When Both Spouses Have Functional Decline: Spousal Collaboration Dynamics in Mastering Daily Stressors Using Ecological Momentary Assessment
運用生態瞬間評估探索夫婦協同應對老化過程中的日常挑戰
Funding Scheme :
General Research Fund
Project Number :
17605119
Institution :
The University of Hong Kong
Abstract :
In a super-aging society like Hong Kong, a huge number of older couples are getting frail together. Current research on informal carer dominantly takes a spousal caregiving perspective by clearly distinguish between roles of caregivers and care-receivers, overlooking a prevalent phenomenon that both spouses are at risk of functional decline and help with each other in daily life. Despite there is a few literature on the concordant health outcomes between spouses, no systematic research has been conducted to examine couple’s experiences of handling daily stressors and its well-being impacts. To address these research gasps, the proposed study advocates a paradigm shift from an individual-based examination of caregiver and care-receiver to investigating collaborative care arrangements within older couples and takes a first step to investigate the vivid experiences of how functionally impaired couples dealing with daily stressors. Objectives: The study aimed to test specific functions of couple’s collaborative dynamics in mastering daily stressors that could facilitate more positive individual and relational well-being outcomes, and whether the effectiveness of collaboration varies as a function of perceived control of self and spouse during collaboration. By integrating interdependence theory and frameworks of dyadic coping, this study will test two sets of hypothesizes: (1) spousal collaboration buffers the temporal relationship between daily stressors and psychophysiological responses, and such buffering effects are enhanced when spouses exhibit a reciprocal pattern of control in collaboration; and (2) more frequent use of collaboration to deal with daily stressors is prospectively associated with greater well-being and marital satisfaction. Methodology: We propose to use a combined research design comprising a longitudinal survey and ecological momentary assessment (EMA). The EMA research protocol has been validated in our previous work as a feasible and reliable method for studying real-life experiences of community-dwelling older adults. A sample of 75 older couples wherein both spouses reported functional decline will be recruited to participate in a baseline survey, a 14-day EMA, and a 12-month follow up survey. During the 14-day EMA period, each participant will be instructed to use mobile devices to provide self-report data (e.g., daily stressors, affect) and cardiovascular recordings four times daily. Conclusion: The findings of this study will serve as the first evidence of the phenomenon of collaborative dynamics of functionally impaired couples’ mastering on daily problems. Findings will also inform the development of couple-centered care models that address the joint health needs of both spouses in super-aging societies globally.
面對超高齡社會的來臨,越來越多的老年夫婦會一起攜手經驗老化的過程。以往關於照顧者的研究一般會假設夫妻中有需要照顧的一方,另一方為主要照顧者。但是在日常生活中經常觀察到的是夫婦一起經驗老化的日常,有時候你照顧我,有時候我照顧你,有時候互相照顧,區分照顧者和被照顧者在理論上和實際上都未能解釋夫妻共老的實際經驗,夫妻在健康層面互相影響的研究也非常有限。本研究提出照顧者研究需要一個新的研究範式 – 系統研究夫妻兩人如何協同應對老化中的日常挑戰,特別是在當夫婦體驗到功能健康逐漸衰落的情境下。 故此,本研究目的是1)探索夫妻在面對共同老化的日常過程中如何運用協同應對策略;2)在協同應對過程中對自己及對方行為的控制感是有效協同的關鍵。為了實現這兩個研究目的,擬檢驗以下的兩個假設:首先,夫妻間的協同能緩衝老化過程日常的挑戰與健康指標之間的關係,這種緩衝會在夫妻有協同應對策略的情境下得到強化;其次,在日常生活中越多運用協同應對策略,越有機會有良好的健康與婚姻滿意度。 在本研究團隊發展的一套有效生態瞬間評估方法實踐步驟的基礎上,本研究綜合運用生態瞬間評估及長期問卷調查的方法。擬在社區招募75對老年夫婦,邀請參與夫婦在12個月間隔前後參與標準化的問卷調查,並在兩次調查之間參與14天的生態瞬間評估。 本項目是首個系統探索夫妻協同應對老化日常中挑戰的研究專案,預計研究結果將對瞭解及預測夫妻共同應對老化的理論和實際有建設性的影響,深化照顧者研究理論及為支援照顧者政策和服務的實際提供實證基礎。