Actor-partner Interdependence Model Research Articles

Actor–Partner Effects of Personality Traits and Psychological Flexibility on Psychological Distress Among Couples Coping with Cancer

In this study, we applied the actor–partner interdependence model (APIM) to explore the associations between personality traits (Big Five) and psychological flexibility, on the one hand, and depression and anxiety, on the other hand, among patients with cancer and their spouses. Method: Forty-six patient—spouse dyads (N = 92) completed the anxiety and depression scales from the Patient-Reported Outcomes Measurement Information System (PROMIS), the ten-item personality inventory (TIPI), and the psychological flexibility scale (AAQ-2). Multilevel APIM models, adjusted for multiple testing, showed that neuroticism and psychological flexibility had actor effects on patients’ depression and anxiety. Furthermore, neuroticism had actor effects on spouses’ depression and anxiety, and agreeableness had actor effects on spouses’ anxiety. In addition, patients’ psychological flexibility and neuroticism had partner effects on spouses’ depression. Conclusion: Being psychologically flexible but emotionally stable is important for one’s own and one’s partner’s psychological outcomes in the context of dyadic coping with cancer. Implications include informing couples’ therapists in the context of psycho-oncology on the importance of considering personality traits and improving psychological flexibility.

Emotion dysregulation and eating disorder symptoms in mother-daughter dyads: An actor-partner interdependence modeling approach

Introduction: This study investigates dyadic associations between emotion dysregulation and eating disorder symptoms in mother-daughter dyads. This study employs the Actor-Partner Interdependence Model (APIM) to test three hypotheses: (1) emotion dysregulation will associate with an individual's own eating disorder risk beyond the effect of their partner's emotional dysregulation (actor effect); (2) emotion dysregulation will associate with a dyad member's eating disorder risk beyond the effect of their emotion dysregulation (partner effect); (3) dyad members’ emotional dysregulation will interact to associate with stronger eating disorder risk in each dyad member (actor-partner interaction effect). Methods: 104 dyads completed a series of self-report measures, including the Difficulties with Emotion Regulation Scale, Body Dissatisfaction Scale, and Eating Disorder Diagnostic Scale. Eligible dyads were required to consist of an adolescent daughter aged 11-21 years old, as well as their mother, and were required to converse in English and live in the US. Results: Two APIMs were specified, predicting body dissatisfaction and eating disorder symptoms, respectively. Concerning the body dissatisfaction model, actor effects indicated higher emotion dysregulation was associated with higher body dissatisfaction reports for both mothers and daughters. Partner effects indicated one member's higher emotion dysregulation was significantly related to the other member's higher body dissatisfaction. Regarding the eating disorder symptoms model, actor effects showed higher emotion dysregulation was associated with more eating disorder symptoms for both mothers and daughters. For both body dissatisfaction and eating disorder symptoms models, no significant actor-partner interaction effects were found. Discussion: Implications of these findings are discussed.

Social Support, Depression and Anxiety in Cancer Patient-Relative Dyads in Early Survivorship: An Actor-Partner Interdependence Modeling Approach.

Cancer places a psychological burden on both patients and their relatives. Perceived social support influences the extent of psychological distress. Our aim was to investigate associations between positive support, detrimental interactions, depression and anxiety in patient-relative dyads in the initial period after diagnosis. Patients with a solid tumor and their relatives participated in this prospective, multicenter observational study. Participants answered validated measures including the Illness-specific Social Support Scale (SSUK-8), the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder Scale (GAD-7). We analyzed cross-sectional data from the initial time following diagnosis with paired t-tests and actor-partner interdependence models. A total of 347 dyads of patients (mean age 59.9years) and their relatives (mean age 56.7years) participated. Compared to their relatives, patients reported significantly higher levels of depression (patients: M=6.31, SD=4.94; relatives: M=5.44, SD=4.77) and lower levels of anxiety (patients: M=4.40, SD=4.10; relatives: M=4.98, SD=4.47) as well as more positive support (patients: M=14.31, SD=2.07; relatives: M=12.46, SD=3.29) and a lower frequency of detrimental interactions (patients: M=3.21, SD=2.97; relatives: M=3.66, SD=2.93). Intrapersonal effects: Positive support was associated with lower distress only for relatives, whereas detrimental interactions were associated with higher distress for both patients and relatives (all p<0.05). Interpersonal effects: More positive support and fewer detrimental interactions experienced by relatives were associated with lower patient distress (all p<0.05). Better support for relatives may not only reduce their own distress, but also patients' distress. Relatives experience similar levels of distress and poorer social support than patients.

Associations between caregiver-adolescent emodiversity and internalizing symptoms.

Relationships between adolescents and primary caregivers play an important role in the development of internalizing (depressive and anxious) symptoms. We examined associations among caregiver-adolescent emotions and their emodiversity (their breadth and frequency) with adolescents' and caregivers' internalizing symptoms. A total of 181 adolescents (aged 13-17 years old) and their primary caregivers participated in a 14-day daily diary study between 2022 and 2023 where they reported their emotions at the end of each day. We used actor-partner interdependence models to examine whether positive and negative emotions and their emodiversity predicted each individual's and their family member's internalizing symptoms. Primary results concentrated on the actor effects of adolescents' and caregivers' mean levels of positive and negative emotions and their own internalizing symptoms. Greater negative emotion and lower positive emotion were associated with greater internalizing symptoms, for both caregivers and adolescents. Caregivers who showed greater positive emodiversity also showed greater internalizing symptoms. In contrast, relatively few partner effects were observed. Our findings point to the need for more research on the role of interpersonal emotions in daily life as they relate to internalizing symptoms. Although our sample captured diversity in ethnicity, results may not generalize across levels of socioeconomic status, gender identity, and caregiver education.

The Mediating Role of Resilience between Dyadic Perceived Social Support and Depression at the Older Adults with Disabilities and their Family Caregivers in China: an Actor-partner Interdependence Model Extended to Mediation

The Mediating Role of Resilience between Dyadic Perceived Social Support and Depression at the Older Adults with Disabilities and their Family Caregivers in China: an Actor-partner Interdependence Model Extended to Mediation

Racial Discrimination and Trauma Symptoms Among Black Adolescent-Caregiver Dyads

ABSTRACT Objective Research to date has produced compelling evidence of the potentially traumatic consequences of racial discrimination among Black adolescents and adults. Seldom explored, however, is how the potentially traumatic effects of racial discrimination may be shared across the family context. To clarify the relevance of racial trauma across the family system, the current study examined the relationship between racial discrimination and trauma symptoms among a sample of Black adolescent-caregiver dyads. Method Data were drawn from a larger self-report survey study examining Black family life experiences. For this study, data from 202 Black adolescents (Mage = 14.50, 52% female) and their caregiver (Mage = 41.63, 83% female) were used to test actor-partner interdependence models examining the associations of racial discrimination and trauma symptoms. Results Significant actor effects revealed that racial discrimination was positively associated with self-reported trauma symptoms among adolescents and caregivers. Additionally, partner effects were found, such that adolescent and caregiver experiences of discrimination were positively associated with the trauma symptoms of their family member. Analyses also revealed that the association between racial discrimination and trauma symptoms among caregivers was dependent upon youth experiences of racial discrimination. Conclusion The current study lends credence to theories linking racism and trauma-related symptomatology across the life course and family system. Collectively, study findings highlight the importance of understanding the effects of racism beyond the individual and underscores the value and need for family tailored interventions that can repudiate the shared impact and potential intergenerational effects of racial discrimination across Black families.

Predictors of Decisional Capacity in Alzheimer's Disease Biomarker Test Candidates.

Deciding to learn one's Alzheimer's disease (AD) biomarker status is a high-stakes endeavor that requires comprehending and deliberating about complex and nuanced information. Assessing capacity to consent to AD biomarker testing and disclosure is further complicated when candidates have cognitive impairment and present with family care partners. The objective of this analysis was to identify predictors of decisional capacity for an amyloid Positron Emission Tomography (PET) disclosure study among persons with mild cognitive impairment (MCI) and their family care partners. This analysis used an analytical correlational design, using baseline data from a randomized controlled trial of amyloid PET results disclosure. Simple linear regression was used to examine predictors of decisional capacity. Focusing on persons with MCI, the predictor variables of interest were sociodemographic characteristics, level of knowledge of MCI/AD, global cognition, and neuropsychological tests of language and executive functioning. Dyadic analyses were conducted with data from 82 dyads of persons with MCI and care providers using the Actor Partner Interdependence Model to assess for presence of actor and partner effects among key variables. Capacity to consent scores demonstrated sufficient capacity for all participants to consent to the study. For persons with MCI, lower age, higher mental status scores, MCI/AD knowledge scores, and better performance on measures of language and executive functioning were predictors of decisional capacity. The model revealed positive actor relations for MCI/AD knowledge with decisional capacity for both persons with MCI and family care partners and negative partner relationships for family care partners MCI/AD knowledge with the decisional capacity of persons with MCI. Assessment of decisional capacity is imperative when considering participation in AD research, including studies with high-stakes procedures like biomarker results disclosure. Our findings highlight that not only do individual characteristics put persons with MCI at risk for lower decisional capacity, but dyadic effects from family care partners may also be present.

Application of the Actor-Partner Interdependence Model in Parent-Adolescent Mental Health Knowledge and Depression.

To explore the individual and interpersonal association between mental health knowledge (MHK) and depression in adolescents and one of their parents, and to explore whether gender differences exist between fathers and mothers in these associations. Participants were 3456 father-adolescent dyads and 4478 mother-adolescent dyads, recruited from eight middle schools in Wuhan, who completed self-report assessments of MHK and depression from September to October 2021. With the application of the actor-partner interdependence model, A positive actor effect between MHK and depression in adolescents was found. Adverse partner effects from fathers' MHK and mothers' MHK to adolescent depression were noted and showed no significant difference. Adolescents' depression was significantly associated with parental depression in both fathers and mothers. It is implied that milder adolescent depression was associated with lower levels of adolescent MHK, along with higher levels of MHK in both fathers and mothers. For parents, it is important to emphasise the improvement of their own MHK and increase their attention to adolescent mental health problems, as this may contribute to enhancing the mental health of adolescents. This study is instructive and related to family-based nursing interventions for mental health, emphasising the potential influence of parents in the family on adolescent depressive symptoms. The findings suggest that parental involvement should be encouraged and that the family's role in supporting the child's mental health should be recognised, contributing to the development of relevant policies. This study highlights that higher parental MHK is associated with lower levels of adolescent depression, with no gender differences between fathers and mothers. Family-based nursing interventions that emphasise mental health education for parents may have an impact on improving depression in adolescents. Guidelines were followed using the STROBE reporting method. None.

Parenting Under Pressure: Associations between Perceived Social Pressure and Parental Involvement among Mothers and Fathers

In many Western countries, the ideology of intensive parenting has gained prominence in the discourse of experts, policymakers, and within popular culture. This ideology emphasizes deep parental involvement in emotional, physical, and financial aspects (Lee et al., 2014). Meeting these demanding standards can exert significant pressure on parents, especially on mothers often considered as the primary caregiver. Moreover, these pressures may prompt parents to be highly, and potentially overly, involved in their children’s lives. Using data from 146 parent dyads (N = 292 parents; Mage = 47.57 years) of Swiss adolescents, the study explores parental perceptions of pressure to be a perfect parent and its association with one positive (responsiveness) and two negative types of involvement (overprotection and overvaluation). Thereby, we estimated Actor-Partner Interdependence Models (APIM) to examine mutual influences between mothers and fathers. The results indicated that mothers reported experiencing significantly more pressure than fathers. We found evidence for a positive association between perceptions of pressure and parental overprotection among both parents. The results also showed that there was a significant association between feelings of pressure and overvaluation, but only among fathers. Associations between pressure and responsiveness were not significant, and no significant partner effects were observed in any of the models. In conclusion, mothers particularly face heightened pressure to be perfect parents, but both parents may adapt their parenting strategies in response to perceived pressure to be perfect as a parent. These findings highlight the potential issues associated with societal pressures on parents and their impact on parenting behavior.

Who is in control? Longitudinal connections between marital power and parental psychological control.

The present study explored longitudinal associations between marital power dynamics and parental psychological control and tested whether partners' sense of relational autonomy mediated these connections. Self-determination theory supports that harmful marital dynamics may spill into parenting practices, such as engaging in parental psychological control, and that parents' autonomy may mediate connections. Using an actor-partner interdependence model and an actor-partner interdependence mediation model, this study examined direct associations between marital power and parental psychological control, as well as indirect associations with autonomy as a mediator. Longitudinal dyadic data of 321 married, two-parent families were drawn from three waves of the Flourishing Families Project collected annually from 2009 to 2011. Results indicated that wives' perceptions of a power struggle in the marriage were associated with both partners' greater parental psychological control concurrently and were predictive of increases in their own parental psychological control across the span of 1 year. Although notable connections were found between marital power and autonomy, autonomy did not mediate pathways to parental psychological control. These findings highlight the importance of marital functioning in the use of certain parenting practices and suggest marital power as a potential intervention point when psychological control of children is present. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Male infertile couples: an actor-partner interdependence model of attachment styles and fertility pressure

BackgroundCouples undergoing artificial insemination by donor semen(AID) represent a unique group of infertility patients, the relationship between fertility pressure and attachment styles remains unclear. To investigate the fertility pressure and attachment dimensions in artificial insemination by donor semen(AID) couples, and develop an Actor-Partner Interdependence Model (APIM) for patient care.MethodsThis study is a cross-sectional study. From June to September 2021, couples who were about to receive AID treatment in our hospital were assessed using the Fertility Problem Inventory, and the Experiences in Close Relationships(ECR). Dyadic analysis applying the APIM was used.ResultsA total of 448 valid questionnaires were recovered, the effective response rate was 94.9%. The average score of men’s fertility pressure was higher than that of women’s(P = 0.021). The score of male attachment anxiety was higher than that of females(P = 0.038). Attachment avoidance(β = 0.46) and attachment anxiety(β = 0.33) in wives significantly impacted their fertility pressure. Attachment avoidance(β = 0.17) and attachment anxiety(β = 0.52) in husbands significantly impacted their fertility pressure. The attachment avoidance of wives’ had a significant impact on the husbands’ fertility pressure(β = 0.11).ConclusionOverall, the study revealed that in the couples who use donor sperm to expect pregnancy, the male has higher fertility pressure. Insecure attachment can cause more severe fertility pressure, fertility pressure is also affected by one’s partner.

The Interaction of Positive and Negative Relationship Characteristics and Their Association with Relationship and Individual Health Outcomes in Older Couples.

The purpose of this study was to examine how positive and negative relationship characteristics and their interaction were predictive of global relationship happiness, psychological symptoms, and physical health in a large sample of older couples. The NSHAP Wave 2 partner data n = 955) were used to estimate both actor (within person) and partner (between person) effects using the Actor Partner Interdependence Model with Moderation. Global relationship happiness was predicted by the interaction of positive and negative characteristics, suggesting that more positive characteristics are only predictive of greater happiness in the presence of some negative characteristics. Male partners' depressive symptoms were predicted by the female partners' interaction of positive and negative characteristics, suggesting that negative characteristics were only associated with male partner depressive symptoms when positive characteristics were rated very low by their partner. Positive and negative characteristics were predictive of anxiety and stress but not their interaction, and only the male partner's perception of positive characteristics was predictive of the female partner's physical health. These results are discussed in the context of controversy over the measurement of relationship satisfaction in the field.

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

ObjectiveTo explore how dyadic coping (DC) influences the psychological resilience (PR) levels of patients with cervical cancer (CC) and their spouses. MethodsFrom 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. ResultsThe 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. ConclusionsPatients 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. Trial registrationNo registration

Substance Use and Discrimination in a Sample of U.S.-Based Latinx Sexual Minority Men and Their Main Partners.

Substance use, including drug and alcohol misuse, is associated with myriad health conditions, including a higher risk for HIV infection. Although preliminary evidence suggests that higher levels of relationship functioning can buffer against the deleterious health consequences of discrimination on mental health broadly, such protective associations have been understudied with respect to alcohol and drug use. The topic is particularly understudied among Latino sexual minority men even though they are at greater risk for problematic substance use behaviors and are likely to experience multiple forms of discrimination (e.g., racism, homophobia). To address this gap in the literature, we sampled 95 predominantly Latino sexual minority male couples to assess their drinking and drug use behaviors, relationship functioning, and experiences of discrimination. We used Actor-Partner Interdependence models to test our hypotheses. We found that having a partner who experienced discrimination and higher partner reports of relationship functioning buffered against the negative relationship between own experiences of discrimination and drug use, but not problematic drinking. Our results suggest that higher relationship functioning serves as a buffer between the negative ramifications of discrimination on drug use, but not problematic drinking. We explicate implications for policy and practice to facilitate well-being among coupled Latino sexual minority men.

A dyadic multimethod study of “partner phubbing”, smartphone conflict, and relationship quality in opposite-sex couples from Belgium

Existing research indicates that ‘partner phubbing’ is associated with heightened conflict and lower relationship satisfaction. However, previous studies have relied on cross-sectional designs involving subjective self-reports of only one partner. In this study, the main hypothesis entailed that the link between partner phubbing and relationship quality will be mediated by conflict over smartphone use. We utilized experience sampling (ESM) with objective smartphone logging measures collected over 14 days from 35 mixed-gender intimate dyads from Belgium (N = 70). An Actor-Partner Interdependence Model revealed that perceived relationship quality was negatively predicted by partner’s smartphone use in husbands only, but there were no indirect effects via smartphone conflict. We reported a low occurrence of smartphone frustration and conflict in couples. An outstanding dyad analysis revealed some incongruencies between partner’s smartphone use and its perception within couples. The design allowed us to distinguish between phone use frequency and screen time, which facilitated a nuanced understanding of smartphone use impact, and gender differences, to some extent refuting the previous literature. The findings prompt us to debate whether co-present smartphone use ought to be associated with negative outcomes exclusively, a rare notion to be explored in future research.

Prevalence and predictors of help-seeking steps in a nationally representative Dutch sample of romantic couples.

Couples appear to frequently experience relationship problems, yet estimates of the prevalence and prediction of three distinct help-seeking steps, (1) recognition of serious relationship dissatisfaction, (2) considering help, and (3) receiving relationship help, are unknown for representative population samples. This is unfortunate as such knowledge may inform policy makers in the development of strategies to motivate couples to seek help. The prevalence of these steps along with reasons for not acquiring help was studied in a representative population sample of 1014 Dutch heterosexual couples. Multilevel Actor-Partner Interdependence Modeling (APIM) analyses estimated the extent to which static socio-demographic factors were predictive of help-seeking behaviors. Of all partners, 28.6% reported having ever been seriously dissatisfied with their relationship (step 1), of which 86.2% had told their partner they were dissatisfied, on average 1.5 years after onset of the dissatisfaction. Of the seriously dissatisfied partners 36.4% considered professional relationship help (step 2) and 19.5% eventually received help (step 3), on average 3.7 years after the onset of dissatisfaction. Of these, 88.5% consulted a (couple) therapist. Main reasons for not acquiring help were that "things got better" (48.8%) and "the partner did not want relationship help" (35.4%), whereas financial considerations and shame were rarely endorsed. Although serious relationship dissatisfaction was common (i.e., 40.1% of all couples consisted of at least one partner who was ever dissatified), few couples sought help and they did so rather late. Waxing and waning of dissatisfaction often guided the decision to not seek help. Women and younger partners were more proactive in help-seeking. Marital status, having children, and education were largely unrelated to help-seeking.

The Association Between Mutuality and Quality of Life in Adults With Chronic Illnesses and Their Nurses: Actor-Partner Interdependence Model Analysis.

To examine the association between mutuality and quality of life in nurse-patient dyads. A cross-sectional multi-centre study was conducted. The study was conducted in five tertiary hospitals in Italy. We enrol both inpatients and outpatients with chronic diseases and their nurses with a convenience sampling. One-hundred ninety-two dyads participated to the study. A self-assessment instrument including the Short-Form 12 Health Survey (SF-12), and the Nurse Patient Mutuality in Chronic Illness scale (NPM-CI scale), in the two versions-one for patients and one for nurses, was administered. The effects of nurse-patient mutuality on the physical and mental quality of life of nurses and patients were estimated with a series of actor-partner-interdependence models (APIM). Patients' and nurses' perceptions of their mutuality were positively correlated. For patient mental quality of life, there was a statistically significant actor effect both for patients, and for nurses. There was also a consistent statistically significant partner effect for patient mental quality of life. There were no statistically significant actor or partner effects for the nurses' and patients' physical quality of life. This construct may be influenced by additional components, further studies are needed. Mutuality between nurses and patients in chronic diseases influence both patient and nurse quality of life. Our results support the importance of taking a dyadic perspective when considering mutuality and quality of life in nurse-patient dyads. Nurse-patient mutuality is an indicator of a high-quality relationship, which allows shared goals and shared decision-making. Quality of life is one of the most important outcomes for chronic conditions patients and is an indicator of well-being. Quality of life is also an important variable in healthcare professionals' lives. Little is known about the association between mutuality and quality of life in nurse-patient dyads. Mutuality has an actor effect on patient's and nurse's quality of life and has a negative partner effect on patient's quality of life. The understanding of mutuality and interdependence within the dyad, could increase mental quality of life in nurse-patient dyads. STROBE checklist for cross-sectional studies was followed in this study. Patients were involved in the sample of the study.

Associations between school engagement and mental well-being among Finnish parent-child dyads

Abstract Background To understand how individual differences in mental well-being emerge for children and adolescents, it is important to understand the amenable factors in the context in which the development takes place - that is, for children, primarily in the family and in school. There is a notable gap in the research exploring the positive impacts of school factors on parent-child dyads and their mental well-being, and if there are any associations between school engagement and the mental well-being of parents and their children. Methods Data from 307 parent-child dyads were included in the study, the data stemming from a Finnish l research project (CONSENSUS) encompassing longitudinal survey data collection among both children in grades 4-6 and their parents. By exploring bivariate correlations and using the Actor-Partner Interdependence Model (APIM), the present study aims to investigate actor and partner effects of school engagement and mental well-being among parents and their child in grade 4-6. Results Preliminary results show that there are statistically significant correlations between parents’ and their children’s mental well-being, but that there are no significant correlations between children’s school engagement and parental school engagement. Further, statistically significant actor effects emerge between children’s school engagement and mental well-being, and between parental school engagement and mental well-being. Conclusions By clarifying the interaction between school engagement and mental well-being in parent-child dyads, this study not only contributes to the theoretical understanding of these constructs but also offers insights that can inform future development of mental well-being promotion interventions aimed at families and educational settings in Finland and elsewhere. Key messages • This study offers an innovative exploration of the links between mental well-being and school engagement among 274 Finnish parent-child dyads. • Results show various interactions between school engagement and mental well-being among the parent-child dyads, with implications for interventions intended to support well-being in families.

Shared care in heart failure management is linked with physical and mental health by perceived control in patient-caregiver dyads

Abstract Background Patients with heart failure (HF) and their family caregivers have interdependent relationships in managing HF. Shared care within dyads refers to interpersonal interactions characterized by exchanging care and support in chronic illness management. High levels of shared care improve patients’ health outcomes, but it is unclear if shared care is equally beneficial for caregivers. Also unknown is how shared care contributes to the outcomes of both dyad members. We propose that perceived control may be critical in the link between shared care and health status for dyads. Thus, the purpose of this study was to determine whether perceived control over one’s health mediates the association between shared care and physical and mental health in patients with HF and their caregivers. Method Patients with HF and their primary caregivers (N=151 dyads) completed questionnaires in this cross-sectional study. Shared care, perceived control over one’s own health, and health status were assessed using the three subscales of the Shared Care Instrument (i.e., communication, decision-making, and reciprocity), the Cardiac Attitudes Scale-Revised, and the Medical Outcomes Study Health Survey-36, physical and mental health scales, respectively. A series of actor-partner interdependence models with mediation dyadic analyses were conducted. Results Patients with HF (mean age 60.3 Years, 64% male) and their caregivers (mean age 56.6 years, 75% female) reported similar levels of communication and reciprocity in shared care, but patients reported higher scores of decision-making in shared care than their caregivers (P &amp;lt; .001). Perceived control over one’s own health significantly mediated the association between communication and physical health (indirect actor effect = .1487; 95% CI: 0.0478 to 0.2759) and between communication and mental health (indirect actor effect = .1650; 95% CI: 0.0454 to 0.3260) for patients, not caregivers (Figures A1 &amp; A2). Similarly, perceived control significantly mediated the association between reciprocity and physical and mental health for patients, not caregivers (Figures B1 &amp; B2). Perceived control mediated the association of decision-making with physical health and mental health for caregivers, not patients (Figures C1 &amp; C2). Conclusion Higher levels of communication and reciprocity increased patients’ perceived control, ultimately improving their physical and mental health, whereas caregivers’ decision-making improved their health by enhancing their perceived control over their health. The different patterns of shared care are linked to the health of patients and caregivers by enhancing perceived control over one’s health.Figure A &amp; BFigure C

The Relationship Between Dyadic Coping and Mental Health in Stroke Survivors and Their Spouse Caregivers: An Actor-Partner Interdependence Model.

To investigate the relationship among dyadic coping, mental health and the individual and mutual influences on stroke survivors and their spouse caregivers. A cross-sectional descriptive study was conducted in China from November 2019 to August 2020. The STROBE checklist was used to report the present study. The analysis included 224 dyads of stroke survivors and their spouse caregivers in China. Data on stroke survivors and their spouse caregivers were collected using the Dyadic Coping Inventory (DCI), the Patient Health Questionnaire nine-item scale (PHQ-9) and the Generalised Anxiety Disorder seven-item scale (GAD-7). The dyadic analysis was conducted based on the Actor-Partner Interdependence Model (APIM). Regarding actor effects, spouse caregivers' dyadic coping and perceived dyadic coping had a negative predictive effect on their own anxiety and depression. Stroke survivors' perceived dyadic coping had a negative effect on their own depression. Regarding partner effects, spouse caregivers' perceived dyadic coping also had a negative predictive effect on the depression of the patients. In contrast, stroke survivors' perceived dyadic coping was positively associated with spouse caregivers' anxiety and depression. These findings suggested that mental health of stroke survivors and their spouse caregivers was affected by various dyadic coping dimensions. Our research has the potential to contribute to the understanding dyadic coping and mental health of stroke survivor-spouse caregiver dyads. The findings reveal that the coping strategies employed by stroke couples are closely related to the mental health of both partners. This study provides evidence for the significant impact of dyadic coping on the psychological well-being of stroke survivors and their spouse caregivers. Therefore, dyadic interventions aiming at strengthening dyadic coping may have positive effects on their mental health. This study directly involved the patients and family caregivers in hospital settings.