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

应对早期阿尔茨海默病的老年夫妇的同理心、支持交流和幸福感

• 批准号: 10299814
• 负责人: Meng Huo
• 金额: $ 42.43万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10299814
• 关键词: Activities of Daily Living; Address; Alzheimer' s Disease; Alzheimer' s disease care; Alzheimer' s disease caregiver; Behavior; Behavioral Model; Caregiver Burden; Caregivers; Caring; Chronic Disease; Communication; Couples; Data; Data Reporting; Development; Dimensions; Disease; Effectiveness; Elderly; Emotional; Emotions; Empathy; Face; Feeling; Foundations; Frequencies; Future; Helping Behavior; Individual; Intervention; Interview; Joints; Knowledge; Lead; Literature; Nature; Outcome; Participant; Patient Self-Report; Personal Satisfaction; Persons; Play; Problem Solving; Process; Provider; Quality of Care; Reporting; Research; Role; Shapes; Source; Spouse Caregiver; Spouses; Stress; Surveys; Telephone; Thinking; Time; Variant; care delivery; care recipients; caregiver interventions; caregiving; caregiving outcomes; coping; depressive symptoms; effective intervention; experience; improved; improved outcome; innovation; knowledge base; member; non-drug; novel strategies; preservation; prevent; primary caregiver; recruit; skills; social; stressor; theories; therapy development

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.

项目总结 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 降低了他们自己的幸福感。然而，这些照顾者提供的护理质量各不相同， 他们面临的负担。学者们提出，照顾者的同理心(即他们分享和理解的能力 其他人的情绪)解释了这种差异，他们认为同理心是对照顾者进行干预的一个关键点。 然而，人们对同理心影响照看体验和护理的机制知之甚少 结果，这阻碍了旨在使患有阿尔茨海默病的老年人和 他们的照顾者。这项拟议的研究试图区分移情的多个方面，这些方面 在先前的研究中相互交织在一起，并确定促进有效照料的方面。我们还建议 利用二元方法，检查患有AD的老年人的积极贡献，他们经常 仅仅被视为压力和负担的来源。二元应对理论假设，二元应对成员可以 在共同的压力下共同解决问题，包括与AD相关的问题，以及 有效的二元应对对于维持两个二元成员的幸福感至关重要。患有早期疾病的老年人 (即，轻度至中度)AD保留了社会情感技能，这可能允许提供情感 支持，他们也可能仍然能够提供工具性的支持和简单的任务。此外，这些较老的 成年人报告的同理心水平与健康的正常老年人相当，他们的同理心很可能 影响他们自己的行为和他们伴侣提供的关怀。此R21提供了一项创新研究， 将调查应对早期阿尔茨海默病的老年夫妇的支持交换动态，并检查 移情、支持交流和幸福感之间的二元关联。我们将利用自我报告数据 来自早期可能或可能患有AD的老年人及其配偶照顾者(N=60对夫妇)。目标1 我将调查两个二人组成员的共鸣与支持的频率和质量之间的关系 以及彼此之间的距离。目标2将考察两个二元体成员的共情与他们的评价之间的关系 相互支持，相互支持。目标3将确定两个二元体成员的共鸣如何与他们的 并考虑将支持经验作为一种基本机制。我们建议在-和 跨配偶数量关联，并依靠定性数据来更好地理解含义和 这些关联背后的过程。我们还将比较两个成员之间的关联。发现 将推动我们理解AD护理是如何从持续的密切联系中产生的，以及作为一种 这一纽带的突出维度，促进了互利交流。这项研究将提供必要的 指导发展和完善非药物护理干预措施的知识，并为 未来R01将考察早期互利交流是否会影响AD的轨迹- 从长远来看，相关下降以及照顾者帮助和应对压力的方式。