Browsing by Subject "Relationships"

Problem: Dementia has become a global public health priority. A total of 47 million people worldwide lives with dementia, and nearly 60% of whom live in low-and middle-income countries (LMIC). The fastest growth of population living with dementia takes place in China. In addition, the number will be greater if we take persons with mild cognitive impairment (MCI) into account. The estimated prevalence of MCI and dementia among older adults in China is between 13% and 20%. My population of study are persons with cognitive impairment (PWCI) and their informal care partners, including those living with MCI or mild dementia. It is estimated that over 80% of the population with cognitive impairment in China are living in the community and receiving care from their informal caregivers.

There is a severe lack of residential dementia care service and dementia management support at community level in China. The lack of supportive resources and quality services in China posed severe challenges to PWCI and their informal care partners. The complexity of PWCI and their care partners’ changing experience of living with cognitive impairment is interpreted in the dynamic nature of their spousal relationship and relationship with others, patterns of communication, daily activities and care during the extended period of cognitive decline. The purpose of my dissertation is to describe the cultural relevance of person-centered dementia care in home and community-based setting and provide empirical evidence for understanding the changing experience of living with cognitive impairment through the dyadic experiences of PWCI and their spousal care partners.

Methods: We used semi-structured open-ended interviews (Ashton, 2014) to explore the experiences and perceptions of PWCI and their care partner’s, regarding living with cognitive impairment, working with each other, communicating with each other and taking care of each other. We then applied the person-centered dementia care framework, and Nolan’s senses framework to the analysis of the interviews to understand their experiences and perceptions. We conducted a longitudinal qualitative study of a subset of 6 dyads of PWCI and their care partners over three years with three data collection time points (2015 to 2017). We employed the approach of prospective QLS in this study to capture the complexities of relationships, experiences, and the impact on health policy.

Findings: Person-centered care processes are a means of establishing and nurturing the healthy relationships between PWCI and their care partners. Our findings suggest that PWCI and their spouses experience the six senses through the person-centeredness in their daily interactions with each other. It also indicated successes and challenges to being person-centered early in the disease and identified their unmet needs as well as barriers and facilitators to improve their well-being. PWCI and their care partners used strategies to adapt to the changes and cope with challenges. The dyads experienced a lack of sense of continuity of their relationships, communication patterns, and daily life and activities. PWCI and their care partners have a lack of access to clinical expertise and quality care services in the home and community-based settings and formal LTC settings. It is acknowledged that PWCI deserves opportunities to be engaged in meaningful social relationships with others. It is crucial to help PWCI and their care partners choose a more positive attitude and nurturing the belief that there is a significant meaning in the journey of living with cognitive impairment. A lack of knowledge of the disease, treatment, and caregiving can potentially negatively affect PWCI and their care partners’ coping and overall well-being throughout the process of living with cognitive impairment. Our findings also provided many examples of when care partners respected PWCI’s choices, regarding caregiving as assisting and guiding PWCI to help themselves instead of telling them what to do, resulting in a profound positive impact on the well-being of PWCI and their care partners and most importantly, on their spousal relationships.

The Romantic Construal Model proposes that people interpret actions as romantic to the extent that they perceive that those actions take the receiver’s idiosyncratic likes and dislikes into account (personalization), are out of the ordinary in terms of either frequency or the manner with which they are enacted (specialness), and convey that the person values the receiver and the relationship (conveyed value). This model was tested in two studies.

In Study 1, 132 participants (67 men and 65 women) were instructed to modify generic behaviors to make them either more or less romantic. These modifications were then coded for personalization, specialness, and conveyed value. The results showed that higher mean levels of personalization, specialness, and value were found when participants were asked to make a behavior more rather than less romantic. Furthermore, regression analyses predicting participant ratings of romance for the modified actions were significantly predicted by the levels of specialness and conveyed value, but personalization was not related to romantic ratings.

In Study 2, 132 participants (67 men and 65 women) read 8 vignettes describing potentially romantic behaviors that experimentally manipulated all combinations of high or low personalization, high or low specialness and high or low conveyed value. Participants rated each vignette for how romantic they thought the behavior was; the degree to which the behavior was personalized, special, and conveyed value; and how good, committed, and loved would they feel if their partner enacted that behavior in their relationship. The results of Study 2 showed that although personalization and specialness were successfully manipulated in the vignettes, value was not. Furthermore, significant effects of personalization and specialness, but not value, were obtained on romantic ratings for half of the vignettes. In contrast, participants’ subjective ratings of the romanticness of the behaviors were predicted by their ratings of value but not personalization or specialness. The implications of this study for the Romantic Construal Model are discussed and evaluated within the context of previous findings on the communication of affection

One of the most frequent things we do as consumers is make purchase. We pay for a coffee or for food, we pay for necessities around the house, we even pay for one another, buying drinks or dinner for a friend every now and then. In today’s marketplace, the decision of whether to purchase is also coupled with the decision of how to make a purchase. Consumers have so many different methods to pay for their transactions. Can the way a consumer chooses to pay change the likelihood that s/he make a purchase? And then post-purchase, can the payment method used to pay for a purchase influence how connected individuals feel to that product, brand, or organization? Given that we sometimes pay for others (and vice versa), can the way we pay influence our interpersonal relationships?

In what follows, I argue that the way individuals pay, and specifically the pain associated with making a payment, can have a pervasive effect on their decision to make a purchase and how they feel post-transaction. Across three essays, I focus on how the pain of paying can influence the likelihood to purchase an item from a consideration set (Essay 1) and subsequently, how the pain of paying can influence post-transaction connection to a product, organization, or even to other people (Essay 2 and 3). Across field, laboratory, online, and archival methods, I find robust evidence that increasing the pain of paying may initially deter individuals from choosing. However, post-transaction, increasing the pain of payment may have an upside: individuals feel closer and more committed to a product that they purchased, organization that they donated to, and feel greater connection and rapport to who they spent their money on. However, I also demonstrate the boundary conditions of these findings. When individuals are spending money on something that is undesirable, such as paying for a competitor, increasing the pain of payment decreases interpersonal connection and rapport.