| BackgroundBreast cancer is the most common malignant tumors in the world.According to the developmental-contextual model of couples coping,cancer can be characterised as a situation of dyadic stress because it affects both members of the couple.However,in the process of coping with dyadic stress,the interaction mechanism between breast cancer patients and their spouses is still unclear.ObjectiveTo verify the applicability of the Developmental-Contextual Model of Couples Coping in the dyadic relationship between breast cancer patients and their spouses,explore the role of resilience in the among dyadic appraisal,dyadic coping and dyadic adjustment of breast cancer patients and their spouses,and construct the actor-partner interdependence mediation model of resilience in the dyadic relationship between breast cancer patients and their spouses.MethodsA cross-sectional design using convenient sampling method survey was employed in this study.This study was conducted at the Class 3,Level a Hospital of An Hui Province from December 2019 to December 2020.The participants were 360 breast cancer patients and their spouses(N=720)who completed the general information questionnaire,Resilience Scale(RS-14),Brief Illness Perception Questionnaire(BIPQ),Dyadic Coping Inventory(DCI)and Dyadic Adjustment Scale(DAS).Epi Data 3.1software was used to input data,SPSS 23.0 was used to manage and analyze the input data,Amos 21.0 was used to construct actor-partner interdependence mediation model,and bootstrap mediating effect of latent variables was analyzed,so as to further explore the relationship among resilience,dyadic appraisal,dyadic coping and dyadic adjustment of breast cancer patients and their spouses,and whether resilience plays a mediating role in it.Results1.The score of resilience of breast cancer patients was(75.27±10.61),which was lower than that of their spouses(78.42±10.23).There were differences of resilience level due to the education level of breast cancer patients and their spouses,the age and current treatment stage of patient(all P < 0.05);2.The score of dyadic appraisal of breast cancer patients was(31.54 ± 10.39),which was higher than that of their spouses(28.44±9.54).There were differences of dyadic appraisal level due to the age of breast cancer patients and their spouses,the disease stage of patients(all P < 0.05);3.The score of dyadic coping of breast cancer patients was(127.69 ± 13.55),which was lower than that of their spouses(130.32±12.16).There were differences of dyadic coping level due to the education level of breast cancer patients and their spouses,the residence,disease stage,diagnosis time and current treatment stage of patients,and occupational status of spouses(all P < 0.05);4.The score of dyadic adjustment of breast cancer patients was(111.64±16.29),which was lower than that of their spouses(114.66±13.24).There were differences of dyadic adjustment level due to the disease stage and current treatment stage of patients,and education level of spouses(all P < 0.05);5.Correlation analysis showed that there was a pairwise correlation between resilience,dyadic appraisal,dyadic coping and dyadic adjustment of breast cancer patients and their spouses(r=-0.405～0.840,all P<0.001);6.In the dyadic relationship,the actor mediating effect of resilience between the dyadic appraisal and dyadic coping of breast cancer patients and their spouses was found(β=-0.074,95%CI=-0.128～-0.034 and β=-0.080,95%CI=-0.136～-0.039).The mediating effect of partner is only the dyadic appraisal of breast cancer spouses,which influences the dyadic coping of patients through the resilience of spouses(β=-0.039,95%CI=-0.086～-0.007);7.In the dyadic relationship,the actor mediating effect of resilience between the dyadic coping and dyadic adjustment of breast cancer patients and their spouses was found(β=0.117,95%CI=0.055～0.188 and β=0.183,95%CI=0.099～0.279).The mediating effect of partner is only the dyadic coping of breast cancer spouses,which influences the dyadic adjustment of patients through the resilience of spouses(β=0.070,95%CI=0.024～0.130).ConclusionThe behavioral responses of breast cancer patients and their spouses in coping with the disease are interrelated and influence each other.Resilience has the mediating effect of actor-partner interdependence between the dyadic appraisal and dyadic coping,dyadic coping and dyadic adjustment of breast cancer patients and their spouses.The resilience of spouses has the partner effect on the dyadic coping and dyadic adjustment of patients.The medical staff should promote patients and their spouses to actively cope with the disease and improve the life quality. |
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