A couple-based dyadic coping intervention for couples coping with colorectal cancer: A pilot feasibility study

Symptoms associated with concurrent chemoradiotherapy in patients with cervical cancer: Application of latent profile analysis and network analysis

Objective

This study aims to explore symptom subgroups and influencing factors among patients undergoing concurrent chemoradiotherapy (CCRT) for cervical cancer, to construct a symptom network, and to identify core symptoms within the overall sample and its various subgroups.

Methods

A cross-sectional survey was conducted with 378 patients undergoing CCRT for cervical cancer from June 2023 to May 2024 at a tertiary hospital in Anhui Province. Participants completed the General Information Questionnaire, the Symptom Assessment Scale for Patients Undergoing CCRT for Intermediate and Advanced Cervical Cancer, and the Dyadic Coping Inventory. Latent profile analysis (LPA) identified symptom subgroups, while multivariate logistic regression examined influences on these subgroups. Symptom networks were developed using R language to analyze centrality indices and identify core symptoms.

Results

Patients were classified into three subgroups: low symptom burden (n ​= ​200, 52.91%), moderate symptom burden with prominent intestinal response (n ​= ​75, 19.84%), and high symptom burden (n ​= ​103, 27.25%). Multivariate logistic regression indicated that age, tumor stage, chemotherapy frequency, and dyadic coping (DC) were predictive of subgroup membership (P ​< ​0.05). Network analysis revealed sadness (r s  ​= ​1.320) as the core symptom for the overall sample, nausea (r s  ​= ​0.801) for the low symptom burden group, and vomiting (r s  ​= ​0.705, 0.796) for both the moderate symptom burden with intestinal response prominence group and the high symptom burden group.

Conclusions

Three symptom subgroups exist among patients undergoing CCRT for cervical cancer, with sadness, nausea, and vomiting identified as core symptoms. Health care professionals should provide individualized symptom management tailored to these subgroups.

Feasibility and preliminary efficacy of a systematic transaction model-guided dyadic coping nursing intervention for patients with breast cancer and their spousal caregivers: A pilot study

Objective

This study aimed to assess the feasibility, acceptability, and preliminary efficacy of a Systematic Transaction Model (STM)-guided dyadic coping nursing intervention for patients with breast cancer and their spouses.

Methods

A single-arm, pre-test/post-test pilot study was conducted at a tertiary hospital in Wuxi, China, recruiting 28 breast cancer patient-caregiver pairs. Each dyad participated in six hybrid intervention sessions. Paired t-tests were used to evaluate pre- and post-intervention changes, and effect sizes were calculated. Feasibility was assessed by recruitment and retention rates, acceptability via the Client Satisfaction Questionnaire-8 (CSQ-8), and preliminary efficacy through measures of body image, dyadic coping, post-traumatic growth, and marital satisfaction.

Results

All 28 dyads completed the intervention. Patients showed small-to-moderate improvements in body image, post-traumatic growth, dyadic coping, and marital satisfaction (d ​= ​0.4-0.5, P ​≤ ​0.022), with clinically meaningful changes observed in 39%-68% of patients. Spousal caregivers also demonstrated improvements in post-traumatic growth, dyadic coping, and marital satisfaction (d ​= ​0.3-0.6, P ​≤ ​0.033), with 36%-46% showing clinically important differences.

Conclusions

This pilot study supports the feasibility and initial efficacy of an STM-guided dyadic coping intervention, which may benefit breast cancer patients and their spouses as a unit. Further large-scale trials are recommended to validate these findings.

Trial registration

China Clinical Trial Registry (ChiCTR2400083416).

Delineating the dyadic coping process in HIV serodiscordant male couples: a dyadic daily diary study using the common fate model

PURPOSE

Although HIV is likely to be a couple-based issue among serodiscordant male couples due to cross-partner transmission, little is known about how they cope with HIV as a team. This study aimed to examine the dyadic coping process among serodiscordant couples.

METHODS

A dyadic daily diary study was used to answer our research questions. One hundred and forty-one Chinese HIV serodiscordant male couples completed measures of we-disease appraisal, common dyadic coping, quality of life, and relationship satisfaction for 14 consecutive days and ART adherence, attitudes toward PrEP, quality of life, and relationship satisfaction at a 2-month post-diary assessment. Computations were based on the common fate mediation model, using multilevel structural equation modeling.

RESULTS

Regarding direct effect, we-disease appraisal was associated with both partners' quality of life at the between-person level, post-diary quality of life, attitudes toward to PrEP, relationship satisfaction at both levels as well as post-diary relationship satisfaction. Common dyadic coping mediated the association between we-disease appraisal and both partners' quality of life as well as relationship satisfaction at the within-person level. However, no mediating effects were observed at the between-person level.

CONCLUSIONS

Our findings highlighted the importance of the daily dyadic coping process among HIV serodiscordant couples. Future interventions should direct resources toward fostering a shared disease appraisal and training couples in common dyadic coping strategies for their daily lives.

Resilient together for dementia: A qualitative study of couples' treatment preferences to address distress early after diagnosis

BackgroundDespite technological advances and earlier and more confident diagnoses, there is a lack of post-diagnosis support for couples navigating the challenges of early dementia. Clinically elevated emotional distress is common for both partners after diagnosis, and interferes with the health, relationships, and adjustment of both partners if not addressed.ObjectiveOur objective was to gather in-depth information on couples' preferences to inform the development of a proposed dyadic intervention addressing emotional distress early (within 6 months) after one partners' receipt of a dementia diagnosis.MethodsWe recruited couples after a recent dementia diagnosis (N = 16 dyads; 32 participants) from a large academic medical center via direct provider referrals for 60-min virtual dyadic interviews. Data were analyzed using a hybrid inductive-deductive approach to thematic analysis.ResultsWe identified themes within 3 a-priori determined domains. For dyadic intervention format (domain 1), couples preferred to participate in sessions together and to have flexible options for telehealth and in-person participation. Preferences for intervention content (domain 2) included information on dementia, skills to reduce distress and promote resiliency, and support to communicate about the diagnosis and related stress. Barriers and facilitators (domain 3) included denial or hesitation, resource constraints, and interests in learning skills and connecting to others.ConclusionsWe gathered comprehensive information that could be used to adapt existing dyadic interventions and to tailor support to match couples' preferences early after dementia diagnoses. Early interventions should prioritize flexible delivery of information and skills to couples to support adaptive coping following dementia diagnoses.

Parent-adolescent family resilience and psychological adjustment in chronically ill adolescents: An actor-partner interdependence mediation model

AIMS

This study explored the relationships between family resilience, dyadic coping and psychological adjustment among adolescents with chronic illnesses and their parents. The actor-partner interdependence mediation model was used to validate the mediating role of dyadic coping in the relationship between family resilience and psychological adjustment.

DESIGN

This is a cross-sectional study.

METHODS

A total of 318 parent-adolescents dyads were recruited from three paediatric hospitals in Wenzhou, Hangzhou, Shanghai city, China, between June 2022 and August 2023. The parents had a mean age of 41.62 years, and the adolescents had a mean age of 12.66 years. Participants independently completed a self-report questionnaire assessed family resilience, dyadic coping and psychological adjustment. Data analysis was conducted using the actor-partner interdependence mediation model.

RESULTS

The findings suggest that in the actor effects, family resilience directly influenced psychological adjustment, and family resilience is related to psychological adjustment through positive dyadic coping. In the partner effect, parents' family resilience influenced adolescents' psychological adjustment through the parents' positive dyadic coping. Similarly, adolescents' family resilience influenced parents' psychological adjustment through both parents' positive dyadic coping and adolescents' negative dyadic coping. Additionally, there was a partner effect between parents' family resilience and adolescents' psychological adjustment.

CONCLUSION

This study demonstrated the importance of developing effective dyadic interventions based on family resilience or positive dyadic coping strategies to improve the mental health of adolescents with chronic illnesses and their parents.

IMPACT

The mediating role of dyadic coping in the relationship between family resilience and psychological adjustment among adolescents with chronic illnesses and their parents was demonstrated. Future psychosocial interventions should focus on increasing parents' positive dyadic coping strategies and improving adolescents' negative dyadic coping strategies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

A feasibility study of a coping-focused, couple-based family resilience intervention (CCFRI) in supporting couples experiencing colorectal cancer

PURPOSE

Colorectal cancer patients and their spousal caregivers possess the potential to build family resilience and navigate the challenges of the cancer journey. However, few intervention studies have focused on enhancing family resilience among colorectal cancer couples. This study aimed to evaluate the feasibility, acceptability, and preliminary effects of a coping-focused, couple-based family resilience intervention guided by the Walsh Family Resilience Model.

METHODS

A one-group, six-week pre- and post-intervention study was conducted. Six intervention sessions were delivered either face-to-face or by telephone. Quantitative data were collected using self-report questionnaires assessing family resilience, hope, family sense of coherence, spiritual well-being, perceived social support, and couple communication quality. Qualitative data were gathered through semi-structured interviews with open-ended questions and note-taking.

RESULTS

A total of 24 colorectal cancer patient-spousal caregiver dyads were initially recruited for the intervention, but only 19 couples completed all six intervention sessions. Feasibility outcomes indicated a couple recruitment rate of 68.6% and a retention rate of 79.2%. Small to moderate improvements were identified in family resilience, hope, family sense of coherence, perceived social support, and couple communication quality, though spiritual well-being showed limited change. The majority of participants were satisfied with the intervention and provided valuable suggestions for future improvements.

CONCLUSIONS

This study showed that the coping-focused, couple-based family resilience intervention may effectively support colorectal cancer couples, improving adaptation and coping. Future research with larger samples is needed to confirm long-term effects and further refine intervention components.

Couple-based group intervention for social isolation in colorectal cancer couples: A pilot study

PURPOSE

Colorectal cancer (CRC) patients and their spousal caregivers frequently experience social isolation. Nevertheless, interventions targeting social isolation mitigation in CRC dyads remain limited. This pilot study aimed to evaluate the feasibility, acceptability, and preliminary effects of couple-based group intervention for alleviating social isolation in Chinese CRC couples.

METHODS

The study utilized a single-arm pre-post intervention design, comprising a structured six-session group program that blended face-to-face and online components. Feasibility was evaluated through recruitment and retention rates. Acceptability was assessed via a mixed-methods approach combining post-intervention surveys with open-ended interviews. Outcome measures included validated instruments: the General Alienation Scale, Lubben Social Network Scale-6, Medical Outcomes Study 12-item Short-Form version 2, Dyadic Coping Inventory, and Perceived Social Support Scale.

RESULTS

The program demonstrated feasibility with a 62.5 % recruitment rate and an 85 % retention rate. Quantitative and qualitative data supported its acceptability through CRC couples' overall satisfaction. Effectiveness was evidenced by medium effect sizes (Cohen's d = 0.54-0.59) on both subjective and objective measures of social isolation and most secondary outcomes in CRC patients and spousal caregivers. Notably, spousal caregivers showed borderline significant improvements in physical health (d = 0.50, P = 0.056) and social support (d = 0.49, P = 0.063).

CONCLUSION

The feasibility, acceptability, and preliminary effects of the couple-based group intervention for social isolation in CRC couples were confirmed. These findings warrant a large-scale randomized controlled trial to rigorously evaluate the intervention's long-term effectiveness and potential for clinical implementation.

Social isolation profiles and conditional process analysis among postoperative enterostomy patients with colorectal cancer

PURPOSE

This study aimed to identify social isolation latent profiles and analyze the specific mechanisms in which social support, resilience, and posttraumatic growth associated social isolation from the perspective of positive psychology. Suggestions were offered to improve the mental health status of postoperative enterostomy patients with colorectal cancer.

METHODS

This was a cross-sectional survey. From December 2022 to September 2023, convenience sampling was used to select 303 enterostomy patients from three hospitals in Guangzhou. A paper questionnaire was used to investigate their levels of social support, resilience, posttraumatic growth, and social isolation. T-test, ANOVA, Pearson Correlation Analysis, Latent Profile Analysis and Conditional Process Analysis were used to analyze the correlation between variables.

RESULTS

(1) Education level, occupation, family monthly income per capita and times of changing enterostomy bag per week were significantly associated with social isolation. (2) Social isolation of patients included low alienation-fluctuation group (Class 1, 13.9%), medium group (Class 2, 64.0%), high alienation-low meaning group (Class 3, 22.1%). (3) Social isolation was negatively correlated with social support, resilience, and posttraumatic growth (P < 0.001). (4) Resilience played a mediating role in the association between social support and social isolation. (5) The second half path of the mediation model was moderated by posttraumatic growth.

CONCLUSIONS

Clinical staff, community personnel and family members should pay attention to the potential differences in social isolation experienced by patients. Suitable psychological strategies should be employed to enhance resilience, promote posttraumatic growth, for improving the patients' mental health levels and help them return to society.

Using expressive writing to improve cancer caregiver and patient health: A randomized controlled feasibility trial

PURPOSE

This study examined the feasibility and preliminary efficacy of Expressive Writing (EW) in improving informal cancer caregiver (IC) and patient health, and enhancing ICs' emotion regulation.

METHOD

Fifty-eight breast cancer ICs and patients participated in a randomized controlled feasibility trial of remote EW. ICs were randomly assigned to the EW or control group and completed 3 weekly writing sessions. ICs and patients completed health and emotion regulation assessments at baseline, intervention completion, and 3 months post-intervention. Screening, recruitment, assessment process, randomization, retention, treatment adherence, and treatment fidelity were computed for feasibility. Effect sizes were calculated using the PROMIS Depression Short Form, RAND Short Form 36 Health Survey, Breast Cancer Prevention Trial Hormonal Symptom checklist, healthcare utilization, and the Emotion Regulation Questionnaire for efficacy.

RESULTS

Of the 232 interested individuals, 82 were screened, and 60 enrolled (6 monthly). Two individuals withdrew and 19 were lost to follow-up, leaving 39 individuals. ICs completed at least one assessment and two sessions, and patients completed at least two assessments. All sessions were administered as intended. ICs generally followed instructions (88%-100%), wrote the full time (66.7%-100%), and were engaged (M(SD) = 3.00(1.29)-4.00(0.00)). EW had small-to-medium effects in improving IC health (g = -0.27-0.04) and small-to-large effects in improving patient health (g = -0.28-0.86). EW moderately decreased suppression (g = 0.53-0.54) and slightly increased reappraisal, at least 3 months post-intervention (g = -0.34-0.20).

CONCLUSIONS

Remote EW may be feasible with cancer ICs and improve cancer IC and patient health. However, it can benefit from additional retention strategies and rigorous testing.

TRIAL REGISTRATION

CenterWatch Clinical Trials Listing Service (#TX217874); ClinicalTrials.gov (#NCT06123416).

A couple-based dyadic coping intervention for colorectal cancer patient-spousal caregiver dyads: A randomized controlled study

PURPOSE

To evaluate the clinical effects of a couple-focused dyadic coping intervention in colorectal cancer (CRC) couples.

METHODS

The study was a single-blinded randomized controlled study which 226 CRC couples were recruited and randomized to either the intervention (N = 113) or the control (N = 113) group. All couples received usual care while the six-week dyadic coping intervention was provided to the intervened couples in psycho-education and skill training methods through face-to-face combined with telephone formats. Measurement data, including dyadic coping, marital satisfaction, quality of life and psychological well-being were collected at pre- and post-intervention periods. And multilevel model (MLM) was applied to analyze the effects of the intervention and the role tendency.

RESULTS

A total of 173 couples completed the program and post-intervention evaluation. The retention rate was 76.5%. Results from MLM showed that the dyadic coping intervention is effective in promoting levels of dyadic coping (P < 0.001), marital satisfaction (P = 0.042), mental health (P = 0.006), and positive psychological well-being (P < 0.001), and alleviating depression (P = 0.015) in CRC couples. For role tendency, the intervention found to be more effective in CRC spousal caregivers' positive psychological well-being compared to the patients (P = 0.037).

CONCLUSION

The couple-based dyadic coping intervention is effective in promoting dyadic coping and improving psychological adjustment in CRC couples. More studies were needed to further evaluate the program and its long-term efficacy in the future. In addition, given the positive effects of the intervention, clinical nursing stuffs may consider implementing such intervention in their routine work while caring for CRC couples.

The Illness Perceptions and Coping Experiences of Patients with Colorectal Cancer and Their Spousal Caregivers: A Qualitative Study

(1) Background: Illness perception (IP) is an important psychological construct for couples dealing with cancer, which impacts health outcomes and the psychological adjustment to cancer. More research is needed to explore the traits of IP and the efforts of couples coping with cancer. Thus, this study was designed to explore the coping experiences and features of the IPs of couples dealing with cancer. (2) Methods: A total of 24 patients with colorectal cancer (CRC) and 20 spousal caregivers (SCs) participated in semi-structured interviews. All interviews were recorded digitally, transcribed, and analyzed by using an inductive thematic analysis. (3) Results: Two themes (individualized and predominant IP; IP sharing and restructuring) were developed. A preliminary framework was formulated to illustrate the relations among subthemes and the relations between themes with an adjustment of a positive IP to CRC. In this framework, based on multiple sources and factors, the natural disparities formed the IPs of the partners of couples and determined the incongruence of IPs. The effects of IP incongruence on lives under the disease guided the three directions of coping approaches (i.e., information and available support, appropriate disclosure and reflection, and leaving the CRC diagnosis behind) which were adopted by couples dealing with CRC to share and restructure the IP with their spouses for effective dyadic coping. (4) Conclusions: This study provides insights to healthcare providers into the experiences of couples dealing with CRC and the development of couple-based IP intervention programs: (a) it initially provides adequate factual knowledge for enhancing beliefs in the ability to control illness, (b) encourages illness-centered conversations and disclosure regarding thoughts and emotions for promoting positive congruence of IP between the partners of couples dealing with a hard dilemma, and (c) guides couples to perceive positive changes and explore the illness's meaning. Understanding each theme of personalized IP and adopting effective IP coping approaches can help guide couples dealing with CRC to efficiently promote constructive IP and better health outcomes.

A couple-based unmet supportive care needs intervention for colorectal cancer couples: A preliminary feasibility study

PURPOSE

To support colorectal cancer couples cope with cancer, we developed a couple-based unmet supportive care needs intervention program guided by the Supportive Care Needs Framework and examined the feasibility, acceptability, and initial effects of the unmet supportive care needs program.

METHODS

The design of a pre-and post-intervention study was conducted among Chinese colorectal cancer couples. The intervention was delivered in five sessions through in-person and telephone interventions combined. To measure program feasibility through recruitment and retention rates, and to test program acceptability through quantitative and qualitative post-intervention program assessments. The complete data (N = 20 pairs) were used to calculate effect sizes to assess the initial intervention effect.

RESULTS

There was evidence of the feasibility of the intervention program in terms of recruitment (66.7%) and retention (83.3%) rates. Participants' satisfaction with the program also attested to its acceptability. The intervention (Cohen's = 0.15-0.56) had a small-moderate effect size in improving unmet supportive care needs and most cancer-adapted outcomes for colorectal cancer couples, validating the initial effect of the program.

CONCLUSIONS

The unmet supportive care needs program is feasible, acceptable, and preliminarily effective in supporting Chinese colorectal cancer couples to improve unmet supportive care needs and cancer adaptability, as provided by this study.

Dyadic coping, resilience, and quality of life in young and middle-aged couples after gynecologic cancer: An actor-partner interdependence mediation model

PURPOSE

To examine the effects of dyadic coping on quality of life (QoL) and the mediating role of resilience in these effects among young and middle-aged couples after gynecologic cancer (GC).

METHODS

A cross-sectional study was conducted between July 2022 and June 2023 from one tertiary hospital in Wuhan, China. 240 pairs of young and middle-aged GC couples were recruited. The demographic and clinical characteristics questionnaire, the Dyadic Coping Inventory, the 10-item Connor-Davidson Resilience Scale, and the 12-item Short-Form Health Survey were used to collect data. The process of dyadic analysis was based on the actor-partner interdependence mediation model.

RESULTS

GC patients' dyadic coping had an actor effect on both their own physical and mental QoL, while spouses' dyadic coping only exerted an actor effect on their own mental QoL. The mediating effects of resilience on the relationship between dyadic coping and QoL were identified in dyads. Moreover, spouses' dyadic coping could indirectly influence patients' QoL through their own and patients' resilience.

CONCLUSION

The findings confirm the dyadic relationships between dyadic coping, resilience, and QoL among young and middle-aged couples facing GC. These results suggest that it is necessary to develop couple-based interventions to improve dyadic coping and resilience, thus enhancing the QoL of both members.

An integrated intervention programme for couples facing colorectal cancer: A randomized controlled trial

BACKGROUND

Under the guidance of a preliminary Live with Love Conceptual Framework, a Caring for Couples Coping with Colorectal Cancer (4Cs: CRC) programme was designed specifically for colorectal cancer couples. The objectives of this study included examining the efficacy of the programme for couples adapting to colorectal cancer and comparing the effects of different intervention delivery modes (online, face-to-face and blended) on couple outcomes.

METHODS

A four-arm randomized controlled trial was conducted among Chinese colorectal cancer couples. Couples were randomly assigned to an online intervention, a face-to-face intervention, a blended intervention or a control group. Self-efficacy, dyadic coping, communication and dyadic outcomes (physical and mental health, negative and positive emotions and marital satisfaction) were evaluated at baseline and 6 weeks later. Analysis of variance (ANOVA) and repeated measures ANOVA were employed to assess between-group differences and within-group effects in the four groups, respectively.

RESULTS

A total of 179 couples completed the 6-week study and post-study assessments. The intervention showed generally medium-to-large effects across multiple measured outcomes, including self-efficacy, dyadic coping, communication, mental health, negative emotions and positive emotions for both patients and spouse caregivers. Additionally, interventions delivered through different modes produced equally significant effects on couple outcomes.

CONCLUSIONS

The integrated intervention programme is effective in improving cancer adaptation in colorectal cancer couples. Long-term follow-up and a mix of quantitative and qualitative assessments are crucial for further evaluation of the programme.

TRIAL REGISTRATION

Retroactive registration is under review.