Relationship between dyadic coping and quality of life among women of childbearing age with cancer and their spouses: mediating roles of fertility concerns and self-disclosure based on the actor-partner interdependence mediation model.
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PURPOSE: To explore the influence of dyadic coping (DC) strategies on the quality of life (QoL) of women of childbearing age with cancer and their spouses, considering fertility concerns and self-disclosure as mediators. METHODS: A total of 302 couples (patients and spouses) were recruited from five tertiary hospitals in China between March and October 2023. Data were collected using the self-designed information scale and standardized scales (Dyadic Coping Inventory, COMPI-Fertility Problem Stress Scales-Short Form, Distress Disclosure Index, World Health Organization Quality of Life Scale-BREF) and analyzed via Actor-Partner Interdependence Mediation Model (APIMeM). RESULTS: Patients reported a mean QoL score of 54.58 ± 6.81, while spouses scored 56.23 ± 7.24. Both partners' DC strategies positively correlated with their own QoL. Spouses' DC indirectly influenced patients' QoL through patients' fertility concerns (β = 0.028, P = 0.020) and their own QoL via spouses' fertility concerns (β = 0.052, P = 0.002). Patients' DC mediated their own QoL through self-disclosure (β = 0.028, P = 0.018). CONCLUSIONS: This study highlights the bidirectional relational dynamics of DC in cancer-affected couples. While DC strategies directly enhance individual QoL, spouses' coping behaviors indirectly shape partners' well-being through fertility-related distress, whereas patients' DC primarily influences their own QoL via communication processes. These findings emphasize DC as a relational process requiring couple-centered interventions to address interdependent coping needs, rather than isolated individual approaches.