Department of Psychiatry.
Institute for Social Research.
Psychol Aging. 2022 May;37(3):371-387. doi: 10.1037/pag0000679. Epub 2022 Mar 28.
Chronic health conditions among individuals and their partners may diminish perceived control, particularly when these conditions are highly complex. We considered how chronic condition discordance (i.e., the extent that two or more conditions have nonoverlapping self-management requirements) at the individual level and the couple level (i.e., between spouses) was linked to health-related control and personal mastery across an 8-year period, and whether these links varied by age. The U.S. sample included 879 wives ( = 53.81 years) and husbands ( = 57.19 years) from three waves (2006, 2010, and 2014) of the Health and Retirement Study. Dyadic growth curve models controlled for age, minority status, education, own and partner baseline negative marital quality, and own and partner time-varying depressive symptoms, and number of chronic health conditions. Overall, both individual-level and couple-level degrees of chronic condition discordance were associated with initial levels of and rates of change in perceived control. When wives had greater individual-level discordance, they reported lower initial personal mastery. When husbands had greater individual-level discordance, they reported lower initial health-related control and faster declines in health-related control and personal mastery, and their wives reported faster declines in personal mastery. When there was greater couple-level discordance, wives reported lower initial health-related control. Age moderated the associations between wives' individual-level discordance and their own initial level of health-related control and rate of change in personal mastery. Interventions to improve later-life well-being may be enhanced by targeting increases in perceived control among individuals and couples managing complex patterns of chronic conditions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
慢性健康状况在个体及其伴侣中可能会降低感知控制能力，尤其是当这些状况非常复杂时。我们考虑了个体层面和夫妻层面（即配偶之间）的慢性疾病不和谐（即两种或多种疾病的自我管理要求没有重叠的程度）与健康相关的控制和个人掌握能力之间在 8 年内的关系，以及这些关系是否因年龄而异。美国样本包括来自健康与退休研究的三个波次（2006 年、2010 年和 2014 年）的 879 名妻子（年龄 = 53.81 岁）和丈夫（年龄 = 57.19 岁）。二元增长曲线模型控制了年龄、少数民族地位、教育程度、自身和伴侣的基线负面婚姻质量以及自身和伴侣的时变抑郁症状和慢性健康状况的数量。总体而言，个体层面和夫妻层面的慢性疾病不和谐程度都与感知控制的初始水平和变化率有关。当妻子的个体层面不和谐程度较大时，她们报告的初始个人掌握能力较低。当丈夫的个体层面不和谐程度较大时，他们报告的初始健康相关控制和健康相关控制以及个人掌握能力的下降速度较快，他们的妻子报告的个人掌握能力下降速度也较快。当夫妻层面的不和谐程度较大时，妻子报告的初始健康相关控制较低。年龄调节了妻子个体层面不和谐与自身初始健康相关控制和个人掌握能力变化率之间的关系。针对个体和夫妻管理复杂慢性疾病模式来提高感知控制能力，可能会增强改善晚年生活质量的干预措施。（PsycInfo 数据库记录（c）2022 APA，保留所有权利）。
