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.

Abstract

Background: 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.

Objective: 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.

Methods: 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.

Results: 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).

Conclusions: The model revealed a significant mediating effect of FoP on the association between the PSA and DC of patients with malignancy and their caregivers.

Implications for practice: 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.