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.