Spousal collaboration mediates the relation between self-rated health and depressive symptoms of Chinese older couples: an actor-partner interdependence approach

BACKGROUND

Dyadic coping resources have been considered a potential explanatory mechanism of spousal interdependence in health, but the mediation of spousal collaboration for the relationship between self-rated health and depressive symptoms has yet to be examined. This study aimed to investigate the within- (actor effect) and between-partner effects of self-rated health on depressive symptoms in community-dwelling older couples facing physical functioning limitations and to examine the role of spousal collaboration in mediating the actor and cross-partner effects of self-rated health on depressive symptoms.

METHOD

Data from 185 community-dwelling older Chinese married couples were analyzed using the actor-partner interdependence mediation model (APIMeM). Couples were interviewed through trained research assistants using the 5-item common dyadic coping subscale of the Dyadic Coping Inventory (DCI), the Visual Analog Scale (VAS) of the QoL questionnaire EQ-5D and the Patient Health Questionnaire-9 (PHQ-9).

RESULTS

Husbands' self-rated health had an actor effect on their own depressive symptoms and a partner effect on their wives' depressive symptoms. Wives' self-rated health had an actor effect on their own depressive symptoms. The actor effects between self-rated health and depressive symptoms were partially mediated by their own perception of spousal collaboration. Furthermore, husbands' self-rated health not only affects wives' depressive symptoms directly but also indirectly by influencing wives' perceptions of spousal collaboration.

DISCUSSION

The findings from this study underscored the importance of viewing couples' coping processes from a dyadic and gender-specific perspective, since more (perceived) collaborative efforts have beneficial effects on both partners' mental health outcomes.

Dyadic effects of family resilience on quality of life in patients with lung cancer and spousal caregivers: The mediating role of dyadic coping

PURPOSE

This study explored the effects of family resilience on quality of life (QOL) and examined whether dyadic coping mediates these effects in patients with lung cancer and their spousal caregivers.

METHODS

In total, 313 dyads were recruited from three tertiary hospitals in Fujian Province, China, between March and July 2022. Study participants independently completed sociodemographic and clinical characteristics questionnaires, the Shortened Chinese version of the Family Resilience Assessment Scale, the Dyadic Coping Inventory, and the 8-Item Short-Form Health Survey. Data analysis utilized the actor-partner interdependence mediation model (APIMeM).

RESULTS

Family resilience of both patients with lung cancer and their spouses were positively and directly associated with their own QOL, which was mediated by dyadic coping. Family resilience did not significantly influence the partners' QOL. The APIMeM model produced acceptable fit (χ2/df = 2.857, RMSEA = 0.077, CFI = 0.992, TLI = 0.941, and NFI = 0.998).

CONCLUSION

Dyadic coping mediated both actor and partner effects between family resilience and QOL, and there was no significant direct partner effect between individual family resilience and their partner's QOL. The development of efficient family- or dyad-based interventions is essential to improve family resilience and encourage dyadic coping strategies among patients with lung cancer and their spousal caregivers who experience poor family resilience and low dyadic coping. Such interventions have the potential to enhance QOL for both parties.