Psychosocial Adjustment Research Articles

Psychosocial Adjustment Of Breast Cancer Patients Post-Treatment Therapy and Mentoring. (Case Study of 4 Breast Cancer Patients in Sapkandara Community Medan)

Psychosocial Adjustment Of Breast Cancer Patients Post-Treatment Therapy and Mentoring. (Case Study of 4 Breast Cancer Patients in Sapkandara Community Medan)

Longitudinal bidirectional relations between psychological maltreatment by teachers and psychosocial adjustment during early adolescence

This study examined three models (relationship-driven model, symptom-driven model and transactional model) testing the across-time bidirectional relations between psychological maltreatment by teachers and early adolescents' psychosocial adjustment (i.e., internalizing problems, externalizing problems, and academic achievement) during early adolescence. A total of 4169 Chinese early adolescents (Mage = 9.93 years, SD = 0.73, 54% males) completed assessments across five waves, every six months. Employing autoregressive latent trajectory models with structured residuals (ALT-SR), the results revealed that adolescents’ internalizing problems and academic achievement were predicted by psychological maltreatment by teachers (supporting the relationship-driven model), whereas externalizing problems and psychological maltreatment by teachers were bidirectionally related (supporting the transactional model). Moreover, sex moderated the relations between psychological maltreatment by teachers and psychosocial adjustment. The finding of differential relations between psychological maltreatment by teachers and three components of psychosocial adjustment (i.e., internalizing problems, externalizing problems, and academic achievement) indicated that prevention and interventions should be tailored to different psychosocial adjustment difficulties.

Longitudinal Relationships among Parenting, Prosocial Behaviors, and Emotional Problems: Examining Between- and Within-Person Associations in Adolescents.

Although bidirectional associations between parenting and adolescents' social and emotional outcomes have been investigated, how parental warmth and harsh parenting as two different parenting dimensions, adolescents' prosocial behaviors, and emotional problems were longitudinally and bidirectionally related at between- and within-person levels remains unclear. With a three-wave longitudinal design, the present study examined these associations by employing the random-intercept cross-lagged panel model. Data from 606 Chinese adolescents (Mage = 13.80 years, SD = 0.52, at T1; 45.7% girls) were collected at six-month intervals over one year, and participants completed questionnaires assessing their perception of parenting, prosocial behaviors, and emotional problems online. The results indicated that parental warmth and harsh parenting were significantly associated with adolescents' prosocial behaviors and emotional problems at the between-person level. At the within-person level, adolescents' more prosocial behaviors at T1 predicted later within-person decreases in their emotional problems at T2, which in turn predicted subsequent increased prosocial behaviors and more parental warmth at T3. Additionally, a higher level of harsh parenting at T2 unidirectionally predicted more adolescents' emotional problems at T3. These findings highlighted the developmental cascade processes among adolescents' prosocial behaviors, emotional problems, and parenting and the importance of fostering adolescents' prosocial behaviors in reducing their emotional problems and then promoting subsequent psychosocial adjustment and parent-child bonding.

The Influence of Low-Income Families on Adolescents’ Psychosocial Ad-justment: 10 Helpful Tips for Professionals to Work with Low-Income Families

The Influence of Low-Income Families on Adolescents’ Psychosocial Ad-justment: 10 Helpful Tips for Professionals to Work with Low-Income Families

A study of a PERMA-based positive psychological intervention programme in subthreshold depressed patients with newly diagnosed breast cancer: formulation and application.

Depression seriously affects the quality of life of breast cancer patients and even hinders treatment and recovery after diagnosis. Subthreshold depression should be worthy of attention, and the risk of subthreshold depression developing into depression increases if timely intervention is not available. However, there is limited research on interventions for subthreshold depression, especially for newly diagnosed breast cancer patients. Exploring the efficacy of a PERMA-based positive psychological intervention programme in newly diagnosed breast cancer patients with subthreshold depression. Using PERMA as a framework, we constructed the intervention programme through a literature review and expert discussion approach, and revised the programme using the Delphi method. Then we selected 84 newly diagnosed breast cancer patients for a randomised controlled trial. The control group received conventional care (primary care, specialist care, psychological care, etc.), and the observation group received a PERMA-based positive psychological intervention programme. Patient data were collected before and after the intervention, and the dataset consisted of patient responses to general information, the Depression Screening Scale (CES-D), the Hamilton Depression Inventory (HAMD-17), and the Questionnaire on Psychosocial Adjustment in Breast Cancer Patients. A total of 79 patients completed the study (38 patients in the observation group and 41 patients in the control group), and before the intervention, there were no statistical differences in the comparison of general information, subthreshold depression scores, and psychosocial adaptation scores between the two groups (p > 0.05). After the intervention, the subthreshold depression (CES-D and HAMD-17 scores) scores of the observation group were lower than those of the control group (p < 0.01), and the psychosocial adaptation scores were significantly higher than those of the control group (p < 0.01). A positive psychological intervention programme using PERMA as a framework was more effective in reducing subthreshold depression levels and promoting levels of psychosocial adjustment in newly diagnosed breast cancer patients. Interventions for subthreshold depression are not limited to the traditional aftercare model, but rather from a positive psychology perspective. Especially for patients newly diagnosed with breast cancer, this is a new endeavour that has important implications for them. Because, instead of focusing on their negative emotions, we help them gradually adapt to their new identity and treatment process from a positive aspect during their most difficult period, thus reducing their subthreshold depression level and preventing it from developing into a more severe depression.

Menopause dynamics: From symptoms to quality of life, unraveling the complexities of the hormonal shift

The article delves deeply into the nature and process of menopause through which women undergo, which comprises profound transitions that occur during all menopausal stages. These findings emphasize the critical importance of comprehending and effectively addressing the diverse array of menopausal symptoms. The profound decline in progesterone and estrogen levels has been identified as the catalyst for triggering a spectrum of symptoms, which include but are not limited to hot flashes, mood swings, sleep disturbances, and genitourinary issues. These symptoms are noted to have a tangible impact on the daily functioning and overall well-being of women. This article underscores the pivotal role played by hormonal shifts in the manifestation of these symptoms and highlights the pressing need for the development of robust management strategies. Furthermore, hormone replacement therapy (HRT) is a well-researched treatment option, albeit with the caveat that its potential risks necessitate a personalized and nuanced approach. It also emphasizes the importance of lifestyle modifications, such as engaging in regular physical activity, adopting a balanced diet, and considering cognitive behavioral therapy, as pivotal elements in mitigating certain menopausal symptoms while concurrently enhancing overall health. The article also underscores the importance of addressing sexual health through therapeutic interventions, acknowledging their potential to significantly ameliorate vaginal symptoms and enhance sexual function, thereby fostering greater intimacy and relational satisfaction. Additionally, it highlights the profound psychosocial adjustments that women undergo during menopause, which are intrinsically intertwined with sociocultural factors. A holistic approach to menopause management is advised, which encompasses psychological support, medical treatments, and social interventions, underscoring their collective importance in effectively supporting women through this important life transition.

Child and adolescent social withdrawal predict adult psychosocial adjustment: A meta-analysis

This systematic review and set of five meta-analyses synthesized the results of prospective longitudinal publications on childhood and/or adolescent social withdrawal as a predictor of adult psychosocial adjustment. Meta-analyses were conducted with results for five adult outcomes from 31 publications derived from 14 longitudinal samples and a combined sample size of 19,806 adults (50% women, M = 38.88 years, 83% White) with childhood and/or adolescent ( ≤ 16 years) histories of social withdrawal and their offspring (N = 175). Dependency among publications derived from the same longitudinal samples was explicitly modeled in meta-analyses with clustering. Meta-analytic results support childhood and/or adolescent social withdrawal as a medium-sized risk factor for adult social anxiety and intergenerational difficulties in mothers and their offspring (both p &amp;lt; 0.0001); a small-size risk factor for delayed adult developmental milestones (p &amp;lt; 0.05), adult social withdrawal (p &amp;lt; 0.0001), other anxiety (p &amp;lt; 0.05), and depression (p &amp;lt; 0.01); and a small-size protective factor against adult substance use (p &amp;lt; 0.01). However, meta-analytic results did not support childhood and/or adolescent social withdrawal as a predictor of physical health, likely due to the heterogeneous nature of the investigated health outcomes. Consistent with a Developmental Science Model, results are interpreted as supporting interpersonal mechanisms (missing out, interpersonal stress, and poor relationship quality) and developmental cascades (cross domain-influences) in socially withdrawn children's life-course development. Because evidence for intergenerational difficulties was based on a single longitudinal sample, confidence in intergenerational effects would be increased by replication in other samples. Heterogeneity among effect sizes included in most meta-analyses suggests that the relation between childhood and/or adolescent social withdrawal and adult outcomes is likely to be moderated by other factors. Future directions in this area of research are discussed.

Analysis of Longitudinal Trajectory and Influencing Factors of Supportive Care Needs in Colorectal Cancer Patients With Enterostomy.

The aim of this study was to understand the dynamic changes in the needs of patients with enterostomy during the 3 months after discharge and its possible influencing factors. A prospective observational design. This study investigated the supportive care needs of patients who underwent colorectal cancer surgery with colostomy in three Chinese hospitals from May 2023 to October 2023 during the 3 months following discharge from the hospital. The growth mix model was used to describe the needs trajectory and analyse the heterogeneity of the trajectory. Univariate analysis was used to find the factors that might affect the heterogeneity of needs trajectory of patients with enterostomy, and then logistic regression analysis was used to determine the influencing factors of the heterogeneity of needs trajectory of patients with enterostomy. The reporting of this study adhered to the STROBE checklist. A total of 232 patients with enterostomy completed follow-up. There was heterogeneity in the developmental trajectories of supportive care needs of enterostomy patients and the trajectories of the five dimensions of supportive care needs. The heterogeneity factors affecting the trajectory of supportive care needs included the enterostomy patient's psychosocial adjustment score, type of enterostomy, and educational background and the heterogeneity factors affecting the five dimensions trajectory of supportive care needs include psychosocial adjustment score, tumour staging, type of enterostomy, smoking, chemotherapy and enterostomy self-care knowledge score. The needs of patients with enterostomy within 3 months after discharge were dynamic. Identifying and meeting the unmet needs of patients with enterostomy was crucial to improving the health-related quality of life of patients with enterostomy. None. The needs of patients with enterostomy were dynamic, with the needs of most patients with enterostomy decreasing within 3 months of discharge, but some patients with enterostomy continued to have high needs at 3 months after discharge, and clinical nurses were expected to pay special attention to these patients.

Childhood psychosocial adjustment and midlife obesity, diabetes and hypertension: prospective study from two birth cohorts.

Understanding how childhood psychosocial adjustment (CPA) influences later life health outcomes is crucial for developing interventions to mitigate the long-term risk of cardiometabolic diseases (CMDs). To investigate the association between CPA and incident CMDs in mid-life, and the mediating roles of educational attainment, smoking habits and depression during young adulthood. A prospective cohort study utilised data from the 1958 National Child Development Study (NCDS; 1958-2013) and the 1970 British Cohort Study (BCS70; 1970-2018), encompassing 22 012 participants assessed for CPA in childhood, who were subsequently evaluated for educational attainment, smoking habits and depression in young adulthood, followed by assessments for CMDs in mid-life. CPA was assessed using the Bristol Social Adjustment Guides in the NCDS and the Rutter Child Behaviour Scale in the BCS70, with higher scores indicating poorer psychosocial adjustment. The primary outcomes were the mid-life incidences of hypertension, diabetes and obesity. Compared with children in the lowest tertile for CPA scores, those in the middle tertile had an adjusted odds ratio for hypertension of 0.98 (95% CI 0.90-1.06), whereas those in the highest tertile had an odds ratio of 1.17 (95% CI 1.08-1.26). For diabetes, the corresponding odds ratios (95% CI) were 1.15 (0.98-1.35) and 1.39 (1.19-1.62). For obesity, the corresponding odds ratios (95% CI) were 1.08 (1.00-1.16) and 1.18 (1.09-1.27). These associations were partially mediated by educational attainment (2.4-13.9%) and depression during young adulthood (2.5-14.9%). Poorer CPA is correlated with the development of hypertension, diabetes and obesity in mid-life. Interventions aimed at improving CPA may help in reducing the burden of these diseases in later life.

Impact of psychological resilience and social support on psycho-social adjustment in postoperative patients with primary hepatocellular carcinoma: mediating effects of fear of progression.

Postoperative patients with primary hepatocellular carcinoma (HCC) confront not only physiological challenges but also psychological and social adaptation issues. It is imperative to enhance psycho-social adjustment (PSA) levels and further improve the quality of life among this population. However, research on PSA levels in postoperative HCC patients is lacking, and investigations into its associations with psychological resilience, social support, and fear of progression (FoP) remain unexplored currently. This study aims to: (1) investigate the current status of PSA and analyze its influencing factors among postoperative HCC patients; (2) explore the interrelationships among psychological resilience, social support, FoP and PSA based on the Chronic Illness Adaptation Model employing a structural equation model. Convenience sampling methods were employed to recruit participants from the Department of Hepatobiliary Surgery at a tertiary hospital in Xi'an, Shaanxi, China, and a total of 399 patients completed the surveys. The survey instruments included a general information questionnaire, Connor-Davidson Resilience Scale (CD-RISC), Social Support Rating Scale (SSRS), Fear of Progression Questionnaire-Short Form (FoP-Q-SF), and Psychosocial Adjustment to Illness Scale Self-report (PAIS-SR). Data entry was conducted using Epidata 3.1 with dual verification, followed by statistical analyses performed using SPSS 27.0 and Amos 28.0. The structural equation model revealed two paths. In Path 1 (psychological resilience → FoP → PSA), the direct effect was -0.383 (95% CI [-0.589, -0.112]), with an indirect effect of -0.075 (95% CI [-0.170, -0.018]). In Path 2 (social support → FoP → PSA), the direct effect was -0.297 (95% CI [-0.587, -0.063]), with an indirect effect of -0.069 (95% CI [-0.156, -0.019]). Postoperative patients with primary HCC exhibit lower levels of PSA. Higher levels of psychological resilience and social support correspond to elevated PSA levels. Conversely, advanced age, greater financial burden, and increased FoP are associated with lower PSA levels. FoP serves as a partial mediator between psychological resilience and PSA, as well as between social support and PSA. Future research would benefit from longitudinal designs to elucidate the developmental trajectories and causal links among these variables.

Quantifying Toxic Friendship: A Preliminary Investigation of a Measure of Victimization in the Friendships of Adolescents.

Although friendship is a key source of support and intimacy for adolescents, adolescent friendships can also involve victimization, which can be harmful to youth well-being. To date, our understanding of victimization in friendship has been limited by a lack of measures that comprehensively capture the variety of negative behaviors occurring in this relationship. This study outlines the development and preliminary validation of the Friendship Victimization Scale for Adolescents (FVS-A), which assesses victimization and controlling behaviors in adolescent friendships. Adolescents (N = 706, Mage = 15.93, SD = 1.67; 62.3% cisgender girls, 33.7% cisgender boys) from high schools in Canada completed the FVS-A and other measures in the fall of 2019. The factor structure and psychometric properties of the measure were examined. The FVS-A demonstrated excellent internal consistency and a 3-factor structure (relational victimization, physical/verbal victimization, controlling behavior). There was evidence for demographic differences such that cisgender girls reported more overall friendship victimization, as well as relational victimization and control, than did cisgender boys. Greater friendship victimization was associated with greater dating victimization and gender-based bullying and was uniquely associated with greater depressive symptoms after accounting for these other types of victimization. Findings suggest that friendship victimization is common among adolescents. The results provide evidence for the utility of the FVS-A as a measure of an understudied source of interpersonal risk. Future work is needed to understand the long-term implications of friendship victimization and to elucidate the temporal associations between friendship victimization and other indicators of psychosocial adjustment.

Contextual-compassion training for borderline personality disorder with long lasting symptoms: a randomized clinical trial

Long-term follow-up studies have shown that the symptoms of borderline personality disorder (BPD) tend to remit over time. However, many patients present long lasting symptoms (LLS), including low mood, emptiness, and persistent impairment in psychosocial adjustment. Given the high rate of LLS in BPD patients, new treatment strategies are needed. We conducted a randomized clinical trial (RCT) to evaluate the efficacy of a novel intervention that combines self-compassion and contextual-based skills for patients with persistent symptoms. Sixty BPD individuals with LLS who had received dialectical behavior therapy skills training (DBT-ST) in the previous six months were recruited and randomized to receive the experimental intervention or treatment as usual (TAU) for 12 weeks. All participants were evaluated pre- and post-intervention and at 3-months follow-up. The primary outcome measure was self-reported well-being. Other clinical variables were also evaluated, including depressive symptoms, BPD symptoms, functionality, self-compassion, and self-criticism. Participants in the experimental arm showed a significant increase in indicators of well-being (e.g., happiness and quality of life) and a significant decrease in depressive symptoms. These results were sustained—and even continued to improve—at the three-month follow-up. No significant changes were observed in BPD severity, self-criticism, or self-compassion. More RCTs are needed to test the efficacy of new interventions targeting this population with persistent symptoms, not only to reduce symptoms but also to promote well-being and personal recovery.

Using Interactive Design to Support the Reconstruction of Cultural Identity and Community Necessitated by Migration

Global warming has caused sea levels to rise. Ultimately, low-altitude land will be submerged, necessitating migration to higher altitudes. In this process, people’s cultural identity and community structure will be shattered, requiring fundamental reconstruction. Climate migrants face the struggle of adapting to rapid psychological and cultural change. This dissertation explores ways in which interactive design can be used to support the psychosocial (having both psychological and social parts) adjustments that migrants need to make. The dynamic process of acculturation to the new environment while maintaining cultural continuity is discussed. This study examines the use of interaction design to support migrants’ integration into a new society and help them negotiate the bureaucratic challenges that they face in that process. Based on findings from case studies, this study suggests strategies to enhance cultural inclusion and diversity through interaction design.

Exploring psychological help-seeking behaviors and stigma perception among cancer patients: a study on their impact on psychosocial adjustment.

The study investigates the relationships between psychological help-seeking behaviors, stigma perception, and psychosocial adjustment among cancer patients. Understanding these dynamics is crucial for enhancing the mental health and overall well-being of individuals battling cancer. This descriptive cross-sectional study involved 387 cancer patients, with data collected through structured questionnaires assessing attitudes toward seeking psychological help (ATSPPH-SF), stigma perception (SSRPH), and psychosocial adjustment (PAIS-SR). Statistical analyses, including correlation and hierarchical regression models, were conducted to explore the associations between these variables. The findings revealed a significant inverse relationship between perceived stigma and help-seeking behaviors, indicating that higher stigma is associated with reduced likelihood of seeking psychological support. Additionally, patients who were more reluctant to seek help demonstrated poorer psychosocial adjustment. Factors such as age, education level, marital status, and treatment status also played significant roles in influencing these outcomes. The study underscores the need for targeted interventions to reduce stigma and encourage help-seeking among cancer patients to improve their psychosocial adjustment and quality of life. Integrating mental health services into oncology care and addressing the stigma associated with psychological support are essential steps in enhancing patient outcomes.

Psychosocial Factors and Psychological Adjustment Among Adolescents and Young Adults: A Comparative Analysis of Occasional Drug Craving and Non-Craving.

The rate of drug craving not only in Pakistan is escalating rapidly, but also from a wide range of cultures and geographically have been impacted by the drug problem. Recently, drug cravings among young Pakistani school and college students have significantly increased, particularly illegal substances like hashish, heroin, and ecstasy. We recruited 338 students and gathered demographic and drug-craving data through a survey. To assess the study variables, we used the parental acceptance-rejection short version, peer pressure questionnaire, and adult personality assessment scale. The prevalence rate of occasional drug craving was 44.1% (tobacco, 39.9%; heroin, 1.8%; ice, 0.6%; and others), and 55.9% have never tried them. Initially, drug craving at the first onset at the age of 14 in friend gatherings (15.7%) in stressful situations (11.2%), high-income families, particularly in joint family systems with paternal rejection, peer enforcement, and maladjustment had a higher risk than affectionate parents and conventional peers. Stepwise binary logistic regression analysis disclosed that age, socioeconomic status, father affection, hostility, rejection, negligence, peer influences, and psychosocial adjustment, mother hostility were independently associated with occasional drug cravings. Findings suggested the high prevalence of occasional drug cravings in Pakistani students in the capital territory. Furthermore, the demographic and other social and clinical aspects could be linked. This study carried out theoretical significance in understanding the predictors of occasional drug craving and psychological adjustment, highlighting the peer and parent's roles and the educational institutions.

Implementation of intentionally structured psychosocial through folk games and traditional sports in elementary school students

This study aimed to examine the impact of intentionally structured psychosocial programs through folk games and traditional sports on elementary school students. Psychosocial factors influence individual thoughts and behaviors, and traditional games and sports are known for their character-building and cultural values. The research used a pretest-posttest group design with a quantitative approach, focusing on 5th-grade students from Sumur Batu 06 Public Elementary School in Central Jakarta. The primary instrument was the Questionnaire on Psychosocial Adjustment Needs of Grade 7 Students, covering social cognitive, socio-emotional, social, teacher-student, peer, parent, and sibling relationships. The study followed Kendellen's model, which emphasizes focusing on one psychosocial component per lesson, introducing it at the lesson's beginning, teaching it throughout the lesson, and reviewing it at the end. Data analysis was conducted using SPSS version 22, including only students with at least 80% attendance who completed both pre-tests and post-tests. Normality tests confirmed that data from both integrated and non-integrated groups were normally distributed, while homogeneity tests showed that the samples were from a homogeneous population. Paired sample t-tests revealed significant improvements in psychosocial outcomes for both groups, with the integrated group showing a t-value of 7.453 (Sig. 0.000) and the non-integrated group a t-value of 5.121 (Sig. 0.000). These results indicate a significant positive effect of psychosocially integrated traditional games and sports on the psychosocial development of elementary school students. Keywords: Intentionally Structured, Psychosocial, Sports, Traditional Games

Trajectories of temperamental shyness and attention shifting in Chinese children and their relations to psychosocial adjustment at entry to elementary school

Trajectories of temperamental shyness and attention shifting in Chinese children and their relations to psychosocial adjustment at entry to elementary school

The process of change and efficacy of trauma-focused social adjustment therapy (TF-SAT) on psychosocial adjustment of young individuals with complex trauma-related disorders: A case study.

The process of change and efficacy of trauma-focused social adjustment therapy (TF-SAT) on psychosocial adjustment of young individuals with complex trauma-related disorders: A case study.

Is the Identity Project College-Ready? A Feasibility Pilot Study of an Ethnic-Racial Identity Development Intervention with U.S. College Students

ABSTRACT Ethnic-racial identity (ERI) development promotes psychosocial and academic adjustment during adolescence and early adulthood. However, preventive intervention research into ERI promotion among young adults is limited. The current feasibility pilot study analyzed qualitative data (i.e. interviews, surveys, field notes) to explore the supports and impediments to implementing the Identity Project (IP), an ERI promotive curriculum developed for high-school aged adolescents, with college-going young adults at one U.S. university. Participants (N = 48; M age = 19.52, SD = 1.56; 86.36% female or non-binary) were randomly assigned to participate in the IP curriculum or to only complete surveys; all participants were invited to participate in interviews. Axial coding and thematic analysis revealed that: (a) young adult developmental needs and the ubiquitous salience of ERI in college promoted demand for structured interventions like the IP; (b) college cultural norms and values (e.g., emphasis on instrumental educational aims and ERI not being universal) limited access to the resources necessary for the IP intervention to be practical in college; and (c) implementing the IP as an extracurricular activity is not feasible and should instead be done as a campus requirement. Implications for future IP studies and college-based ERI interventions are discussed.

Association Between Dyadic Coping and Psychosocial Adjustment and the Mediation Effect of Fear of Disease Progression in Patients With Malignancy and Their Caregivers: Based on the Actor-Partner Interdependence Model.

Psychosocial adjustment (PSA) in patients exhibits a positive correlation with dyadic coping (DC) and a negative correlation with fear of disease progression (FoP). However, few studies have explored how DC impacts PSA and whether FoP mediates this relationship. To investigate the status of DC, FoP, and PSA in patients with malignancy and their caregivers and to explore the actor-partner and mediating effect of FoP on the association between PSA and DC. This study employed a cross-sectional design with convenience sampling to select patients with malignancy and their caregivers from 2 hospitals in China. SPSS and AMOS were used for data analysis. The model showed the mediation effect accounts for 28.30% of the total effect. For the actor effects, patients' and their caregivers' DC influenced their PSA directly (both β = -.138, P < .05) or through their FoP (β = -.050 and β = -.55, both P < .05). As for partner effects, patients' DC influenced the caregivers' PSA directly or through the patients' FoP (β = -.118 and β = -.020, both P < .05). Caregivers' DC also influenced patients' PSA directly (β = -.118, P < .05) or through the patients' or caregivers' FoP (β = -.098 and β = -.018, both P < .05). The model revealed a significant mediating effect of FoP on the association between the PSA and DC of patients with malignancy and their caregivers. Nurses should adopt a comprehensive perspective that includes caregivers in holistic care to improve their PSA by improving their level of DC or mitigating FoP.