Distinct dyadic coping profiles in Chinese couples with breast cancer

Association Between Dyadic Coping and Quality of Life in Breast Cancer Patients and Their Spouses: An Actor-partner Interdependence Mediation Model

PURPOSE

This study aims to examine the relationship between dyadic coping (DC), intimate relationship, and quality of life (QOL), and to explore the mediating role of intimate relationship in patients with breast cancer (BC) and their spouses from a dyadic perspective.

METHODS

A cross-sectional design was used in this present study, and 205 dyads of BC patients and their spouses who completed a sociodemographic and clinical questionnaire and self-reported measures assessing their DC, intimate relationship, and QOL were recruited. The actor-partner interdependence mediation model (APIMeM) was adopted for dyadic distinguished data analysis. The paired t-test, Pearson's correlation coefficients, and the structural equation model were employed for data analysis by using SPSS 22.0 and Amos 24.0.

RESULTS

The current study revealed that, for BC patients and their spouses, intimate relationship mediates completely the actor effect of DC on QOL. That is to say, DC was positively related to intimate relationship and then improved QOL. It was interesting to find that, for both patients and their spouses, the intimate relationship could exert a partner-actor complete mediation effect between DC and QOL.

CONCLUSIONS

The DC perceived by both BC patients and their spouses has significant actor effects on QOL by improving the level of an intimate relationship. Furthermore, intimate relationship has significant actor-actor and partner-actor complete mediation effects for both patients and their spouses. Given the vital role of patient-spouse dyads, nursing staff should take patients' spouses into account when conducting related psychosocial interventions aiming to improve the QOL of BC patients and their spouses.

Dyadic typology of illness perceptions in human immunodeficiency virus (HIV) Serodiscordant couples

OBJECTIVE

Illness perceptions direct coping resources in the illness adaptation process. Previous studies regarding illness perception profiles have been conducted at the individual level, without considering the couple as a unit. This study aimed to investigate the dyadic topologies of illness perceptions in HIV-serodiscordant couples and the association between the identified profiles and individual- and couple-level outcomes.

METHODS

A comprehensive examination was undertaken, encompassing 231 Chinese HIV-serodiscordant couples, who voluntarily participated in this cross-sectional study during the period spanning June to October 2022. To discern various patterns of illness perception, dyadic latent profile analyses were performed, followed by the implementation of one-way analyses of variance to investigate outcome differences at both the individual and couple levels across the identified profiles.

RESULTS

We identified three distinct profiles of illness perception, namely the incongruent-but-low, congruent-but-high, and incongruent-and-high profiles. Except for the partner's sex (p < .01, Cramer' v = 0.214) and the education levels of persons living with HIV and their partners (both p < .01, Cramer' v = 0.236 for persons living with HIV and 0.198 for partners), no significant demographic differences across the various profiles were found. Furthermore, we observed significant differences in all outcomes among the different couple profiles (all p < .001). These differences were of medium-to-large magnitudes (partial η2 values ranging from 0.07 to 0.22).

CONCLUSION

A couple-centered typological approach provides a useful way of identifying the couple's configuration of illness perceptions, which will inform the provision of tailor-made treatment for couples with different profiles.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Identification of age differences in cancer-related symptoms in women undergoing chemotherapy for breast cancer in China

BACKGROUND

Both contextual and cancer-related factors could be identified as causes of the interindividual variability observed for symptoms experienced during breast cancer treatment with chemotherapy. Understanding age differences and the predictors of latent class memberships for symptom heterogeneity could contribute to personalized interventions. This study aimed to identify the role of age differences on cancer-related symptoms in women undergoing chemotherapy for breast cancer in China.

METHODS

A cross‑sectional survey was conducted among patients with breast cancer in three tertiary hospitals in central China between August 2020 to December 2021. The outcomes of this study included sociodemographic and clinical characteristics, Patient-Reported Outcomes Measurement Information System (PROMIS)-57 and PROMIS-cognitive function short form scores.

RESULTS

A total of 761 patients were included, with a mean age of 48.5 (SD = 11.8). Similar scores were observed across age groups for all symptoms except for fatigue and sleep disturbance domains. The most central symptoms varied among each group, and were fatigue, depression, and pain interference for the young-aged, middle-aged, and elderly-aged groups, respectively. In the young-aged group, patients without health insurance (OR = 0.30, P = 0.048) and in the fourth round of chemotherapy or above (OR = 0.33, P = 0.005) were more likely to belong to low symptom classes. In the middle-aged group, patients in menopause (OR = 3.58, P = 0.001) were more likely to belong to high symptom classes. In the elderly-aged group, patients with complications (OR = 7.40, P = 0.003) tended to belong to the high anxiety, depression, and pain interference classes.

CONCLUSIONS

Findings from this study indicated that there is age-specific heterogeneity of symptoms present for Chinese women being treated for breast cancer with chemotherapy. Tailored intervention should consider the impact of age to reduce patients' symptom burdens.

Cancer-related symptoms among young and middle-aged women undergoing chemotherapy for breast cancer: Application of latent class analysis and network analysis

PURPOSE

To identify subgroups and symptom networks of cancer-related symptoms for women under 60 years who are undergoing chemotherapy for breast cancer.

METHODS

A cross-sectional survey in Mainland China was conducted between August 2020 and November 2021. Participants completed questionnaires that collected demographic and clinical characteristics and featured the PROMIS-57 and the PROMIS-Cognitive Function Short Form.

RESULTS

A total of 1033 participants were included in the analysis, and three-class model was identified: "severe symptom group" (17.6%; Class 1), "moderately severe anxiety, depression, and pain-interference group" (38.0%; Class 2), and "mild symptom group" (44.4%; Class 3). Patients who were in menopause (OR = 3.05, P < .001), undergoing a combination of medical treatments (OR = 2.39, P = .003), and who had experienced complications (OR = 1.86, P = .009) were more likely to belong to Class 1. However, having two or more children increased the likelihood of belonging to Class 2. Additionally, network analysis showed that severe fatigue level was the core symptom among the full sample. As for Class 1, feeling helpless and severe fatigue level were the core symptoms. Regarding Class 2, the impact of pain interfere on the ability to participate in social activities and feeling hopeless were found to be the targeted symptoms for intervention.

CONCLUSION

Menopause, receiving a combination of medical treatments, and experiencing complications characterize the group with the most symptom disturbance. Moreover, different interventions should be performed for core symptoms in patients with varied symptom disturbances.

Heterogeneity of symptoms and functions among women receiving chemotherapy for breast cancer in China: A multicentre, cross-sectional study

Background

Currently, few studies have explored the heterogeneity of symptoms and functions in patients with breast cancer. This study aimed to identify the subgroups of symptoms and functions in women receiving chemotherapy for breast cancer and determine whether the subgroups differed in demographic and clinical characteristics.

Methods

A cross-sectional multicenter survey involving five hospitals in Zhejiang, Shanghai, Shandong, and Guangxi provinces of Mainland China was implemented between August 2020 to December 2021. Participants completed questionnaires that included the PROMIS-57, PROMIS cognitive function short form, and demographic and clinical characteristics. Latent class analysis was performed, followed by chi-square test and analysis of variance. Subsequently, significant variables were included in multinomial logistic regression.

Results

A total of 1,180 patients were investigated, with an average age of 48.9 years. Three classes were identified: low symptom burdens and functions group (26.2%, Class 1), moderate symptom burdens and functions group (16.9%, Class 2), and low symptom burdens and high functions group (56.9%, Class 3). Compared with patients in Class 1 and 3, those in Class 2 consistently showed a higher tendency of having urban employee health insurance (odds ratio = 2.506, P &lt; 0.05) and rural health insurance (odds ratio = 2.207, P &lt; 0.05). Additionally, patients in Class 2 tended to be in their fourth cycle of chemotherapy. However, receiving chemotherapy and surgery increased the likelihood of belonging to Class 1.

Conclusions

A high proportion of patients experienced varying degrees of symptom and function issues, suggesting that attention is warranted for women with breast cancer undergoing chemotherapy. Patients with the urban employee basic medical system, the new rural cooperative medical system and in the early stage of chemotherapy cycles were more likely to have symptom burdens. Middle-aged postmenopausal women reported varying degrees of cognitive issues. Additionally, surgery increased the presence of potential long-term effects in functional levels.