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<p> Coping with chronic illness often takes place within the context of the marital relationship. Among married couples, collaborative efforts to cope with one partner's chronic health condition have been linked to a range of positive outcomes, including better disease management among patients and greater emotional and interpersonal adjustment among patients and their spouses. Theory suggests that dyadic forms of coping with disease, such as collaboration, may be more beneficial when they are consistent with, or match, partners' appraisal of who is responsible (couple vs. patient) for managing the patient's disease. Very few studies, however, have examined this possibility. The current study of couples coping with one partner's diabetes addressed this research gap by investigating whether disease-related collaboration was more strongly related to better adjustment among partners who view diabetes management as their shared responsibility compared to those who view diabetes management as the patient's responsibility alone. Three major areas of adjustment were examined: 1) patients' disease management; 2) patients' and spouses' emotional well-being; and 3) patients' and spouses' relationship quality. Participants were 126 married couples in which one partner (the patient) was at least 55 years old and had been diagnosed with type 2 diabetes for at least one year and the other partner (the spouse) did not have diabetes. Patients and spouses separately completed a baseline interview and 24-day electronic daily diary. Predictor variables were derived from interviews; outcome variables were derived from daily diary records, and daily assessments of outcomes were aggregated across the entire diary period. Study hypotheses were tested using regression analysis and dyadic multilevel modeling. Results indicated that disease-related collaboration was linked to more positive psychosocial outcomes among patients in "shared responsibility" couples compared to patients "patient responsibility" couples. In contrast, collaboration had mixed associations with spouses' psychosocial outcomes, and none of these associations depended on partners' appraisal of responsibility for diabetes management. Overall, findings suggest that match between partners' collaborative efforts to cope with diabetes and their appraisal of disease management is important for the daily psychosocial adjustment of patients, but not for that of spouses. Implications for theory and intervention are discussed.</p>

The purpose of this study was to explore the relationship between green environments and resilience in older adults. It had two aims: 1) to explore the effect of a reflective garden walking program on resilience and three of its related concepts - erceived stress, personal growth initiative, and quality of life - in older adults, and 2) to explore the resilience patterns of older adults engaging in the reflective garden walking intervention. A parallel mixed method design using a quasi-experimental quantitative and a descriptive exploratory qualitative approach was used. Participants engaged in a six week reflective garden walking program. By the end of the program, resilience levels exhibited a slight increase and perceived stress levels a decrease. The qualitative data supported some beneficial effects of the reflective garden walking program, but also indicated that much of the participants' experience of resilience may have been related to the rich social and nature-filled environment in which already they lived. Patterns of resilience that appeared in the data were maintaining a positive attitude, belief in one's self in the face of one's vulnerabilities, woven into the social fabric, purpose and meaning, personal strength, and communities for growing older. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection