The effects of dyadic coping and marital satisfaction on posttraumatic growth among breast cancer couples

Feasibility and preliminary efficacy of a systematic transaction model-guided dyadic coping nursing intervention for patients with breast cancer and their spousal caregivers: A pilot study

Objective

This study aimed to assess the feasibility, acceptability, and preliminary efficacy of a Systematic Transaction Model (STM)-guided dyadic coping nursing intervention for patients with breast cancer and their spouses.

Methods

A single-arm, pre-test/post-test pilot study was conducted at a tertiary hospital in Wuxi, China, recruiting 28 breast cancer patient-caregiver pairs. Each dyad participated in six hybrid intervention sessions. Paired t-tests were used to evaluate pre- and post-intervention changes, and effect sizes were calculated. Feasibility was assessed by recruitment and retention rates, acceptability via the Client Satisfaction Questionnaire-8 (CSQ-8), and preliminary efficacy through measures of body image, dyadic coping, post-traumatic growth, and marital satisfaction.

Results

All 28 dyads completed the intervention. Patients showed small-to-moderate improvements in body image, post-traumatic growth, dyadic coping, and marital satisfaction (d ​= ​0.4-0.5, P ​≤ ​0.022), with clinically meaningful changes observed in 39%-68% of patients. Spousal caregivers also demonstrated improvements in post-traumatic growth, dyadic coping, and marital satisfaction (d ​= ​0.3-0.6, P ​≤ ​0.033), with 36%-46% showing clinically important differences.

Conclusions

This pilot study supports the feasibility and initial efficacy of an STM-guided dyadic coping intervention, which may benefit breast cancer patients and their spouses as a unit. Further large-scale trials are recommended to validate these findings.

Trial registration

China Clinical Trial Registry (ChiCTR2400083416).

Effects of dyadic coping on post-traumatic growth in patients and couples with breast cancer: an analysis based on the actor-partner interdependence model

PURPOSE

Based on a dyadic perspective, the interaction between two variables of dyadic coping and post-traumatic growth in couples with breast cancer is explored, which facilitates an empirical basis for healthcare professionals to develop an intervention program to improve psychological care and quality of life for breast cancer couples.

METHODS

Two hundred ten pairs of breast cancer couples attending the department of surgical oncology of a hospital affiliated with Bengbu Medical University from July to December 2023 were surveyed through a cross-sectional method. Both breast cancer couples' completed questionnaire data were investigated using the General Information Questionnaire, the Dyadic Coping Inventory, and the Post-Traumatic Growth Inventory. Investigating the connection between post-traumatic growth and dyadic coping in patients and partners using an actor-partner interdependence model.

RESULTS

Breast cancer patients had higher dyadic coping scores (118.32 ± 12.10) than their spouses (117.76 ± 11.93); post-traumatic growth scores (65.30 ± 10.24) were significantly higher than their spouses (62.11 ± 10.30). In breast cancer couples, positive dyadic coping positively predicted post-traumatic growth in both themselves and their partners (P < 0.001). Patients' and spouses' negative dyadic coping had a negative effect on their post-traumatic growth.

CONCLUSION

Dyadic coping is an important correlate of post-traumatic growth in spouses and patients with breast cancer. Accordingly, healthcare professionals can incorporate dyadic coping into family-wide dyadic interventions that enhance the couple's post-traumatic growth and life quality.

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

Objective

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

Methods

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

Results

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

Conclusions

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

The relationship between dyadic coping and post-traumatic growth in breast cancer patients and spouses: based on potential profile analysis

BACKGROUND

The disease impact of breast cancer is to view the couple as a whole, breast cancer is a disease shared by the couple. Cancer coping has evolved from an individual perspective to a dyadic coping perspective for couples. The purpose of this study was to identify and describe the dyadic coping categories of couples with breast cancer and to analyze the relationship between dyadic coping categories and post-traumatic growth (PTG) in couples with breast cancer.

METHOD

In this study, breast cancer patients and their spouses were selected as the study population from several tertiary hospitals in Jinzhou City using convenience sampling method in 2023. A general information questionnaire, Dyadic Coping Inventory (DCI), and Post-traumatic Growth Inventory (PTGI) were used to survey 254 couples with breast cancer. Latent profile analysis (LPA) was performed using Mplus (version 8.3). SPSS 26.0 was used for data entry, and data were analyzed using one-way analysis of variance and multifactor logistic regression. Significance level α = 0.05.

RESULT

The study examines the influence of various factors such as educational attainment, age, income, residence, medical insurance, surgical procedure type, disease stage, and breast cancer recurrence on patients' coping strategies. Multiple logistic regression analysis showed that education level, age at marriage, place of residence, form of health care coverage, stage of the disease, and whether or not the disease recurred were significant predictors of each indicator (P < 0.05). The LPA yielded four dyadic coping subgroups, with high relative entropy (0.942), respectively, each accounting for 7.4%, 17.1%, 24.3%, and 51.2% of the total. The study found that the high-level coping group scored significantly higher in all dimensions of binary coping with post-traumatic growth among different patient and spouse subgroups.

CONCLUSION

Couple dyadic coping in breast cancer patients was categorized into four groups. The low-level coping group is the one that needs focused observation and intervention. This is a better reference for caregivers to provide more targeted coping programs based on the different dyadic coping categories of couples of breast cancer patients.

Associations between dyadic coping, marital satisfaction, and prenatal depression symptoms among couples with gestational diabetes mellitus

AIMS/BACKGROUND

Coping with gestational diabetes mellitus (GDM) presents significant challenges for pregnant women and their partners, which may result in elevated prenatal depression symptoms. However, research has predominantly centred on pregnant women with GDM, with little involvement of their partners. To understand their dyadic interactions, it is imperative to involve GDM couples in the study. This study aims to examine the interplay between dyadic coping and prenatal depression symptoms among GDM couples and to explore the possible mediating role of marital satisfaction.

DESIGN/METHOD

A cross-sectional study was conducted in Guangzhou, China. A total of 400 couples completed the Dyadic Coping Inventory, Locke-Wallace Marital Adjustment Scale, Edinburgh Postnatal Depression Scale, and sociodemographic data sheet. The actor-partner interdependence mediation model was utilised for dyadic data analysis.

RESULTS

Overall, 13.0% of pregnant women with GDM and 8.3% of partners experienced elevated prenatal depression symptoms. Dyadic coping was directly or indirectly related to their own and partners' prenatal depression symptoms in GDM couples, with marital satisfaction acting as a mediator. Specifically, positive dyadic coping was associated with lower prenatal depression symptoms, while negative dyadic coping exhibited an opposite relationship.

CONCLUSION

The prevalence of elevated prenatal depression symptoms was high in GDM couples. It is important to view pregnant women with GDM and their partners as a dyad of a transactional system in prenatal clinical care. Couple-centred interventions targeting to enhance positive dyadic coping and mitigate negative dyadic coping might be beneficial to prevent and alleviate prenatal depression symptoms.

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

BACKGROUND AND OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Dyadic coping and associated factors in women with high-risk pregnancy and their spouses: Do they interact?

OBJECTIVE

The objective of this study was to examine the present situation of dyadic coping in pregnant women with high-risk pregnancy and their spouses, as well as the relevant factors and the interactions between partners.

METHODS

From October 2022 to September 2023, a cross-sectional survey was undertaken, involving 460 pairs of pregnant women with high-risk pregnancy who were hospitalized for childbirth and their accompanying spouses. These participants completed self-assessments on dyadic coping, marital satisfaction, perceived stress, and self-efficacy through the completion of paper questionnaires. The collected data was then subjected to analysis utilizing correlation analysis and multiple linear regression. The actor-partner interdependence model (APIM) was then developed using the structural equation modeling(SEM) to test the binary association.

FINDINGS

Pregnant women preferred to utilize stressful communication, whereas their spouses employed supportive and delegated coping. Both external (such as education level, employment status, and medical insurance) and internal (such as marital satisfaction, perceived stress, and self-efficacy) factors were associated with pregnant women's dyadic coping. Education level and internal factors were also associated with the spouses' dyadic coping. In contrast to spouses, who can only have a partner effect on pregnant women through marriage satisfaction, all pregnant women's internal elements played the partner effect on the spouses' dyadic coping.

IMPLICATIONS

The study's findings help identify populations with inadequate coping ability. Promoting marital satisfaction, self-efficacy, and reducing perceived stress are associated with enhancing the dyadic coping ability of pregnant women with high-risk pregnancy and their spouses. It also suggests that antenatal care should intervene with pregnant women with high-risk pregnancy and their spouses as a whole, and emphasize collaborative coping and effective mutual support between couples rather than spousal support alone.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

The dyadic regulation approach of coping and illness representations in female cancer patients and their partners

Purpose

Adjustment to any illness is a 'dyadic' process whereby patients and their partners mutually determine each other's perceptions, behaviours, and well-being. The present study explored the association between dyadic coping strategies and illness representations in newly diagnosed female cancer patients and their partners.

Methods

The sample consisted of 92 female cancer patient-partner pairs from 3 oncology hospitals in Greece and Cyprus. The Actor Partner Interdependence Model was applied to test for dyadic regulation effects.

Results

The findings revealed that patients' evaluations of dyadic coping were related to their own illness representations and, in some cases, to partners' illness representations of control. However, partner evaluations of dyadic coping were not associated with either patients' or their own illness representations. Relationship satisfaction did not moderate the relationship between dyadic coping and illness representations.

Implications

The study suggests that patients' perceptions of support provided by themselves and their partners play a significant role in shaping their illness representations. Future research could delve into the underlying reasons for the observed differences in the impact of dyadic coping on illness representations between patients and partners, considering factors such as gender roles and specific gender-related issues.

Dyadic effects of social support, illness uncertainty on anxiety and depression among lung cancer patients and their caregivers: a cross-sectional study

OBJECTIVES

To explore the dyadic relationships between perceived social support, illness uncertainty, anxiety, and depression among lung cancer patients and their family caregivers. To examine the potential mediating role of illness uncertainty and the moderating role of disease stage in lung cancer patient-caregiver dyads.

METHODS

A total of 308 pairs of lung cancer patients and their family caregivers from a tertiary hospital in Wuxi, China, from January 2022 to June 2022 were included. Participants' perceived social support, illness uncertainty, anxiety, and depression were assessed by corresponding questionnaires. To test for dyadic relationships between the variables, we employed the actor-partner interdependence mediation model.

RESULTS

There were actor and partner effects of both patient and caregiver perceived social support on anxiety and depression, and illness uncertainty mediated the effect of perceived social support on anxiety and depression. Lung cancer stage plays a moderating role in lung cancer patient-caregiver dyads. There is an indirect positive partner effect of perceived social support from family caregivers on anxiety and depression in patients with early lung cancer; there is a direct or indirect negative partner effect of social support from family caregivers on anxiety and depression in patients with advanced lung cancer.

CONCLUSIONS

This study confirmed the dyadic interdependence between perceived social support, illness uncertainty, anxiety, and depression among lung cancer patients and family caregivers. Furthermore, studies on differences between different lung cancer stages may provide a theoretical basis for different dyadic supportive interventions based on lung cancer stages.

Cognitive Appraisal, Dispositional Coping, and Posttraumatic Growth among Patient-Caregiver Dyads Undergoing Hemodialysis

The present study aims to investigate the mediating effect of dispositional coping on the relationship between cognitive appraisal (which includes areas of threat, challenge, harm/loss, and benign/irrelevant appraisals) and posttraumatic growth (PTG) among patient-caregiver dyads undergoing hemodialysis. In total, 237 dyads of patients undergoing hemodialysis and their family caregivers were recruited from a tertiary hospital in Tianjin, China. Dyadic data were analyzed using the Actor-Partner Interdependence Mediation Model (APIMeM). The final APIMeM model examining dyadic effects of challenge appraisal and dispositional coping on PTG demonstrated an excellent model fit. The challenge appraisal of family caregivers was directly associated with the PTG of patients undergoing hemodialysis. Dispositional coping mediated the pathways between challenge appraisal and PTG for both patients undergoing hemodialysis and family caregivers. By exploring the cognitive appraisal and dispositional coping of patient-caregiver dyads undergoing hemodialysis may help both partners foster PTG.

Correlates of posttraumatic growth among spouses of newly diagnosed gynecological cancer survivors: A cross-sectional study

PURPOSE

Despite increasing research on posttraumatic growth (PTG) of spouses of cancer patients, and the positive effects of spouses' PTG on both spouses and patients, there is little information on PTG and its correlates among husbands of gynecological cancer survivors, especially those of newly diagnosed survivors. We aimed to assess PTG among spouses of newly diagnosed gynecological cancer survivors and to examine its correlates.

METHODS

In a cross-sectional study, a total of 400 spouses of newly diagnosed gynecological cancer survivors were recruited and completed questionnaires with information on general characteristics, rumination, self-disclosure, locus of control, and PTG. Univariate analysis and multiple linear regression analysis were performed.

RESULTS

The mean score of PTG among the spouses was 57.77 (SD = 12.03). There were significant differences in PTG among spouses with different education levels, marriage duration, number of children, per capita monthly income, other traumatic events within 6 months, and time since diagnosis groups. Pearson's correlation analysis revealed that deliberate rumination, self-disclosure, and locus of control were significantly associated with PTG. The multiple regression model revealed that 53.6% of the variance in PTG was explained by marriage duration, time since diagnosis, self-disclosure, deliberate rumination, and internality locus of control.

CONCLUSIONS

This study was one of the early attempts in evaluating PTG among spouses of newly diagnosed gynecological cancer survivors and identified several significant, potentially modifiable factors (self-disclosure, deliberate rumination, and internality locus of control) associated with PTG, providing an important guide for the development of effective psychosocial interventions for this population.