Dyadic relationship experience in Chinese patients with advanced cancer and their spouses: A longitudinal qualitative study.

ObjectiveHow patients and their partners cope with advanced cancer as a couple, may impact their emotional functioning (EF). The aim of this study was to assess dyadic coping (DC) of couples confronted with advanced cancer and its association with EF.MethodsActor‐partner interdependence models were used to analyze baseline data of 566 couples facing advanced cancer participating in an observational study on quality of care and life. Measures included the DC Inventory and the European Organization for Research and Treatment of Cancer quality of life questionnaire (EOQLQ‐C30).ResultsNegative DC (mean 86–88) was most often used and common DC (both mean 66) was least often used. We found small to moderate interdependence (r = 0.27−0.56) between patients' and partners' DC perceptions. Compared to partners, patients were more satisfied with their DC (p < 0.001). Partners' satisfaction with DC was positively associated with their own (B = 0.40, p < 0.001) and patients' (B = 0.23, p = 0.04) EF. We found positive actor (patients B = 0.37 B = 0.13, p = 0.04) and partner (both B = 0.17, p < 0.05) associations for negative DC in patients and partners. Partners' supportive DC was negatively associated with patients (B = −0.31, p = 0.03) and partners' EF (B = −0.34, p = 0.003).ConclusionsThis study highlight the importance of DC (especially from the partners' perspective) for EF in advanced cancer but also identifies differences in the experience of patients and their partners. Future research is needed to understand the mechanisms of such relations and the common and unique support options that may facilitate adjustment in patients with advanced cancer and their partners.

Chronic heart failure (CHF) has emerged as a significant global public health challenge. Fear of progression (FoP) constitutes a critical psychosocial issue among patients with CHF, with dyadic coping (DC) and social support serving as key influencing factors; however, the intrinsic mechanisms linking these components remain ambiguous. In this study, our aim was to elucidate the mediating role of social support within patient-spouse dyads as a bidirectional dependency in the relationship between DC and FoP, thereby providing a scientifically grounded foundation for clinical intervention strategies. Between July 2024 and February 2025, a total of 221 CHF patient-spouse dyads were recruited via convenience sampling at a tertiary hospital in Tangshan City, Hebei Province. Data collection instruments included a demographic questionnaire, the Fear of Progression Questionnaire-Short Form, the Dyadic Coping Inventory, and the Perceived Social Support Scale. Data were analyzed using AMOS 24.0 for the actor-partner interdependence mediation model. Analysis of the actor-partner interdependence mediation model demonstrated significant actor effects across all pathways (β = -0.204 to 0.228, P <.01), with partial partner effects observed (β = -0.066 to 0.116, P <.05). Notably, significant mediating effects were identified (β = -0.043 to -0.017; 95% confidence interval: -0.071, -0.003; P <.05). Actor effects indicated that social support partially mediated the relationship between individual DC and FoP. Partner effects revealed that social support partially mediated the association between spouses' DC and patients' FoP. The findings illuminate the interactive dynamics among DC capabilities, social support, and FoP within dyads of patients with CHF and their spouses. Clinical interventions should adopt a dyadic approach, simultaneously enhancing mutual coping skills and social support levels to effectively mitigate FoP in both patients and their spouses.

The diagnosis and treatment of cancer triggers not only a negative psychological response for the patient, but also a positive psychological outcome. Positive dyadic coping, as a form of coping for mental health outcomes, can maintain or reestablish internal stability between the patient and his or her spouse, resulting in positive physical and psychological changes. However, there is a paucity of research on body image, dyadic coping, and post-traumatic growth in breast cancer patients. The purpose of this study was to explore the relationship and pathways between body image, dyadic coping, and post-traumatic growth in breast cancer patients. A cross-sectional study was conducted from November 2022 to November 2023 at a tertiary care hospital in Wuxi, Jiangsu, China. This study was conducted among 154 breast cancer patients treated at the Affiliated Hospital of Jiangnan University, all of whom completed demographic and clinical information questionnaires, Body image self-rating questionnaire for breast cancer (BISQ-BC), Dyadic Coping Inventory (DCI) and Post Traumatic Growth Inventory (PTGI). A Pearson correlation analysis was used to explore the relationship between body image, dyadic coping, and post-traumatic growth. Structural equation modeling was used to analyze the path relationships among the three and to explore the mediating role of dyadic coping. The level of body image was negatively correlated with post-traumatic growth (r = -0.462, p < 0.01); and the level of body image was negatively correlated with dyadic coping (r = -0.308, p < 0.01). And dyadic coping was positively associated with post-traumatic growth (r = 0.464, p < 0.01). The structural equation modeling results supported the mediation model with the following model fit indices, chi-square to degrees of freedom ratio (χ2/df = 2.05), goodness of fit index (GFI = 0.93), comparative fit index (CFI = 0.99), canonical fit index (NFI = 0.93), incremental fit index (IFI = 0.99), non-canonical fit index (TLI = 0.99) and the root mean square of the difference in approximation error (RMSEA = 0.03). Body image and dyadic coping directly affected post-traumatic growth (β = -0.33, p < 0.05; β = 0.43, p < 0.05). And body image indirectly influenced post-traumatic growth through dyadic coping (β = -0.17, p < 0.05). Interconnections between body image, dyadic coping, and post-traumatic growth in breast cancer patients. A preliminary validation of the mediating role of dyadic coping between body image and post-traumatic growth, body image can have an impact on dyadic coping, which in turn can have an impact on post-traumatic growth. Whereby higher levels of dyadic coping in patients may also be associated with higher levels of post-traumatic growth, whereas body image disturbance may impede levels of post-traumatic growth.

How the dyads of heart failure patients and their informal caregivers cope with the disease process: A qualitative evidence synthesis.

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. 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. 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. 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). 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. 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.

The experience of stroke survivors and caregivers during hospital-to-home transitional care: A qualitative longitudinal study

A diagnosis of young-onset dementia (YOD) is a life-altering event for both persons with dementia and their spousal caregivers. Dyadic coping (DC) theoretical models acknowledge that dyads cope with stressors as a unit, but these models have yet to be used in YOD. To explore the lived experiences of couples managing YOD using an integrated DC model. This qualitative study recruited couples from a single major medical setting and through social media. Eligibility criteria included cohabitation, 1 partner diagnosed with YOD and able to participate, and both partners willing to participate. Live online video interviews were conducted from March to June 2020. One semistructured interview, which was recorded and subsequently transcribed. Recruitment was stopped once thematic saturation was reached. Five themes were deductively derived based on the integrated DC framework, including stress communication, positive individual DC, positive conjoint DC, negative individual DC, and negative conjoint DC. Within each theme, subthemes were inductively identified to further characterize couples' dyadic coping experiences with YOD. A total of 23 couples were interviewed, comprising persons with dementia (11 women [48%]; mean [SD] age, 61.3 [4.65] years; mean [SD] time from diagnosis, 3.11 [3.85]) years; and spousal caregivers (13 women [57%]; mean [SD] age, 60.5 [5.40] years). Data supported the 5 a priori DC themes and novel subthemes describing couples' experiences with YOD. Specifically, couples enacted positive conjoint DC by approaching challenges using a teamwork approach to problem solving and relying on collaborative communication. In contrast, couples engaged in negative conjoint DC through mutual avoidance, leading to increased negative communication and conflict. Couples described initially engaging in avoidance and withdrawal to navigate YOD-related stressors. While these strategies provided short-term relief from challenging emotions, they prevented engagement in adaptive coping (eg, acceptance and collaborative problem-solving) to promote long-term adjustment. This study used an evidence-based integrated DC approach to identify the positive and negative coping behaviors of couples managing YOD. To our knowledge, this is the first study to use a DC framework to guide qualitative analysis, and it provides valuable insights into DC strategies used by couples navigating YOD-related stressors. Findings can inform the development of dyadic psychosocial services for couples managing YOD and have implications for other progressive illnesses.

To investigate the relationships and pathways between dyadic coping, intimaterelationship and post-traumatic growth (PTG) in Chinese patients with breast cancer. A cross-sectional study. Between November 2019 and November 2020, 133 patients with breast cancer who received therapy in tertiary grade-A hospitals at Dalian, China completed questionnaires including demographic and clinical questionnaires, Locke-Wallace Marriage Adjustment Test, Chinese version of the Dyadic Coping Inventory and Chinese version of the Post-traumatic Growth Inventory. Structural equation modelling was used to analyse the pathways. Dyadic coping was positively interrelated with PTG and intimate relationship (r=.355, p<.01; r=.213, p<.05); intimaterelationship was negatively interrelated with PTG (r=-.207, p<.05). The structural equation model demonstrated adequate fit. Dyadic coping and intimaterelationship directly affected PTG (β=.469, p<.05; β=-.309, p<.05). Dyadic coping indirectly affected PTG through intimate relationship (β=-.066, p<.05). Dyadic coping was a stimulus factor, but intimaterelationship was an obstructivefactor in enhancing PTG for the Chinese patients with breast cancer. Furthermore, intimaterelationship may have significant mediating effects in the link between dyadic coping and PTG. Strategies that improve dyadic coping level and avoid excessive intimacy relationships between couples contribute to the development of PTG among patients with breast cancer. The research provides new ideas and intervention entry points for global nurses and psychotherapists so that they can enact and implement targeted PTG intervention plans for patients with breast cancer worldwide.

This paper is a report of a study to explore Chinese patients' and partners' experiences during early convalescence from a first heart attack. There are important socio-cultural differences between Chinese and western populations and comparatively little is known about the experiences of Chinese patients and partners living with a first heart attack. A qualitative study using focus groups was conducted in 2005 with 17 Chinese patients and their partners during convalescence from a first heart attack. The interviews were tape-recorded and transcribed. Analysis was used to identify categories using established qualitative phenomenological techniques. Content analysis of the data revealed five major categories: enduring uncertainty; coping with changes; experiencing emotional reactions; living with medications and needing professional help. The experiences of Chinese patients and partners during early convalescence from a first heart attack are different from their western counterparts and are affected by cultural traditions. Findings from this study may provide useful pointers for health professionals to deliver culturally sensitive and appropriate support and education during early convalescence.

One of the issues that cancer patients with minor or adolescent children face is whether to inform children about their cancer diagnosis. Their perspectives toward this issue are underexplored in China. The aim of this study was to explore Chinese cancer parents' perspectives toward informing children of their diseases. Eighteen cancer patients with children younger than 18 years were recruited using purposive sampling. Semistructured, face-to-face, in-depth interviews were conducted using a phenomenological approach. Data were analyzed using Colaizzi's approach. Six main themes with 2 to 6 subthemes emerged: (a) inappropriate to disclose the true diagnosis to children, (b) appropriate to disclose the true diagnosis to children, (c) communication content between cancer patients and their children in regard to cancer, (d) attitude on ways of disclosing cancer diagnosis to children, (e) reflections on parenting style, and (f) unmet needs for information and support. Perspectives of Chinese cancer parents toward truthfully disclosing their diagnosis vary, but all are for the purpose of protecting their children. Study findings indicate that Chinese cancer parents have culture-specific considerations, such as concepts of death and filial piety, which differ from studies in Western countries. Meanwhile, there are barriers between cancer parents and children in communicating about the illness and unmet needs for information and support. Psychosocial assessments and consultations, education, and interventions need to include a focus on the dependent children of adult cancer parents.

Impact of a nurse-led and a web-based psychoeducational program for advanced cancer patients and their caregivers: Results of a three-arm randomized controlled trial.

Coping with family function changes: A qualitative study of couples facing advanced lung cancer

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 aninterview 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.

e24002 Background: In research, how people act in close relationships is described as “attachment styles” which are composed of multiple attachment style dimensions (ASDs). Attachment avoidance is characterized by the need to isolate from the relationship (i.e. withdrawing and increased independence) while attachment anxiety is defined as needing reassurance and higher dependence. These two insecure ASDs are correlated with reduced quality of life for cancer patients (PT) and the family caregivers (CG). In ovarian cancer, PT and CG ASDs were correlated to dyadic coping, however 27% of PTs were disease-free. Attachment insecurity may be exacerbated by active treatment and uncertain prognosis. Therefore, we investigated the relationship between ASDs, and CG and PT reported dyadic coping and illness-specific communication. Methods: Metastatic sarcoma PTs and their CGs were recruited prospectively for a longitudinal, survey study investigating dyadic coping at Fred Hutchinson Cancer Center from Feb. 2022 – Dec. 2022. Participation rate for eligible PTs was 42% and 68% for CGs. Results are of participants who identified as intimate partners (individuals and dyads were allowed to participate). Attachment avoidance and attachment anxiety were measured via Relationship Structures Questionnaire. Dyadic coping and communication were measured via Dyadic Coping Inventory and Illness-Specific Relationship Talk (ISRT), respectively. Results: Sixty-nine participants enrolled: 43 PTs and 26 CGs (25 dyads). Participants were primarily non-Hispanic and white (91% PTs; 85% CG) with mean age 64 years ( SD= 13.1; range = 26-89). 61% of PTs identified as men; 60% of CGs identified as women. CGs with attachment anxiety were more likely to report worse coping and less ISRT, while PTs with attachment anxiety were more likely to report only worse coping (See Table 1). However, PTs with attachment avoidance were more likely to report both worse coping and ISRT. Conclusions: Advance cancer PTs and their CGs with insecure ASDs report worse coping and communication. Screening for insecure ASDs may identify PTs and CGs who would benefit from supportive care, including psychotherapy. Future research should investigate this in a larger, more heterogenous population at earlier in the rare cancer trajectory and the effect of ASDs on PT, CG, and clinician communication. [Table: see text]

Dyadic coping (DC), how couples cope together to deal with a stressor like chronic illness, has received increased attention over the last three decades. The aim of the current study was to summarize the current state of research on DC in couples. We conducted a scoping review of qualitative, quantitative, and mixed-methods studies published between 1990 and 2020, assessing DC in couples during three decades. 5,705 studies were identified in three electronic databases and hand searches. We included 643 sources in this review (with a total of N = 112,923 study participants). Most studies were based in the global North, particularly in the US and Europe. Publication numbers increased constantly over time. A third of study designs were cross-sectional studies followed by qualitative and longitudinal studies. The most prolific DC research areas were related to DC and minor stressors and DC and major physical health stressors. Overall, DC has been established internationally as a highly relevant construct in many disciplines (clinical, social, developmental, personality psychology, social work, nursing etc.). To conclude, the review reveals that future studies should focus on predictors, trajectories, and the importance of very specific DC behaviors for personal and dyadic functioning.