Köditz Anne-Kathrin, Mehnert-Theuerkauf Anja, Goerling Ute, Zimmermann Tanja, Hornemann Beate, Springer Franziska, Friedrich Michael, Ernst Jochen
Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany, Comprehensive Cancer Center Central Germany (CCCG).
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin, Germany.
Acta Oncol. 2025 Mar 18;64:431-438. doi: 10.2340/1651-226X.2025.42561.
Dyadic coping (DC) considers the perception of both the individual and their partner's coping behavior and influences various health outcomes. Given the paucity of research investigating the course of DC after a cancer diagnosis, we explored longitudinal data to find statistically distinct trajectories of DC and to characterize and predict those based on medical, psychological and sociodemographic characteristics.
In this prospective, multicenter study, we assessed patients with primary solid tumors at four measurement points using validated self-report questionnaires: first within 8 weeks of diagnosis, then at 6-month intervals. We measured DC using the Dyadic Coping Inventory (DCI). Clusters were identified via a feature-based clustering approach, characterized with t-tests and chi-squared tests and predicted with multinomial logistic regression.
We analyzed data from 418 patients in a partnership (mean age 61 years, 55.3% men, 84.8% married). Most prevalent cancers were prostate cancer (25.6%), skin cancer (17.5%) and breast cancer (16.3%). One cluster (33.5%) reported a stable high trajectory of coping behavior, indicating good coping behavior. It had the following characteristics: male (62.9%), regularly employed (57.9%), prostate cancer (34.3%) and childless (27.1%). The remaining sample contained a cluster with increasing coping behavior (34.7%) and another with decreasing coping behavior (31.8%). Lack of regular employment, having children and generalized anxiety are significantly associated with worsening coping behavior. This study is one of the first to examine DC trajectories in a large sample of cancer patients in the early phase after diagnosis. It is essential to understand markers such as psychological stress or family and work-related issues to optimize clinical and psycho-oncological outcomes and facilitate the support or maintenance of couple-related disease management in the long term.
二元应对（DC）考虑个体及其伴侣应对行为的认知，并影响各种健康结果。鉴于对癌症诊断后二元应对过程的研究匮乏，我们探索了纵向数据，以找出二元应对在统计学上不同的轨迹，并根据医学、心理和社会人口学特征对其进行特征描述和预测。
在这项前瞻性多中心研究中，我们使用经过验证的自我报告问卷在四个测量点对原发性实体瘤患者进行评估：首次在诊断后8周内，然后每隔6个月进行一次。我们使用二元应对量表（DCI）测量二元应对。通过基于特征的聚类方法识别聚类，用t检验和卡方检验进行特征描述，并用多项逻辑回归进行预测。
我们分析了418对处于伴侣关系中的患者的数据（平均年龄61岁，男性占55.3%，已婚者占84.8%）。最常见的癌症是前列腺癌（25.6%）、皮肤癌（17.5%）和乳腺癌（16.3%）。一个聚类（33.5%）报告了应对行为的稳定高轨迹，表明应对行为良好。其具有以下特征：男性（62.9%）、有固定工作（57.9%）、前列腺癌（34.3%）且无子女（27.1%）。其余样本包含一个应对行为增加的聚类（34.7%）和另一个应对行为减少的聚类（31.8%）。没有固定工作、有子女和广泛性焦虑与应对行为恶化显著相关。本研究是首批在诊断后早期对大量癌症患者样本中的二元应对轨迹进行研究的之一。了解诸如心理压力或家庭及工作相关问题等指标对于优化临床和心理肿瘤学结果以及长期促进夫妻相关疾病管理的支持或维持至关重要。
