Yue Xian, Wang Yanhui, Zheng Ruishuang, Li Laiyou
Department of Nursing, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Hepatobiliary, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Asia Pac J Oncol Nurs. 2025 Feb 11;12:100665. doi: 10.1016/j.apjon.2025.100665. eCollection 2025 Dec.
Dyadic coping practices can vary depending on cultural contexts, socioeconomic factors, and the stages of the cancer journey. This study aimed to explore the dyadic coping experiences of hepatocellular carcinoma (HCC) patients and their spouses following postoperative recurrence in the Chinese cultural context, where cancer recurrence is frequently seen as a death sentence, and family-centered care is prioritized.
A descriptive qualitative research design was used, involving face-to-face, in-depth semi-structured interviews with 13 pairs of hepatocellular carcinoma patients and their spouses at a tertiary cancer hospital from July to October 2023. The interview guide was designed based on the Actor-Partner Interdependence Model (APIM) framework. Data were analyzed using thematic analysis, and the study adhered to the COnsolidated criteria for REporting Qualitative research (COREQ) checklist.
Three themes were identified: (1) active coping strategies, (2) negative coping tendencies, and (3) the need for systematic coping support. The majority of couples perceived hepatocellular carcinoma recurrence as a death sentence, which prompted them-especially the spouses-to adopt proactive strategies, such as striving to seek advanced treatments and concealing unfavorable information. In contrast, patients, particularly those with a hereditary hepatocellular carcinoma background, often exhibited passivity, withdrawal, and contemplation of treatment abandonment. Spouses frequently felt overwhelmed and unable to alleviate their partners' anxiety about recurrence and death, particularly in the absence of support from health care professionals. They expressed a strong need for professional guidance and targeted interventions to address end-of-life concerns, emphasizing the need for increased financial support, empowerment through knowledge, and access to peer support networks.
This research emphasizes the importance of recognizing the interdependent coping experiences of recurrent HCC patients and their spouses. Health care professionals are encouraged to implement culturally sensitive, dyadic interventions that foster collaborative coping, address death-related anxiety, and empower couples in managing recurrence together, thereby enhancing their coping strategies and confidence.
二元应对方式会因文化背景、社会经济因素以及癌症病程阶段的不同而有所差异。本研究旨在探讨在中国文化背景下肝细胞癌（HCC）患者及其配偶术后复发后的二元应对经历，在中国，癌症复发常被视为死刑宣判，且以家庭为中心的护理受到优先重视。
采用描述性定性研究设计，于2023年7月至10月在一家三级癌症医院对13对肝细胞癌患者及其配偶进行面对面、深入的半结构化访谈。访谈指南基于行动者 - 伙伴相互依赖模型（APIM）框架设计。采用主题分析法对数据进行分析，本研究遵循定性研究报告的统一标准（COREQ）清单。
确定了三个主题：（1）积极应对策略，（2）消极应对倾向，（3）对系统性应对支持的需求。大多数夫妻将肝细胞癌复发视为死刑宣判，这促使他们——尤其是配偶——采取积极主动的策略，如努力寻求先进治疗方法并隐瞒不利信息。相比之下，患者，尤其是那些有遗传性肝细胞癌背景的患者，往往表现出消极、退缩以及考虑放弃治疗。配偶们常常感到不堪重负，无法减轻伴侣对复发和死亡的焦虑，尤其是在缺乏医护人员支持的情况下。他们强烈表示需要专业指导和针对性干预措施来解决临终关怀问题，强调需要增加经济支持、通过知识增强能力以及获得同伴支持网络。
本研究强调认识复发性肝癌患者及其配偶相互依赖的应对经历的重要性。鼓励医护人员实施具有文化敏感性的二元干预措施，促进协同应对，解决与死亡相关的焦虑，并使夫妻共同应对复发问题时更有能力，从而增强他们的应对策略和信心。
