A new perspective on dyadic regulation in chronic illness: the dyadic regulation connectivity model

The dyadic associations among self-efficacy, dyadic coping, and health-related quality of life between high-risk pregnant women and spouses: a cross-sectional study

AIM

Health-related quality of life(HRQoL) is essential for high-risk pregnant women and their spouses. This study aimed to explore the dyadic associations (including actor and partner effects) among self-efficacy, dyadic coping, and HRQoL of high-risk pregnant women and their spouses and examine the mediating effect of dyadic coping.

METHODS

This cross-sectional study recruited participants from two Grade A tertiary hospitals in China from October 2022 to September 2023. A questionnaire including the Chinese version of the General Self-Efficacy Scale, Dyadic Coping Inventory, and 12 Short Form Health Survey Scales was used for the survey. The actor-partner interdependence mediation model was constructed to test dyadic associations and mediating effects.

RESULTS

In the actor effects, self-efficacy was positively associated with dyadic coping and HRQoL (P < 0.05). Regarding partner effects, pregnant women's self-efficacy was positively associated with spouses' dyadic coping and physical health (P < 0.05). Dyadic coping partially mediated the relationship between self-efficacy and HRQoL for both groups(P < 0.05).

CONCLUSION

The HRQoL of high-risk pregnant women and their spouses requires urgent attention. Enhancing self-efficacy and dyadic coping in these couples is related to their improved physical and mental health. Healthcare professionals should consider interactions between couples and include them together in perinatal care. Intervention programs for couples or families based on existing positive psychology and dyadic interventions may work together to improve the HRQoL of couples.

An Exploration of Common Dyadic Coping Strategies: A Perspective from Pakistani Couples Living with Chronic Conditions

This qualitative study was conducted to explore the common dyadic coping (DC) efforts of married couples, with a chronically ill partner. The sample for the study consisted of twelve couples chosen from Gujrat, Pakistan. The semi-structured interviews were conducted with the help of an interview guide and analyzed using thematic analysis (Braun and Clarke, 2006). The following four major themes were emerged: "common problem-focused DC," "common emotion-focused DC," "common religious DC," and "combined pattern of intimate relationships." The findings indicated that partners are not preferring relational coping resources for problem- and emotion-focused DC. However, the majority of couples participate in religious DC process in a complementary way to cope with stressful situation in the result of chronic illness. The study also indicated various indigenous factors, for example, socioeconomic status, family culture, lack of physical resource, and religious standpoints contributing in the lack of connectivity and sexual intimacy. To conclude, the results revealed that future research is required to investigate the patient and partner's relationship in greater depth, focusing on above-mentioned contextual factors.

Emotional Support from Care Recipients, Caring Relationship Quality, and Caregiving Self-Efficacy among Family Caregivers of Older Adults

We analyzed 756 family caregivers (mean age = 62.3 years), investigating how emotional support from older care recipients was linked to caregivers' self-efficacy through caring relationship qualtiy. Results indicate a significant positive association between emotional support and caregivers' self-efficacy (r = 0.207, p < .01). Caring relationship quality positively correlated with emotional support (r = 0.292, p < .01) and caregivers' self-efficacy (r = 0.141, p < .01). Controlling for socialdemographic and care-related factors, relationship quality partially mediated the association between emotional support from care recipients and caregivers' self-efficacy. This suggests that interventions supporting caregivers' self-efficacy may benefit from considering both care recipients and dyadic relationships.

Coping target checklist for home-based older adults living with disabilities and their spousal caregivers

BACKGROUND

The substantial rise in the population of older adults living with disabilities is a prominent concern, presenting a profound challenge for healthcare and social welfare systems. Community-based home care is seen as an effective approach to meet the care needs of older adults living with disabilities.

OBJECTIVE

To construct a coping target checklist for home-based older adults living with disabilities and their spousal caregivers.

METHODS

The initial draft was developed based on a comprehensive literature review, followed by two rounds of Delphi correspondence final version.

RESULTS

A comprehensive literature review resulted in the development of 7 modules, 20 topics. After round 1, 3 items were removed, 3 sections, 1 topic and 1 objective were new additions, 16 items were modified, split or combined. Four sections, 3 sections (Individual coping target for spousal caregivers, Individual coping target for older adults living with disabilities, and Shared coping target), 7 modules, 18 topics and 49 objectives were finally identified in round 2. The content of the list tool is derived from three perspectives: self-management strategies for older adults living with disabilities, caregiving strategies for spousal caregivers, and combined.

CONCLUSIONS

The coping target checklist was intended to be evidence-based and reflective of a practical direction for home-based older adults living with disabilities and their spousal caregivers living at home.

Dyadic coping and associated factors in women with high-risk pregnancy and their spouses: Do they interact?

OBJECTIVE

The objective of this study was to examine the present situation of dyadic coping in pregnant women with high-risk pregnancy and their spouses, as well as the relevant factors and the interactions between partners.

METHODS

From October 2022 to September 2023, a cross-sectional survey was undertaken, involving 460 pairs of pregnant women with high-risk pregnancy who were hospitalized for childbirth and their accompanying spouses. These participants completed self-assessments on dyadic coping, marital satisfaction, perceived stress, and self-efficacy through the completion of paper questionnaires. The collected data was then subjected to analysis utilizing correlation analysis and multiple linear regression. The actor-partner interdependence model (APIM) was then developed using the structural equation modeling(SEM) to test the binary association.

FINDINGS

Pregnant women preferred to utilize stressful communication, whereas their spouses employed supportive and delegated coping. Both external (such as education level, employment status, and medical insurance) and internal (such as marital satisfaction, perceived stress, and self-efficacy) factors were associated with pregnant women's dyadic coping. Education level and internal factors were also associated with the spouses' dyadic coping. In contrast to spouses, who can only have a partner effect on pregnant women through marriage satisfaction, all pregnant women's internal elements played the partner effect on the spouses' dyadic coping.

IMPLICATIONS

The study's findings help identify populations with inadequate coping ability. Promoting marital satisfaction, self-efficacy, and reducing perceived stress are associated with enhancing the dyadic coping ability of pregnant women with high-risk pregnancy and their spouses. It also suggests that antenatal care should intervene with pregnant women with high-risk pregnancy and their spouses as a whole, and emphasize collaborative coping and effective mutual support between couples rather than spousal support alone.

Quality of Life and Incidence of Clinical Signs and Symptoms among Caregivers of Persons with Mental Disorders: A Cross-Sectional Study

BACKGROUND

Caring for individuals with mental disorders poses significant challenges for caregivers, often leading to compromised quality of life and mental health issues such as stress, anxiety, and depression. This study aims to assess the extent of these challenges among caregivers in Greece, identifying which demographic factors influence their well-being.

METHOD

A total of 157 caregivers were surveyed using the SF-12 Health Survey for quality-of-life assessment and the DASS-21 questionnaire for evaluating stress, anxiety, and depression symptoms. t-tests, Kruskal-Wallis tests, Pearson's correlation coefficients, and regression analyses were applied to understand the associations between demographics, quality of life, and mental health outcomes.

RESULTS

The study found that caregivers, especially women and younger individuals, faced high levels of mental health challenges. Marital status, educational level, and employment status also significantly influenced caregivers' well-being. Depression was the most significant factor negatively correlating with the mental component of quality of life. The magnitude of the burden experienced by caregivers highlighted the urgency for targeted social and financial support, as well as strategic treatment programs that consider caregiver well-being.

CONCLUSIONS

Caregivers of individuals with mental disorders endure significant stress, anxiety, and depression, influencing their quality of life. Demographic factors such as age, gender, marital status, education, and employment status have notable impacts. Findings emphasize the need for society-wide recognition of caregivers' roles and the creation of comprehensive support and intervention programs to alleviate their burden, particularly in the context of the COVID-19 pandemic.

Impact of Cohabitation during Confinement on Older Adults' Negative Affect: What Specificity of Life as a Couple?

BACKGROUND

Social isolation is a risk factor for older adults' physical and psychological health. The beneficial effect of social connections in times of major health events is undeniable. Nevertheless, it remains unclear whether the positive effect of social support depends on the relationship type.

OBJECTIVES

This study aimed to investigate the influence of older adults' living conditions on the risk of experiencing negative affect during the first lockdown and post-lockdown.

DESIGN

An epidemiological study conducted during the COVID-19 crisis, at the time of the first lockdown, and 2 to 3 months following the lockdown.

SETTING

A subset sample of the PACOVID survey, a population-based survey of older adults.

PARTICIPANTS

Altogether, 277 participants were included into three groups depending on their living conditions: Group 1 "living alone" (n = 141); Group 2 "living with their spouse" (n = 106); Group 3 "living in cohabitation with relatives" (n = 30).

MEASUREMENTS

Mixed logistic regression analyses were used to study the change in the risk of experiencing negative affects over time according to the living conditions. The presence of negative affects during lockdown was assessed using three items from the 20-item Center for Epidemiologic Studies Depression Scale : «Do you feel sad?»; «Do you feel depressed?; «Do you feel lonely?

RESULTS

Participants living with their relatives or partner were significantly less likely to experience negative affect than those living alone during lockdown. Moreover, over time, only those living with their spouse had this lesser risk compared to those living alone.

CONCLUSIONS

These findings highlight the protective effect of social support over time and more specifically of that provided by the spouse. Couple functioning ought to be given consideration when studying the impact of health crisis situation on the mental health of older adults.

Mapping the contributions of dyadic approaches to couples' psychosocial adaptation to prostate cancer: a scoping review

INTRODUCTION

Prostate cancer is the second-most prevalent cancer diagnosis worldwide among males. Although prostate cancer affects the physical, sexual, and mental health of patients, the impact of prostate cancer on partners has also been increasingly recognized. Hence, taking a dyadic approach is of relevance. Moreover, there is evidence of the utility of dyadic approaches to the study of relational stress that chronic diseases such as prostate cancer can bring to couples, even though knowledge is sparse about prostate cancer.

OBJECTIVES

This scoping review aimed to map existing dyadic studies on the psychosocial adaptation of couples to prostate cancer.

METHODS

A systematic search of studies published from 2005 to November 2022 was conducted on electronic databases (PubMed, Cochrane Library, EBSCOHost, Scopus, and Web of Science) following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses-Extension for Scoping Reviews).

RESULTS

The review included 25 eligible studies from the initial 2514 articles retrieved. Overall, the results emphasized the interdependency between couple members and suggested how partners' adaptation influences patients' adaptation to prostate cancer and vice versa, regarding several psychosocial dimensions (eg, intimacy, quality of life).

CONCLUSIONS

This work can bring awareness to health care professionals to adopt a couples approach when managing prostate cancer whenever there is a partner, due to these interdependent influences. For researchers and future studies, this work can strengthen the relevance of dyadic approaches on how couples adapt to prostate cancer and explore which other dimensions influence these complex dynamics.

Parkinson's and the couple relationship: a qualitative meta-synthesis

OBJECTIVE

The aim was to synthesise the current qualitative literature on the impact of Parkinson's on the couple relationship, including individual and dyad studies.

METHODS

Noblit and Hare's meta-ethnography approach was applied; 19 studies were included in the review following a systematic search of four electronic databases. The studies included experiences of 137 People with Parkinson's and 191 partners.

FINDINGS

Analysis produced three themes: (1) Disruption of roles and responsibilities; (2) Challenges to communication and closeness; and (3) Grief, burden, and isolation. The themes are discussed with supporting extracts from the 19 included studies.

CONCLUSION

The findings highlight the challenges that couples experience and the individual and relational resources that support coping. Support should be individually tailored to each couple as the impact on the couple may change in response to individual and contextual factors. This review adds further evidence to the case for relationally focused multidisciplinary team input at all stages of Parkinson's disease.

The dyadic regulation approach of coping and illness representations in female cancer patients and their partners

Purpose

Adjustment to any illness is a 'dyadic' process whereby patients and their partners mutually determine each other's perceptions, behaviours, and well-being. The present study explored the association between dyadic coping strategies and illness representations in newly diagnosed female cancer patients and their partners.

Methods

The sample consisted of 92 female cancer patient-partner pairs from 3 oncology hospitals in Greece and Cyprus. The Actor Partner Interdependence Model was applied to test for dyadic regulation effects.

Results

The findings revealed that patients' evaluations of dyadic coping were related to their own illness representations and, in some cases, to partners' illness representations of control. However, partner evaluations of dyadic coping were not associated with either patients' or their own illness representations. Relationship satisfaction did not moderate the relationship between dyadic coping and illness representations.

Implications

The study suggests that patients' perceptions of support provided by themselves and their partners play a significant role in shaping their illness representations. Future research could delve into the underlying reasons for the observed differences in the impact of dyadic coping on illness representations between patients and partners, considering factors such as gender roles and specific gender-related issues.

Dyadic analysis of illness perceptions among individuals with stroke and their caregivers: effects on activity engagement in community living

PURPOSE

To explore the relationship between activity engagement and dyadic illness perceptions of community-dwelling individuals with stroke and their caregivers.

METHODS

We performed a secondary analysis on a cross-sectional study encompassing eight rehabilitation settings. Participants were recruited from June to December 2019 via the distribution of flyers, use of admission databases, and direct onsite interactions. Activity engagement of individuals with stroke was measured by the Assessment of Life Habits. Dyadic illness perceptions were measured using the Stroke-Specific Illness Perceptions Questionnaire-Revised.

RESULTS

Data from 202 dyads of individuals with stroke (mean age 61.3 ± 8.3 years; 76.7% male; stroke duration 314.3 ± 170.5 days), and caregivers (mean age 52.6 ± 11.6 years; 73.3% female) were analyzed. Results show that individuals with stroke who shared similar optimistic illness perceptions with their caregivers concerning the consequences of stroke had a higher level of activity engagement (ΔR2 = .020, F(2,193) = 5.42, p = .005). Gender differences were found in the dyadic illness perception components concerning acute/chronic and cyclical timeline (ΔR2 = .017, F(2,191) = 4.72, p = .01; ΔR2 = .02, F(2,190) = 3.45, p = .034) and illness coherence (ΔR2 = .012, F(2,191) = 3.42, p = .035).

CONCLUSIONS

Illness perceptions and post-stroke activity engagement with gender differences should be considered at a dyadic level, as the individuals with stroke and their caregivers influence each other's beliefs.

YES, WE COPE: Dyadic Coping as a Mediator Between Perceived Relationship Quality and Emotional Representation of COVID-19

Background

The COVID-19 pandemic has brought about social changes that have impacted the functioning and dynamics of couples in a romantic relationship, arising from the overwhelming amount of added stress they have endured. Specifically, the divorce rate in Portugal has increased after lockdown, which underscores the adverse consequences of COVID-19 on couples. A lower quality of the couple's relationship may worsen the emotional representation of COVID-19; however, the literature suggests that perceived partner dyadic coping responses have a great influence on adverse events. The aim of the present study was to assess the mediating role of partner coping in the association between relationship quality and emotional representation of COVID-19. We also sought to observe whether the length of the relationship moderates this association.

Methods

Participants (N = 528) were adults living in Portugal (84.7% female) currently in a romantic relationship with their current partner for at least 1 year. Online data collection.

Results

We found that relationship quality predicted COVID-19 emotional representation, but this association was fully mediated by total dyadic coping. This association was especially significant in couples with a shorter length of time in the relationship.

Conclusions

We point out the importance of dyadic coping as a protective factor against emotional distress to cope with the ongoing stressors associated with the COVID-19 pandemic. These data suggest the need for relationship education programs that promote positive coping between partners.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-023-10379-4.

Dyadic Interdependence in Non-spousal Caregiving Dyads’ Wellbeing: A Systematic Review

Caregiving dyads (i.e., an informal caregiver and a care recipient) work as an interdependent emotional system, whereby it is assumed that what happens to one member of the dyad essentially happens to the other. For example, both members of the dyad are involved in care giving and care receiving experiences and therefore major life events, such as a serious illness affect the dyad and not only the individual. Consequently, informal caregiving may be considered an example of dyadic interdependence, which is “the process by which interacting people influence one another’s experience.” This systematic review aimed to synthesize studies of dyadic interdependence, specifically in non-spousal caregiving dyads (e.g., adult children—parents, siblings, other relatives, or friends). Electronic databases (PsycINFO, Pubmed, and CINAHL) were systematically searched for dyadic studies reporting on interdependence in the emotional and relational wellbeing of non-spousal caregiving dyads. A total of 239 full-text studies were reviewed, of which 14 quantitative and qualitative studies met the inclusion criteria with a majority of dyads consisting of adult daughters caring for their older mothers. A narrative synthesis suggested mutual influences between non-spousal caregiving dyad members based on: (1) associations between intrapersonal (e.g., psychological functioning) and interpersonal (e.g., relationship processes) variables and emotional and relational wellbeing of the dyad; (2) associations between care context variables (e.g., socio-demographics and care tasks) and emotional and relational wellbeing of the dyad; and (3) patterns of covariation between caregivers’ and care recipients’ wellbeing. Evidence supporting dyadic interdependence among non-spousal caregiving dyads shed light on the ways dyad members influence each other’s wellbeing while providing and receiving care (e.g., via the exchange of support). Future studies investigating mutual influences in dyads, should differentiate subsamples of caregivers based on relationship type, and adopt dyadic and longitudinal designs.

The Interplay Between Individual and Dyadic/Common Coping in Female Patients With Cancer

Abstract. Both individual and dyadic coping behaviors are important for adaptation to a severe illness. However, there is a theoretical controversy regarding the interplay between these two forms of coping. In this cross-sectional study, we examined (a) whether recently diagnosed cancer patients engage mostly with one form of coping or whether they use both in parallel; (b) the relationship of individual and supportive dyadic/common coping to emotional well-being and relationship satisfaction. Participants were 92 women recently diagnosed with cancer (mostly breast cancer) and receiving medical treatment ( Mage = 49.37 years; SD = 10.52). All had been living with their partner for at least 2 years. The parallel use of individual and supportive dyadic/common coping behaviors was frequently reported. Individual and dyadic/common coping proved to be related to each other ( p < .01), and both were related to emotional well-being and relationship satisfaction ( p < .05). The combination of high individual and high supportive dyadic/common coping was associated with greater satisfaction with the relationship ( p < .01). Patients probably use individual and dyadic coping behaviors in concert to better deal with the different aspects of their illness experience. Both types of coping should be considered in the context of personalized intervention programs to facilitate adaptation to cancer.

Self-efficacy, psychological distress, and marital quality in young and middle-aged couples facing lymphoma: The mediating effect of dyadic coping

OBJECTIVE

This study explored the mediating role of dyadic coping between self-efficacy, psychological distress and marital quality among young and middle-aged couples facing lymphoma.

METHODS

A total of 243 couples in which the patients were lymphoma were recruited to complete Dyadic Coping Inventory, Locke-Wallace Marital Adjustment Scale for both. And Strategies Used by People to Promote Health, Fear of Progression Questionnaire-Short Form for patients; General Self-Efficacy Scale and Hospital Anxiety and Depression Scale for spouses. We used the statistical programs SPSS 20.0 and SPSS Amos 20.0 for data analysis.

RESULTS

There were significant correlations between patient-spouse's dyadic coping and marriage quality scores. The patients' dyadic coping scores were significantly associated with their self-efficacy, fear of cancer recurrence scores, marriage quality, their spouse's self-efficacy, and marriage quality. The spouses' dyadic coping scores were significantly associated with their self-efficacy, anxiety, and marriage quality. The actor-partner interdependence mediation model analysis mediator effect of dyadic coping in the relationship between self-efficacy, psychological distress, and marriage quality had a good fit, with χ² /df = 17.106, p = 0.194; root mean square error of approximation = 0.036; GFI = 0.992; CN = 243.

CONCLUSIONS

For both patient and spouses, dyadic coping mediated impact of self-efficacy on marriage quality of themselves and their spouses, and individuals' dyadic coping mediated impact their psychological distress on marriage quality of themselves and spouses. The study highlighted the need for couple-based interventions and including strategies combined with individual and dyadic therapy for both partners.