个人控制下降，而他们的妻子报告了更快的个人控制下降。当夫妻之间存在较大的不一致时，妻子报告的最初健康控制较低。年龄调节了妻子个人层面的不协调与她们自己的健康相关控制的初始水平和个人掌握的变化率之间的关联。改善晚年生活幸福的干预措施可以通过针对个人和管理复杂慢性病模式的夫妇的感知控制的增加来加强。
Chronic health conditions among individuals and their partners may diminish perceived control, particularly when these conditions are highly complex. We considered how chronic condition discordance (i.e., the extent that two or more conditions have non-overlapping self-management requirements) at the individual level and the couple level (i.e., between spouses) was linked to health-related control and personal mastery across an 8-year period, and whether these links varied by age. The U.S. sample included 879 wives (M = 53.81 years) and husbands (M = 57.19 years) from three waves (2006, 2010, and 2014) of the Health and Retirement Study. Dyadic growth curve models controlled for age, minority status, education, own and partner baseline negative marital quality, and own and partner time-varying depressive symptoms and number of chronic health conditions. Overall, both individual-level and couple-level degrees of chronic condition discordance were associated with initial levels of and rates of change in perceived control. When wives had greater individual-level discordance, they reported lower initial personal mastery. When husbands had greater individual-level discordance, they reported lower initial health-related control and faster declines in health-related control and personal mastery, and their wives reported faster declines in personal mastery. When there was greater couple-level discordance, wives reported lower initial health-related control. Age moderated the associations between wives’ individual-level discordance and their own initial level of health-related control and rate of change in personal mastery. Interventions to improve later-life well-being may be enhanced by targeting increases in perceived control among individuals and couples managing complex patterns of chronic conditions.