Empathy, Support Exchanges, and Well-Being in Older Couples Coping With Early Stage Alzheimer’s Disease

项目摘要 当老年人患有阿尔茨海默病（AD）时，配偶通常承担主要照顾者的角色， 降低自己的幸福感。然而，这些照顾者在他们提供的护理质量和 他们面临的负担。学者们提出，照顾者的同理心（即，他们分享和理解 其他人的情绪）解释了这种变化，他们认为同情心是与照顾者进行干预的关键点。 然而，人们对共情影响情感体验的机制知之甚少， 结果，这阻碍了旨在使老年AD患者受益的干预措施的发展， 他们的照顾者。这项拟议中的研究旨在区分移情的多个方面， 在以前的研究交织在一起，并确定促进有效的研究的方面。我们亦建议 利用二元方法，并检查AD老年人的积极贡献，他们经常被 仅仅被视为压力和负担的来源。二元应对理论认为二元个体的成员可能 面对共同的压力源（包括AD相关问题）时，参与联合解决问题， 有效的二元应对对于维持二元成员的幸福至关重要。老年人早期 (i.e.,轻度至中度）AD保留了社会情感技能，可以提供情感 他们也可能仍然能够提供工具性支持，完成简单的任务。此外，这些老年人 成年人报告的同情心水平与健康正常的老年人相当，他们的同情心可能 影响他们自己的行为和他们的伴侣提供的照顾。R21提出了一项创新研究， 将调查老年夫妇应对早期AD的支持交流动态，并检查 移情、支持交换和幸福感之间的二元关联。我们将利用自我报告的数据 来自早期可能或可能AD的老年人及其配偶照顾者（N = 60对）。要求1 我将研究两个二元体成员的同理心是如何与支持的频率和质量相关联的， 也不受彼此伤害目标2将研究两个二元体成员的共情如何与他们的评价相关联 相互支持的方式目标3将确定两个二元体成员的同理心如何与他们的 幸福和考虑支持经验作为一个基本机制。我们建议在内部进行审查， 跨配偶的定量关联，并依靠定性数据，以更好地理解的含义， 这些关联背后的过程。我们还将比较二分体成员之间的关联。结果 将促进我们对AD护理如何从持续的密切联系中产生以及同理心如何作为一种 突出这一纽带的维度，促进互利交流。这项研究将提供必要的 知识，以指导非药物护理干预措施的开发和完善，并为 未来的R01，以检查是否在早期阶段互惠互利的交流影响AD的轨迹， 相关的下降和照顾者帮助和科普压力的方式。

PROJECT SUMMARY Spouses typically take on the primary caregiver role when older adults have Alzheimer’s disease (AD), which reduces their own well-being. These caregivers, however, vary in the quality of care they provide and the burdens they face. Scholars propose that caregivers’ empathy (i.e., their ability to share and understand others’ emotions) explains this variation and they view empathy as a key point of intervention with caregivers. Yet, little is known about the mechanism through which empathy influences caregiving experiences and outcomes, which hinders the development of interventions intended to benefit both older adults with AD and their caregivers. The proposed study seeks to distinguish among multiple aspects of empathy that have been intertwined in prior research and identify the aspects that facilitate effective caregiving. We also propose to utilize a dyadic approach and examine positive contributions of older adults with AD, who have often been viewed solely as a source of stress and burden. Theories of dyadic coping posit that members of a dyad may engage in joint problem solving in the face of shared stressors including AD-related problems, and that effective dyadic coping is crucial for maintaining both dyad members’ well-being. Older adults with early stage (i.e., mild-to-moderate) AD have preserved socioemotional skills that may allow for the provision of emotional support, and they may also still be able to offer instrumental support with easy tasks. Moreover, these older adults report empathy levels comparable to those of healthy normal older adults, and their empathy likely influences their own behaviors and the care their partners provide. This R21 presents an innovative study that will investigate the dynamics of support exchanges in older couples coping with early stage AD, and examine the dyadic associations between empathy, support exchanges, and well-being. We will draw on self-report data from older adults with early stage probable or possible AD and their spousal caregivers (N = 60 dyads). Aim 1 will investigate how both dyad members’ empathy is associated with the frequency and quality of support to and from each other. Aim 2 will examine how both dyad members’ empathy is associated with their appraisal of support to and from each other. Aim 3 will identify how both dyad members’ empathy is associated with their well-being and consider support experience as an underlying mechanism. We propose to examine within- and cross-spouse quantitative associations, and rely on qualitative data to better understand the meanings and processes underlying these associations. We also will compare associations between dyad members. Findings will advance our understanding of how AD care emanates from an ongoing close tie and how empathy, as a prominent dimension of this tie, facilitates mutually beneficial exchanges. This study will provide essential knowledge to guide the development and refinement of nondrug care interventions, and create a foundation for future R01s to examine whether mutually beneficial exchanges in early stages influence the trajectory of AD- related declines and the way caregivers help and cope with stress in the long run.