Couple-Level Coping and Hope Interdependence in Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolisation: Insights From an Actor-Partner Interdependence Model.

BACKGROUND

Hepatocellular carcinoma (HCC) and transcatheter arterial chemoembolisation (TACE) are physically demanding for patients and their caregivers, as well as psychologically stressful. Spouses are often the main informal caregivers, so illness-related stress after TACE is experienced by the couple. Hope can provide psychological support for people with cancer, and dyadic coping refers to how couples cope with the stress of illness through communication. However, evidence remains limited regarding actor and partner associations between hope and dyadic coping in HCC patient-spouse dyads after TACE.

AIM: To examine the actor and partner associations between hope and dyadic coping in HCC patient-spouse dyads after TACE using the actor-partner interdependence model (APIM).

METHODS

This cross-sectional study included 177 patient-spouse dyads recruited from a tertiary hospital in China between October 2023 and June 2024. Participants completed questionnaires on hope and dyadic coping. Data were analysed using SPSS 25.0 and AMOS 24.0. Distinguishable dyads were specified in the APIM, controlling for patient age, Child-Pugh grade, and number of TACE sessions.

RESULTS

Both patients and their spouses reported moderate dyadic coping and relatively high hope. Hope was positively correlated with dyadic coping within and between partners. APIM revealed significant actor associations, indicating that higher hope was associated with better individual dyadic coping in patients (B' = 0.289, 95% CI [0.109, 0.451], p < 0.001) and spouses (B' = 0.381, 95% CI [0.221, 0.521], p < 0.001). Significant partner associations were also observed from patients to spouses (B' = 0.160, 95% CI [0.001, 0.308], p < 0.05) and from spouses to patients (B' = 0.181, 95% CI [0.031, 0.322], p < 0.05). These findings suggest that hope is associated with dyadic coping in both patients and spouses, underscoring the interdependent nature of psychological adjustment among couples managing HCC after TACE.

CONCLUSIONS

Hope was associated with dyadic coping in both patients and spouses, highlighting the interdependent nature of psychological adjustment in couples coping with HCC after TACE.

IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should recognise HCC patient-spouse dyads as an interdependent unit and incorporate assessment of both partners' hope and dyadic coping into oncology care management.