Actor and Partner Effects of Dyadic Coping on Stress Among Hemodialysis Patients and Spouses.

AIMS AND

OBJECTIVES

This study examined the interdependence among dyadic coping, self-efficacy, and stress in Chinese hemodialysis patients and their spouses using the actor-partner interdependence model.

BACKGROUND

End-stage kidney disease creates major psychological challenges for both patients and their spouses. The systemic transactional model views coping as a shared, dyadic process between partners. However, the specific actor and partner effects of dyadic coping on illness-related stress in hemodialysis couples remain understudied.

DESIGN

A cross-sectional correlational design was used.

METHODS

A convenience sample of 200 patient-spouse dyads, comprising 400 individuals, was included in the analytic dataset. Participants completed the dyadic coping inventory, hemodialysis stressor scale, and general self-efficacy scale. The actor-partner interdependence model was applied to analyze the dyadic data.

RESULTS

Paired tests showed significant asymmetry in coping, with spouses reporting higher dyadic coping than patients. Self-efficacy was positively correlated with dyadic coping for both patients and spouses. The actor-partner interdependence model analysis revealed significant actor effects: an individual's own dyadic coping predicted lower personal stress. A significant partner effect also emerged, indicating that a spouse's coping was associated with lower patient stress.

CONCLUSION

These findings confirm the interdependent nature of coping within end-stage kidney disease dyads. Although spouses shoulder a greater share of the coping burden, their efforts effectively alleviate patient distress. Clinical interventions should move from patient-centered to couple-centered approaches that promote shared coping strategies, strengthen resilience, and reduce the risk of caregiver burnout.

RELEVANCE TO CLINICAL PRACTICE: The results support routine dyadic psychosocial assessment in hemodialysis care and the development of couple-based interventions. Such programs should build dyadic coping skills and self-efficacy in both partners while offering targeted support to prevent caregiver burnout.

NO PATIENT OR PUBLIC CONTRIBUTION: This observational survey study did not include patient, caregiver, or public involvement in the design, conduct, analysis, or manuscript preparation beyond participants' completion of questionnaires.