Dyadic Coping and Fear of Progression in Patients With Chronic Heart Failure and Their Spouses: A Social Support-Based Actor-Partner Interdependence Mediation Model.

BACKGROUND

Chronic heart failure (CHF) has emerged as a significant global public health challenge. Fear of progression (FoP) constitutes a critical psychosocial issue among patients with CHF, with dyadic coping (DC) and social support serving as key influencing factors; however, the intrinsic mechanisms linking these components remain ambiguous.

OBJECTIVE

In this study, our aim was to elucidate the mediating role of social support within patient-spouse dyads as a bidirectional dependency in the relationship between DC and FoP, thereby providing a scientifically grounded foundation for clinical intervention strategies.

METHODS

Between July 2024 and February 2025, a total of 221 CHF patient-spouse dyads were recruited via convenience sampling at a tertiary hospital in Tangshan City, Hebei Province. Data collection instruments included a demographic questionnaire, the Fear of Progression Questionnaire-Short Form, the Dyadic Coping Inventory, and the Perceived Social Support Scale. Data were analyzed using AMOS 24.0 for the actor-partner interdependence mediation model.

RESULTS

Analysis of the actor-partner interdependence mediation model demonstrated significant actor effects across all pathways ( β = -0.204 to 0.228, P < .01), with partial partner effects observed ( β = -0.066 to 0.116, P < .05). Notably, significant mediating effects were identified ( β = -0.043 to -0.017; 95% confidence interval: -0.071, -0.003; P < .05). Actor effects indicated that social support partially mediated the relationship between individual DC and FoP. Partner effects revealed that social support partially mediated the association between spouses' DC and patients' FoP.

CONCLUSION

The findings illuminate the interactive dynamics among DC capabilities, social support, and FoP within dyads of patients with CHF and their spouses. Clinical interventions should adopt a dyadic approach, simultaneously enhancing mutual coping skills and social support levels to effectively mitigate FoP in both patients and their spouses.