Reciprocity and Self Health Care in Aging

本研究以110名65岁及以上的老年人为样本，对基于社会交换理论的互惠与健康过程模型进行了实证研究。互惠的概念具有重要的理论意义和临床意义。在社会交换理论中，资源被视为在社会环境中发挥作用的必要条件。身体能力有限的老年人也可能会经历角色功能的限制，因为他们发现互惠资源正在减少，因此，可能会遇到资源枯竭或拥有资源或拥有社会价值较低的资源的困难。面对身体和角色功能下降，以及交换资源枯竭或不断变化，老年人可能忽视保健做法，而不是寻求帮助（社会支持），从而冒着出现更多健康问题和功能障碍的风险。卫生保健专业人员可能没有意识到老年人需要回报，也没有干预和支持建立回报的机会。非正式社会支持网络的成员，即使是出于好意，也可能对老年人需要回报和允许老年人对他人表现出兴趣或分享从生活经验中获得的知识和智慧的重要性不敏感——这些互惠行为不会耗尽老年人的金钱资源，也不需要他们不再拥有的体力。由于经济和生活质量的关系，保持我们日益增长的老年人口的健康非常重要。这项研究的数据将来自对65岁或以上的成年人的采访，他们的日常生活活动或日常生活的工具活动有限。这项研究的结果有望回答重要的理论问题。1)自我保健随着个体年龄和独立自我保健能力的下降而降低；2)互惠对支持持续健康行为所需的请求和/或帮助的影响，这些行为是维持健康和限制慢性疾病有害影响所必需的。结果将提供与健康风险相关的信息，这些信息是基于可能需要的请求援助的沉默，以及随着个人年龄增长与互惠相关的需求。这种认识的应用将为设计干预措施提供基础。

The purpose of this pilot study is to test a Reciprocity and Health Process Model derived from social exchange theory and developed by the investigators with a sample of 110 adults aged 65 and over. The concept of reciprocity is significant theoretically and clinically. In social exchange theory resources are seen as essential to functioning in a social context. Elders who have limited physical ability may also experience limitations in role functioning as they find resources for reciprocity diminishing, and thus, may have difficulties associated with resource depletion or having resources or having resources that are less valued socially. Faced with diminished physical and role functioning, and depleted or changing exchange resources, the older individual may neglect health care practices rather than ask for help ( social support ) risking still more health problems and functional impairments. Health care professionals may be unaware of the older individual's need to reciprocate and fail to intervene and support the building of opportunities for reciprocation. Members of informal social support networks, even when well intentioned, may be insensitive to the older individual's need to reciprocate and the importance of allowing older individuals to show an interest in others, or share the knowledge and wisdom gained from life experiences-those acts of reciprocity that do not deplete the elder's monetary resources or require physical stamina no longer possessed. Maintaining the health of our increasing older population is important because of economics as well as quality of life. Data for the study will come from interviews with adults aged 65 or older who have limitation activities daily living or instrumental activities of daily living. Findings from the study can be expected to answer important theoretical questions. 1) about self health care as individuals' age and ability for independent self-care diminished and 2) the influence of reciprocity on request and/or assistance necessary to support continued health behaviors requisite to optimal maintenance of health and limiting deleterious effects of chronic illnesses. Results will provide information related to health risks based on reticence to ask for assistance that may be needs, as well as needs related to reciprocity as individuals age. Application of this understanding will provide the basis for designing interventions.