Perception of disease, dyadic coping, and the quality of life of oncology patients in the active treatment phase and their life partners: an approach based on the actor-partner interdependence model

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.

Prevalence and influencing factors of the dyadic psychological stress among patients with lung cancer and their family caregivers: a cross-sectional study

BACKGROUND

A lung cancer diagnosis has a huge impact on the psychological well-being of both patients and family caregivers. However, the current psychological stress status among dyads remains unclear. We aimed to determine the prevalence of anxiety and depression and identify the factors that influence patients with lung cancer and their caregivers.

METHODS

We conducted a cross-sectional study of 254 dyads of lung cancer patients and family caregivers from four tertiary hospitals in Hunan Province, China from January 2021 to June 2021. Besides, we used several instruments to collect data on depression, anxiety, illness perception, mindfulness, self-compassion, and dyadic coping. The independent samples t-test, analysis of one-way variance, Spearman's correlation analysis, and multiple linear regression analysis were employed.

RESULTS

Results showed that 21.3% of patients and 29.5% of caregivers experienced depression, while 22.0% of patients and 33.5% of caregivers reported anxiety. For lung cancer patients, patients' illness perception positively predicted their depression scores and patients' level of mindfulness and level of self-compassion negatively predicted their depression scores; patients' illness perception positively predicted their anxiety scores, and only living with children, patients' mindfulness and self-compassion levels were negatively predicted their anxiety scores. For caregivers, caregivers' level of illness perception and the number of other caregivers positively predicted their depression and anxiety scores, and caregiver's dyadic coping level, residence (county or town, and city), and caregiver's self-compassion level, were negatively predicted their depression and anxiety scores.

CONCLUSION

The prevalence of psychological stress response of lung cancer patients and caregivers was high and influenced by family living situation, number of persons assisting in care, place of residence, patient-caregiver relationship, levels of illness perception, mindfulness, self-compassion, and dyadic coping.

TRIAL REGISTRATION

ClinicalTrial.gov NCT06746948.

A feasibility study of a couple-based illness perception intervention for couples coping with colorectal cancer

PURPOSE

As a special psychological variable, illness perception significantly affects the cancer adaptions of colorectal cancer couples. No studies focus on facilitating cancer adaption by targeting the illness perception in colorectal cancer couples. This research attempted to explore the feasibility, acceptability, and potential effectiveness of an illness perception intervention program designed for couples with colorectal cancer, guided by a self-regulation common sense model.

METHODS

A single-group pilot study including pre- and post-testing was carried out with Chinese couples having colorectal cancer. Six sessions were delivered consecutively by researchers via in-person or telephone for couples. By calculating the rates of recruitment and retention, the feasibility of the intervention was analyzed. Intervention acceptability was evaluated by analysis of the post-intervention quantitative and qualitative data. Outcomes were described as illness perception, cancer-related communication problems, dyadic coping, quality of life, anxiety and depression, and benefit finding. Effect sizes were computed to assess the preliminary program effects.

RESULTS

The feasibility was confirmed by the recruitment (67.6%) and retention (82.6%) rates. The acceptability was endorsed by the reported participant satisfaction. Validating the program's preliminary effectiveness, the intervention program has moderate effect sizes (Cohen's d: 0.33-0.79) that boost illness perception and major cancer adjustment results for patients and their spousal caregivers.

CONCLUSIONS

The research proved that the couple-based illness perception intervention among colorectal couples was feasible, acceptable, and initially effective. To investigate this intervention program more thoroughly and apply it to a wider range of disease backgrounds, an extensive randomized controlled experiment is necessary.

Interrelation between dyadic coping and psychological resilience among cervical cancer couples in Northwest China: An Actor-Partner interdependence model

Objective

This study aimed to explore how dyadic coping (DC) influences the psychological resilience (PR) levels of patients with cervical cancer (CC) and their spouses.

Methods

From April to June 2024, this cross-sectional study involved 177 dyads of patients with CC and their spouses from the gynecology and oncology wards of two tertiary hospitals in Xinjiang. Data were collected through questionnaires on demographic information, clinical characteristics, the Resilience Scale, and the Dyadic Coping Inventory, all of which were self-report measures. The results were thoroughly analyzed utilizing the Actor-Partner Interdependence Mediation Model.

Results

The patients had a mean age of 49.94 ​± ​8.05 years (range: 26-64), with the majority being at stage II of CC. Their spouses had a mean age of 51.90 ​± ​8.02 years (range: 27-65). DC scores averaged 105.50 ​± ​23.98 for patients and 103.34 ​± ​22.26 for spouses, while PR scores were 63.51 ​± ​19.68 for patients and 67.44 ​± ​18.97 for spouses. Positive DC, which significantly correlated with higher levels of PR, was observed in patients with CC and their spouses (r ​= ​0.285, P ​< ​0.01; r ​= ​0.697, P ​< ​0.01). Conversely, a negative DC was associated with a lower PR (r ​= ​-0.187, -0.390; P ​< ​0.01). Positive DC by patients with CC and their spouses equally improves both partners' PR. In contrast, negative DC by patients with CC and their spouses affects only their own PR.

Conclusions

Patients with CC and their spouses' PR is significantly influenced by both partners' DC behaviors. When both partners used positive coping strategies, their PR increased. Conversely, negative DC behaviors affected only patients' PR, possibly because of self-concealment and communication barriers, which may explain the lack of a reciprocal impact. Nurses should identify couples at risk for negative DC and implement resilience interventions to encourage both partners' engagement in positive coping.

Family Sense of Coherence, Dyadic Coping, and Quality of Life in Young and Middle-Aged Patients With Advanced Lung Cancer and Spousal Caregivers: An Actor-Partner Interdependence Mediation Model

BACKGROUND

Cancer is now recognized as a dyadic stress that seriously impacts the mental and physical well-being of both patients and their spousal caregivers (SCs). Analyzing from a dyadic perspective whether and how dyadic coping and family sense of coherence (FSOC) affect the quality of life (QOL) of couples is crucial.

OBJECTIVE

To investigate the dyadic association between FSOC, dyadic coping, and QOL in young and middle-aged couples facing advanced lung cancer and to evaluate the mediating role of dyadic coping from a dyadic perspective.

METHODS

From October 2023 to April 2024, 202 dyads were recruited from 2 tertiary care hospitals in Tianjin, China. The participants' measurement indicators were evaluated using corresponding questionnaires. The procedure for dyadic analysis was based on the Actor-Partner Interdependence Mediation Model.

RESULTS

The actor effect of FSOC on the QOL was mediated by the dyadic coping of patients ( β = .100; 95% confidence interval [CI], 0.053-0.155; P = .001) and SCs ( β = .124; 95% CI, 0.059-0.193; P = .002). The partner effect suggested that patients' QOL may be indirectly impacted by SCs' FSOC through patients' dyadic coping ( β = .078; 95% CI, 0.038-0.127; P = .004).

CONCLUSIONS

The QOL, dyadic coping, and FSOC of young and middle-aged couples facing advanced lung cancer were dyadically interdependent. To enhance couples' QOL, strategies for intervention must be developed.

IMPLICATIONS FOR PRACTICE

This study offered a novel viewpoint on the relationship between QOL, dyadic coping, and FSOC and provided a theoretical foundation for the creation of dyadic intervention strategies meant to enhance cancer couples' QOL.

Interpersonal Process of Dyadic Coping in Rheumatoid Arthritis: A Perspective From the Australian Rheumatology Association Database

OBJECTIVE

Dyadic coping, the process of coping that transpires between couples challenged by one partner's illness, is an important predictor of disease adjustment and patient well-being. However, the extent of dyadic coping in rheumatoid arthritis (RA) remains unclear. This study examines the effect of dyadic coping on psychological distress and relationship quality from the perspectives of both participants with RA and their spouses.

METHODS

Participants and their spouses were invited to participate in an online survey study if they were aged ≥ 18 years and had lived together for more than a year. The survey included the Chronic Pain Grade Scale, Dyadic Coping Inventory, Depression Anxiety Stress Scale, and Dyadic Adjustment Scale. Participants and spouses completed the survey independently. The actor-partner interdependence model was used to analyze the dyadic data.

RESULTS

One hundred sixty-three couples participated. Our findings showed that participants who reported higher supportive dyadic coping reported lower depression, anxiety, and stress, and higher relationship quality, whereas participants who reported higher negative dyadic coping reported higher depression, anxiety, and stress, and lower relationship quality. Spouses who reported higher supportive dyadic coping reported higher relationship quality, but no effect on depression, anxiety, and stress was observed. In contrast, spouses who reported higher negative dyadic coping reported higher levels of depression, anxiety, and stress, and lower relationship quality.

CONCLUSION

Participants' and spouses' perceptions of supportive and negative dyadic coping closely influenced their psychological distress and relationship quality. Further, having a partner with RA also seemed to affect the spouse, especially when there was a negative dyadic coping pattern.

Illness perception and intimate relationships in patients with cervical cancer: the mediating role of dyadic coping

BACKGROUND AND OBJECTIVES

A good intimate relationship (IR) can relieve the psychological distress of patients with cervical cancer and promote a sense of well-being during stressful times. Researchers have found that IR is related to illness perception (IP) and dyadic coping (DC). Therefore, this study aimed to (1) describe the IR of patients with cervical cancer, (2) identify the relationships and pathways among IP, DC and IR in patients with cervical cancer and (3) explore the mediating role of DC between IP and IR in cervical cancer patients.

METHODS

A total of 175 patients with cervical cancer were recruited at a tertiary hospital in China from September 2021 to January 2023. The data were collected through a general demographic and disease-related information questionnaire, the Locke-Wallace Marriage Adjustment Test, the Revised Illness Perception Questionnaire of Cervical Cancer and the Dyadic Coping Inventory.

RESULTS

The mean score for intimate relationships was 107.78 (SD = 23.99, range 30-154). Pearson's correlation analysis revealed that intimate relationships were positively correlated with IP (personal control) and DC (stress communication, supportive DC, delegated DC and common DC) and were negatively correlated with IP (consequence, timeline acute/chronic, timeline cyclical and emotional representation) and negative DC. As for the results of the structural equation model, DC fully mediated the influencing effects of both positive and negative IP on IR.

CONCLUSIONS

The level of IR of patients with cervical cancer in China should be improved. DC has a significant mediating effect on the link between the IP and IR.

Interventions strategies and their efficacy in illness perceptions in patients with cancer: A systematic review and meta-analysis

PURPOSES

To identify intervention strategies for improving illness perception (IP) of cancer patients and/or family caregivers; and to examine the effects of IP interventions by meta-analysis.

METHODS

A systematic search was performed to identify literature that focused on improving the IP of cancer patients and/or family caregivers from the establishment of eight databases to August 2023. Manual screening was also applied. The IP intervention strategies for cancer populations were synthesized basing the CSM. Meta-analysis was conducted to assess the effects of IP interventions on health outcomes. Multiple subgroup analyses of the same intervention conditions were conducted to explore the optimal IP-focused intervention.

RESULTS

18 studies were included. 11 studies were conducted in a meta-analysis. No studies on family caregivers' IP were identified. Compared to general care, subgroup analysis revealed that IP interventions had favorable effects on cancer patients' IP as well as quality of life and other outcomes. Six IP intervention strategies (information support, cognitive reframing, emotion adjustment, active coping, effective appraisal, and self-social identification) were generated. Meta-analysis showed that compared with theory-less studies (Z = 8.64, p < 0.01) and single delivery formats (Z = 3.66, p < 0.01), the theory-based interventions (Z = 10.86, p < 0.01) and mixed delivery formats (Z = 7.15, p < 0.01) had higher positive effects on IP outcomes.

CONCLUSIONS

The positive outcomes of IP intervention focusing on cancer patients were highlighted. IP traits and patients' and their caregivers' needs in coping with specific cancer types should be explored before the intervention design. More IP interventions targeting cancer dyads are warranted to develop in the future.

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.

Relationship between family resilience and dyadic coping in colorectal cancer patients and their spouses, based on the actor-partner interdependence model

PURPOSE

To explore the relationship between dyadic coping and family resistance in colorectal cancer patients and their spouses.

METHODS

178 pairs of colorectal cancer patients and their spouses hospitalized in a three tertiary hospital in Changsha were selected from July 2021 to March 2022. The Family Resilience Assessment Scale and the Dyadic Coping Inventory were used to investigate, which relationship was analyzed by APIM.

RESULTS

The total score of patients' dyadic coping was 121.51 ± 16.8, and spouses' score was 123.72 ± 16.6. The total score of family resilience was 176.42 ± 16.0, and spouses' score was 182.72 ± 17.03. There was a significant positive relationship between dyadic coping and family resistance of colorectal cancer patients and their spouses (r > 0.7, P < 0.001). The positive dyadic coping of colorectal cancer patients and their spouses had a positive effect on their own and their spouses' family resilience and the effect was the same. The negative dyadic coping of colorectal cancer patients and their spouses had a negative impact on their own family resilience, and the overall model showed a subject pattern.

CONCLUSIONS

The level of family resilience of colorectal cancer patients and their spouses was affected by the level of dyadic coping. Medical workers should regard patients and their spouses as a whole and formulate mutually supportive coping strategies with family as the center, so as to increase positive coping behavior and enhance their family's ability to cope with cancer.

Self-efficacy as mediators of the association between dyadic coping and quality of life among spousal caregiver of patients with cervical cancer

Objective

This study aims to explore the influence of dyadic coping (DC) on the quality of life (QoL) of spousal caregivers for patients with cervical cancer and to investigate the mediating role of self-efficacy in this relationship.

Methods

A convenience sample of 206 spouses of cervical cancer patients from five hospitals in Jiangsu Province, China, was included in the study. The participants completed three instruments: the 12-item Short-Form Health Survey, the General Self-Efficacy Scale, and the Dyadic Coping Inventory. Structural Equation Modeling (SEM) was used to analyze the mediating effect of self-efficacy in the DC and QoL relationship.

Results

The study found a positive correlation between self-efficacy and DC. Self-efficacy partially mediated the impact of DC on QoL, accounting for 16% of the total effect. Self-efficacy played a mediating role in facilitating the indirect positive effects of DC on QoL.

Conclusions

Spousal caregivers of cervical cancer patients frequently experience a relatively low QoL. The results suggest that interventions aimed at enhancing DC among spousal caregivers should incorporate strategies to improve self-efficacy, given its mediating role in the positive relationship between DC and QoL.

Relationship Between Dyadic Coping with Anxiety and Depression in Infertile Couples: Gender Differences and Dyadic Interaction

BACKGROUND

This study aims to examine the relationship between anxiety and depression and dyadic coping in infertile couples, exploring gender differences and dyadic interactions in these associations.

METHODS

A cross-sectional study was conducted involving 288 couples recruited from the First Affiliated Hospital of Lanzhou University between November 2021 and November 2022. The Dyadic Coping Scale, Anxiety Scale, and Depression Scale were utilized to measure dyadic coping, anxiety, and depression, respectively. The Actor-Partner Interdependence Model was used to analyze the actor effect and partner effect.

RESULTS

Wives exhibited significantly higher anxiety and depression scores compared to husbands (p<0.001). No statistically significant difference was found in dyadic coping between wives and husbands. Positive dyadic coping in infertile couples had significant actor effects on anxiety and depression (p<0.05) and partner effects (p<0.05). Positive dyadic coping negatively predicted anxiety and depression of oneself and one's partner. Negative dyadic coping in infertile couples also had significant actor effects on anxiety and depression (p<0.05) and partner effects (p<0.05). Negative dyadic coping positively predicted anxiety and depression of oneself and one's partner.

CONCLUSION

The dyadic coping style of infertile couples has both actor and partner effects on their own and their partner's anxiety and depression. Anxiety and depression in infertile couples are influenced by their own and their partner's dyadic coping style, respectively. Therefore, dyadic coping serves as an important indicator for predicting psychological outcomes in these couples.