Chronic Conditions and Mutuality of Care in Late Life Marriage:A Multi-method App

晚年婚姻中的慢性病和相互照顾：多方法应用程序

• 批准号: 9282761
• 负责人: JOAN E. MONIN
• 金额: $ 12.57万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-06-01 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9282761
• 关键词: Address; Affect; Aging; American; Ancillary Study; Capsicum; Cardiovascular Diseases; Cardiovascular system; Caregivers; Caring; Chronic; Chronic Disease; Clinical; Couples; Data; Data Analyses; Data Set; Dementia; Disabled Persons; Disease; Educational workshop; Elderly; Emotional; Environment; Epidemiologic Methods; Epidemiology; Family Relationship; Feeling; Goals; Health; Individual; Interpersonal Relations; Joints; Laboratories; Laboratory Study; Learning; Life; Link; Literature; Longevity; Longitudinal Studies; Machine Learning; Major Depressive Disorder; Marriage; Mental Depression; Mental Health; Mentored Research Scientist Development Award; Mentors; Methods; National Institute on Aging; Patient Self-Report; Persons; Physiological; Process; Psychophysiology; Psychosocial Assessment and Care; Psychosocial Factor; Public Health; Public Health Schools; Reaction; Recovery; Reporting; Research; Research Ethics; Research Personnel; Resources; Side; Speed; Spouses; Stress; Surveys; Techniques; Therapeutic Intervention; Time; Training; Universities; Woman; Women' s Health; Work; cardiovascular health; care recipients; career; career development; caregiving; commune; disability; epidemiologic data; experience; experimental study; faculty mentor; family caregiving; functional disability; gender difference; innovation; insight; intimate behavior; longitudinal dataset; member; men; mortality; physical conditioning; programs; public health relevance; secondary analysis; showing emotion; statistics; stressor; theories

DESCRIPTION (provided by applicant): It is estimated that 88% of all older adults have at least one chronic condition, 69% have more than one chronic condition, and 33% experience functional disability. Thus, married older adults are not only likely to cope with chronic conditios and disability of their own but also their spouse's. Understanding how support dynamics in marriage influence each partner's health will provide great insight into helping couples stay healthier and functionally independent into late life. The aim of the proposed Mentored Research Scientist Development Award (MRSDA) is to train the candidate in epidemiology of aging and advanced dyadic data analysis techniques to build on her expertise in experimental research and to understand how mutual care in late-life marriage influence health, particularly cardiovascular health and depression, and longevity. The proposed research focuses on older couples in which both partners suffer from chronic conditions and disability, and drawing from communal relationships theory, mutual care is defined as both partners receiving high levels of balanced instrumental and emotional support from one another. Through this MRSDA, the candidate will (1) learn from expert mentors and consultants about the epidemiology of aging and advanced statistical techniques to analyze dyadic, longitudinal data, (2) conduct secondary analysis on a large epidemiologic dyadic data set to examine how mutual care in older adult marriages influences long-term health and longevity and an experiment to examine a proposed mechanism, cardiovascular stress recovery, (3) complete coursework in epidemiology of aging, advanced epidemiologic statistics, and research ethics, and (4) attend workshops on dyadic data analysis. Yale University is a phenomenal environment to pursue this training as it has extensive resources in epidemiology of aging, statistics for analyzing epidemiologic data, experimental relationships research, and cardiovascular psychophysiology. The candidate has a state-of-the- art observational and psychophysiology lab that she will utilize for this project. Th Yale School of Public Health and the Claude D. Pepper Older American's Independence Center at Yale have excellent junior faculty mentoring programs. The candidate's primary mentor, Dr. Becca Levy at Yale School of Public Health has extensive expertise in bridging experimental and epidemiological methods to study psychosocial factors and health in older adults, including dyads. Dr. Richard Schulz will serve as a co-mentor, as he is the primary investigator for the Cardiovascular Health Effects Study which will be used for Study 1 of the proposed research and is an expert in conducting large, longitudinal studies. Dr. Trace Kershaw, an expert in dyadic data analysis at Yale School of Public Health, will also be a co-mentor. The proposed training will occur in the context of (1) a longitudinal study of married couples in which both members of the couple have chronic conditions and disability (Study 1; The Caregiver Health Effects Study; n=819 couples; an ancillary study to the Cardiovascular Health Study) examining the influence of mutual support on health trajectories (e.g. clinical and subclinical indicators of cardiovascular disease, clinical depression, and self-reported health) and longevity, and (2) an experimental study (Study 2; n=100 couples) examining cardiovascular stress recovery, a proposed mechanism for the link between mutual care and cardiovascular health proposed in Study 1. In the experimental study each partner will discuss a health-related stressor, and mutual support will be manipulated and compared to a control and one-sided support conditions to examine the effects on cardiovascular stress recovery. Consistent with the priorities outlined by the National Institute on Aging, the proposed MRSDA has the potential to address mechanisms for links between interpersonal relationships and health in the context of aging (RFA: PA-11-128). Further, the combination of training and research will serve as a spring board for the candidate's independent research career to elucidate how interpersonal relationships influence health among older adults.

据估计，88%的老年人至少有一种慢性病，69%有一种以上的慢性病，33%有功能障碍。因此，已婚老年人不仅有可能科普自己的慢性病和残疾，而且还有可能应对配偶的慢性病和残疾。了解婚姻中的支持动力如何影响每个伴侣的健康，将为帮助夫妻在晚年保持健康和功能独立提供很好的见解。拟议的指导研究科学家发展奖（MRSDA）的目的是培训候选人在老龄化流行病学和先进的二元数据分析技术，以建立在她的专业知识在实验研究和了解如何相互照顾晚年婚姻影响健康，特别是心血管健康和抑郁症，和长寿。拟议的研究重点是老年夫妇，其中双方都患有慢性疾病和残疾，并借鉴公共关系理论，相互照顾的定义是双方从对方那里获得高水平的平衡的工具和情感支持。通过这个MRSDA，候选人将（1）从专家导师和顾问那里学习有关老龄化的流行病学和先进的统计技术，以分析二元，纵向数据，（2）对大型流行病学二元数据集进行二次分析，以研究老年婚姻中的相互照顾如何影响长期健康和寿命，并进行实验，以研究拟议的机制，心血管压力恢复，（3）完成老龄化流行病学，高级流行病学统计学和研究伦理学的课程，以及（4）参加二元数据分析研讨会。耶鲁大学是一个非凡的环境，追求这种培训，因为它有广泛的资源，在流行病学的老化，统计分析流行病学数据，实验关系的研究，和心血管心理生理学。候选人有一个国家的最先进的观察和心理生理学实验室，她将利用这个项目。耶鲁大学公共卫生学院和克劳德D。耶鲁大学的佩珀老年美国人独立中心有很好的初级教师指导计划。候选人的主要导师，耶鲁大学公共卫生学院的Becca Levy博士在桥接实验和流行病学方法方面拥有广泛的专业知识，以研究老年人的心理社会因素和健康状况，包括二元组。Richard Schulz博士将担任共同导师，因为他是心血管健康影响研究的主要研究者，该研究将用于拟议研究的研究1，并且是进行大型纵向研究的专家。耶鲁大学公共卫生学院的二元数据分析专家Trace Kershaw博士也将担任共同导师。拟议的培训将在以下背景下进行：（1）对已婚夫妇进行纵向研究，其中夫妇双方都患有慢性病和残疾（研究1;护理人员健康影响研究; n=819对夫妇;心血管健康研究的辅助研究），检查相互支持对健康轨迹的影响（例如， 心血管疾病，临床抑郁症，和自我报告的健康）和长寿，和（2）一项实验研究（研究2; n=100对夫妇）检查心血管压力恢复，一个建议的相互照顾和心血管健康之间的联系机制，在研究1中提出。在实验研究中，每个合作伙伴将讨论与健康相关的压力源，相互支持将被操纵，并与控制和单侧支持条件进行比较，以检查对心血管压力恢复的影响。与国家老龄问题研究所概述的优先事项一致，拟议的MRSDA有可能解决老龄化背景下人际关系与健康之间联系的机制（RFA：PA-11-128）。此外，培训和研究的结合将成为候选人独立研究生涯的跳板，以阐明人际关系如何影响老年人的健康。