Dyadic associations between perceived family resilience and fear of disease progression among reproductive-age patients with cervical cancer and their spouses: a cross-sectional study.
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BACKGROUND: Fear of disease progression (FoP) and perceived family resilience may be interrelated within patient-spouse dyads, but member-specific and cross-partner associations in cervical cancer are insufficiently characterized. METHODS: This cross-sectional dyadic study included 208 reproductive-age patients with cervical cancer and their spouses. FoP was assessed using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) in patients and its partner version (FoP-Q-SF/P) in spouses; perceived family resilience was assessed using the Chinese version of the Family Resilience Questionnaire (FaRE). Paired comparisons, intraclass correlation analysis, Pearson correlations, and actor-partner interdependence model (APIM) analyses were conducted for distinguishable patient-spouse dyads. APIMs were estimated without and with adjustment for patient and spouse age and education, clinical stage, metastasis/recurrence status, and childbirth history. RESULTS: Patients reported higher FoP scores than spouses (46.88 ± 9.69 vs. 31.84 ± 4.79; t(207) = 20.71, P < 0.001). A total of 190 patients (91.3%) and 124 spouses (59.6%) scored ≥34; this patient-derived threshold was applied descriptively to spouses. Patient-perceived family resilience was lower than spouse-perceived family resilience (83.13 ± 16.20 vs. 88.22 ± 15.13; t(207) = -3.95, P < 0.001), with an absolute-agreement intraclass correlation coefficient (ICC) of 0.283 (95% confidence interval [CI] 0.156-0.399). In the adjusted APIM, patient-perceived family resilience was negatively associated with patient FoP (β = -0.179, P = 0.001) and spouse FoP (β = -0.544, P < 0.001). Spouse-perceived family resilience was negatively associated with patient FoP (β = -0.176, P = 0.003), whereas its association with spouse FoP was not statistically significant (β = -0.126, P = 0.053). CONCLUSIONS: In the adjusted APIM, higher patient-perceived family resilience was associated with lower FoP in both patients and spouses, and higher spouse-perceived family resilience was associated with lower patient FoP. Further research should evaluate approaches to assessing and managing FoP that include both patients and spouses.