Successful Again through a Family Resilience Lens PDF
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Loma Linda University TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works Loma Linda University Electronic Theses, Dissertations & Projects 6-1-2012 Successful Again through a Family Resilience Lens A'verria Sirkin Martin Loma Linda University Follow this and additional works at:http://scholarsrepository.llu.edu/etd Part of theMarriage and Family Therapy and Counseling Commons Recommended Citation Martin, A'verria Sirkin, "Successful Again through a Family Resilience Lens" (2012).Loma Linda University Electronic Theses, Dissertations & Projects. 86. http://scholarsrepository.llu.edu/etd/86 This Dissertation is brought to you for free and open access by TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works. 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LOMA LINDA UNIVERSITY School of Science and Technology in conjunction with the Faculty of Graduate Studies ____________________ Successful Aging through a Family Resilience Lens by A’verria Sirkin Martin ____________________ A Dissertation submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in Marital and Family Therapy ____________________ June 2012 © 2012 A’verria Sirkin Martin All Rights Reserved Each person whose signature appears below certifies that this dissertation in his/her opinion is adequate, in scope and quality, as a dissertation for the degree Doctor of Philosophy. , Chairperson Brian Distelberg, Assistant Professor of Marriage and Family Therapy Winetta Baker, Assistant Professor of Marriage and Family Therapy Carmen Knudson-Martin, Professor and Director of PhD in Marriage and Family Therapy Lori Montross, Director of Psychology and Integrative Medicine, San Diego Hospice iii ACKNOWLEDGEMENTS I would like to thank Dr. Brian Distelberg for his unending patience, guidance, and detailed editing throughout the production of the doctoral dissertation; you were consistently available to provide clarity, mentoring, and support, which guided me through the dissertation process. In addition, I would like to thank Dr. Carmen Knudson- Martin for the ongoing support she has provided during my doctoral education; your expectations and confidence in my abilities has been a catalyst for my professional growth. Additionally, I would like to thank Dr. Winetta Baker and Dr. Lori Montross for taking the time to be part of my dissertation process and providing valuable feedback that has assisted in the development of a quality product. To Dr. Dilip Jeste and my colleagues at the University of California, San Diego Stein Institute for Research on Aging, thank you for providing me with quality data to pursue my areas of interest. A special thank you to Rebecca Daly for all of her support creating data sets, explaining the nuances of the data, assisting with data cleaning, and consistently providing encouragement. Additionally, I would like to thank Danielle Glorioso who has been an incredibly supportive friend and extremely flexible supervisor throughout my graduate studies. Most importantly I would like to thank my husband, Dale Martin, for all of his love and support during all of our life transitions and for the sacrifices that he has made so I could make my dreams a reality. A heartfelt thank you to my mother who has always been my biggest advocate and has encouraged me to keep going during the most difficult of times; thank you for always being there for me. Lastly, I would like to thank my close iv friend Mynda Ohs for walking with me through this journey and providing me with an outlet for frustration, a shoulder for tears, and a friend for a lifetime. v CONTENT Approval Page .................................................................................................................... iii Acknowledgements ............................................................................................................ iv List of Figures .................................................................................................................... xi List of Tables .................................................................................................................... xii List of Abbreviations ....................................................................................................... xiii Abstract ............................................................................................................................ xiv Chapter 1. Introduction ............................................................................................................. 1 Background ....................................................................................................... 2 Theoretical Framework ..................................................................................... 5 Objectives ......................................................................................................... 7 Phase I ..........................................................................................................7 Phase II.........................................................................................................9 Rationale ......................................................................................................... 10 Conclusion ...................................................................................................... 11 2. The Family Resilience Model ............................................................................... 13 Individual Resilience ...................................................................................... 14 Family Resilience ............................................................................................ 18 Resilience Model of Family Stress, Adjustment and Adaptation ..............19 Walsh’s Key Processes in Family Resilience ............................................21 Macro-Theories in Family Resilience ............................................................. 27 Family Stress Model ..................................................................................28 Family Systems Theory .............................................................................28 vi Developmental Perspective ........................................................................30 Life-Cycle Development ............................................................................30 Ecological Perspective ...............................................................................32 Family Resilience and Successful Aging ........................................................ 33 Conclusion ...................................................................................................... 36 3. Review of the Literature ....................................................................................... 38 Successful Aging ............................................................................................ 39 Outcome Variables for Successful Aging ....................................................... 44 Self-Rated Successful Aging .....................................................................45 Cognitive Health ........................................................................................46 Psychosocial Health ...................................................................................47 Physical Health ..........................................................................................50 Predictors of Successful Aging ....................................................................... 51 Key Processes in Family Resilience ..........................................................52 Control Variables for Successful Aging ......................................................... 54 Age .............................................................................................................54 Gender ........................................................................................................55 Socio-Economic Status ..............................................................................55 Education ...................................................................................................57 Lifestyle .....................................................................................................58 Conclusion ...................................................................................................... 58 4. Methods................................................................................................................. 60 Phase I ............................................................................................................. 60 Pre-Analysis Data Screening .....................................................................62 Exploratory Factor Analysis ......................................................................62 vii Confirmatory Factor Analysis....................................................................63 Phase II............................................................................................................ 66 Structural Equation Modeling ....................................................................66 Sample: The SAGE Study .............................................................................. 67 Sampling Methods for the SAGE Study ....................................................67 Enrollment and Initial Data Collection ......................................................70 Successful Aging through a Family Resilience Lens ..................................... 71 Measures ....................................................................................................71 Predictor Variables: Family Resilience Model ..........................................82 Outcome Variables: Successful Aging ......................................................86 Control Variables .......................................................................................87 Results ............................................................................................................. 92 Limitations ...................................................................................................... 93 Conclusion ...................................................................................................... 94 5. Implications........................................................................................................... 95 Phase I ............................................................................................................. 96 Phase II............................................................................................................ 99 Conclusion .................................................................................................... 100 6. Successful Aging through a Family Resilience Lens: Exploratory Factor Analysis and Confirmatory Factor Analysis ....................... 101 Abstract ......................................................................................................... 102 Introduction ................................................................................................... 103 Background ................................................................................................... 104 Methods......................................................................................................... 107 viii SAGE Study Population ..........................................................................107 Measures ....................................................................................................... 109 Brief Multi-Dimensional Measure of Religiousness/Spirituality ............111 Connor-Davidson Resilience Scale ..........................................................111 Emotional Support Scale ..........................................................................111 Life Orientation Test – Revised ...............................................................111 McArthur Ladder Scale (US) ...................................................................112 Perceived Stress Scale ..............................................................................112 Satisfaction with Finances .......................................................................112 Sociodemographic Characteristics ...........................................................113 Three Dimensional Wisdom Scale...........................................................113 Sample Characteristics .................................................................................. 113 Analyses ........................................................................................................ 115 Results ........................................................................................................... 116 Exploratory Factor Analysis ....................................................................116 Confirmatory Factor Analysis..................................................................124 Discussion ..................................................................................................... 127 Clinical Implications ..................................................................................... 129 Limitations .................................................................................................... 130 Conclusion .................................................................................................... 131 7. Aging and Resilience: The Role of Family and Individual Resilience in Successful Aging .................. 133 Abstract ......................................................................................................... 134 Introduction ................................................................................................... 135 Resilience ...................................................................................................... 137 Individual Resilience ...............................................................................137 Family Resilience .....................................................................................139 Successful Aging .......................................................................................... 143 ix
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