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
TL;DR
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 in both patients and spouses.
Abstract
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. 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. 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). 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.