Li Mingfang, Zhang Lijuan, Zhang Liping, Li Xinyi, Xie Yantong, Qiu Yuqi, Zhao Meng, Chen Jing, Yan Jun
School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.
Br J Health Psychol. 2025 Feb;30(1). doi: 10.1111/bjhp.12771.
To describe and compare dyads' illness perceptions, dyadic coping and illness management among breast cancer patients and their spouses. In addition, we explore the direct actor and partner effects of illness perception on illness management, and whether this association is mediated by dyadic coping.
A descriptive and longitudinal study.
Baseline illness perceptions and dyadic coping during hospitalization were measured by using the Illness Perception Questionnaire-revised (IPQ-R) and the Dyadic Coping Inventory (DCI). At the 3rd month after discharge, the Cancer Self-Management Assessment Scale (CSMAS) and the Caregiver's Contribution to the Cancer Patient's Self-Management Scale (CC-CPSMS) were used to test the dyads' illness management. Then, the actor-partner interdependence mediation model (APIMeM) was constructed to explore intrapersonal and interpersonal effects.
A total of 225 postsurgical breast cancer patients and their spouses completed the questionnaires. It revealed that patients' or spouses' illness perceptions had both positive and negative direct actor effects on their own illness management (positive: personal control and illness coherence dimension; and negative: timeline acute/chronic, consequence, emotional representation and causes-uncontrollable factors dimension). The significant direct partner effects were only displayed in the timeline acute/chronic dimension. Moreover, dyadic coping had mediating effects on these paths, and only the actor-actor and partner-actor indirect effects were statistically significant.
This study demonstrates the significance of illness perceptions in influencing dyads' illness management and reveals the underlying mediating mechanism of dyadic coping. It can provide more specific guidance for dyadic interventions to optimize dyads' behaviour among breast cancer patients and their spouses.
描述并比较乳腺癌患者及其配偶双方对疾病的认知、二元应对方式及疾病管理情况。此外，我们还探讨了疾病认知对疾病管理的直接个体效应和伴侣效应，以及这种关联是否通过二元应对方式介导。
一项描述性纵向研究。
采用修订后的疾病认知问卷（IPQ-R）和二元应对量表（DCI）对住院期间的基线疾病认知和二元应对方式进行测量。在出院后第3个月，使用癌症自我管理评估量表（CSMAS）和照顾者对癌症患者自我管理的贡献量表（CC-CPSMS）来测试双方的疾病管理情况。然后，构建个体-伴侣相互依赖中介模型（APIMeM）以探讨个体内效应和人际效应。
共有225名乳腺癌术后患者及其配偶完成了问卷调查。结果显示，患者或配偶的疾病认知对其自身的疾病管理既有正向直接个体效应（正向：个人控制和疾病连贯性维度；负向：时间线急性/慢性、后果、情感表征和原因-不可控因素维度），也有负向直接个体效应。显著的直接伴侣效应仅在时间线急性/慢性维度中显示。此外，二元应对方式在这些路径中起中介作用，且只有个体-个体和伴侣-个体的间接效应具有统计学意义。
本研究证明了疾病认知在影响双方疾病管理方面的重要性，并揭示了二元应对方式的潜在中介机制。它可以为二元干预提供更具体的指导，以优化乳腺癌患者及其配偶之间的行为。
