The relationships among illness perceptions, dyadic coping and illness management in breast cancer patients and their spouses: A dyadic longitudinal mediation model

OBJECTIVES: To describe and compare dyads' illness perceptions, dyadic coping and illness management among breast cancer patients and their spouses. In addition, we explore the direct actor and partner effects of illness perception on illness management, and whether this association is mediated by dyadic coping. DESIGN: A descriptive and longitudinal study. METHODS: Baseline illness perceptions and dyadic coping during hospitalization were measured by using the Illness Perception Questionnaire-revised (IPQ-R) and the Dyadic Coping Inventory (DCI). At the 3rd month after discharge, the Cancer Self-Management Assessment Scale (CSMAS) and the Caregiver's Contribution to the Cancer Patient's Self-Management Scale (CC-CPSMS) were used to test the dyads' illness management. Then, the actor-partner interdependence mediation model (APIMeM) was constructed to explore intrapersonal and interpersonal effects. RESULTS: A total of 225 postsurgical breast cancer patients and their spouses completed the questionnaires. It revealed that patients' or spouses' illness perceptions had both positive and negative direct actor effects on their own illness management (positive: personal control and illness coherence dimension; and negative: timeline acute/chronic, consequence, emotional representation and causes-uncontrollable factors dimension). The significant direct partner effects were only displayed in the timeline acute/chronic dimension. Moreover, dyadic coping had mediating effects on these paths, and only the actor-actor and partner-actor indirect effects were statistically significant. CONCLUSIONS: This study demonstrates the significance of illness perceptions in influencing dyads' illness management and reveals the underlying mediating mechanism of dyadic coping. It can provide more specific guidance for dyadic interventions to optimize dyads' behaviour among breast cancer patients and their spouses.