Dyadic effects of social support and coping on quality of life and caregiver burden among hemodialysis patient-caregiver dyads: an actor-partner interdependence mediation model.

OBJECTIVE

This study investigates the dyadic mechanisms linking social support, coping styles, quality of life (QoL), and caregiver burden among maintenance hemodialysis (MHD) patient-caregiver dyads, with a focus on the mediating role of adaptive coping strategies.

METHOD: In a cross-sectional design, 200 patient-caregiver dyads with MHD completed self-report measures of QoL, caregiver burden, coping style and social support. Mediation analysis was performed using actor-partner interdependence model extended to mediation (APIMeM) and the bootstrapping method. Bias-corrected 95% confidence intervals were calculated for the study of direct and indirect effects.

RESULTS

Significant actor effects were observed: patients' social support directly associated with improved their QoL (β = 0.224, p = 0.001), while caregivers' support associated with reduced their burden (β = -0.141, p = 0.001). Adaptive coping mediated 46.2% of patient QoL variance via actor effects (total indirect β = 0.288) and 25.0% of caregiver burden reduction via actor effects (total indirect β = -0.047). Partner effects revealed cross-dyad influences: caregivers' support associated with enhanced patient QoL (β = 0.239, p = 0.002), and patients' support associated with reduced caregiver burden (β = -0.475, p = 0.001). Key mediation pathways included caregivers' support affecting patient QoL via caregivers' coping (β = 0.050, 95% CI [0.005, 0.103]) and patients' support affecting caregiver burden via caregivers' coping (β = -0.164, 95% CI [-0.236, -0.103]).

CONCLUSIONS

Enhancing social support networks and fostering adaptive coping strategies through dyad-centered programs may synergistically alleviate caregiver burden and improve patient QoL.