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To explore the association between psychological capital and psychological distress in stroke patient–spouse dyads and examine the mediating effect of relationship satisfaction in this association.
A population of 207 stroke patient-spouse dyads completed the Positive Psychological Capital Questionnaire, Quality of Relationship Index, and Kessler Psychological Distress Scale. A dyadic analysis was conducted using the actor-partner interdependence mediation model.
In stroke-affected couples, a noteworthy interaction exists between moderately elevated levels of psychological capital (p < 0.01). Patients exhibit significantly diminished psychological capital and heightened psychological distress compared to their spouses (t = −5.429, p < 0.001; t = 2.536, p < 0.05). Conversely, there is no significant variance in relationship satisfaction between patients and the partners (t = −0.920, p > 0.05). Patient relationship satisfaction acts as a mediator in the correlation between dyadic psychological capital and patient psychological distress (β = −0.020, p < 0.05; β = −0.011, p < 0.05). Similarly, spousal relationship satisfaction serves as a mediator in the connection between dyadic psychological capital and spousal psychological distress (β = −0.011, p < 0.05; β = −0.020, p < 0.05).
Psychological distress was reduced when psychological capital or relationship satisfaction in stroke dyads was promoted, and relationship satisfaction is an important mediator of the impact of psychological capital on psychological distress in the dyads. Healthcare providers should pay equal attention to spouses and implement dyadic psychological capital interventions centered on stroke couples to enhance relationship satisfaction and reduce psychological distress.
To explore the effectiveness of dyadic intervention on the psychological distress of cancer patients and their partners.
Cancer patients and their partners demonstrated high levels of psychological distress. However, the effects of dyadic intervention on psychological distress were unclear.
A systematic review and meta-analysis of randomised controlled trials was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.
A systematic search on couple-based dyadic intervention for cancer patients and their partners was carried out across eight databases. Our review adhered to the Cochrane risk-of-bias tool as its foundational framework, and data extraction and analysis followed standardised checklists for quantitative research studies.
No statistically significant effects were reported on patients' anxiety, depressive symptoms, or cancer-related distress. However, subgroup analysis revealed that interventions lasting 6 or 12 weeks had positive effects on patients' cancer-related distress. Significant reductions in cancer-related distress scores were only observed when interventions included communication and support (CS) and skill building (SB) components, however. Additionally, patients experienced higher distress levels with less than six interventions or session durations shorter than 6 h. For partners, couple-based dyadic interventions significantly reduced their anxiety and depressive symptom levels.
Couple-based dyadic interventions, with either 6- or 12-week durations, or encompassing both CS and SB components, demonstrated significantly positive effectiveness on patients' psychological distress. Couple-based dyadic interventions also exhibited a propensity for alleviating psychological distress in both cancer patients and their partners, with a more pronounced impact observed among partners.
This meta-analysis highlights the effectiveness of dyadic interventions in reducing psychological distress in cancer patients and their partners. Healthcare professionals should incorporate these interventions into their care practices.
Direct contributions from patients or the public were not included in this review.
PROSPERO number: CRD42023418978; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=418978
To summarize evidence from systematic reviews (SRs)/meta-analyses (MAs) regarding the impact of dyadic interventions delivered to both members of a cancer dyad, including a cancer patient and caregiver (e.g. family caregiver, intimate partner).
This overview of SRs was conducted in accordance with the preferred reporting items for overviews of reviews statement.
A comprehensive search of multiple databases, including PubMed, Cochrane Library, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure and Wan Fang. The methodological and reporting quality of SRs and MAs was assessed using the Assessing the Methodological Quality of Systematic Reviews 2. The quality of the included SRs/MAs was evaluated using the Grades of Recommendations, Assessment, Development and Evaluation approach.
Eighteen SRs/MAs undertook quantitative synthesis to assess the impact of dyadic interventions on cancer dyads. Both the credibility of the SRs/MAs and the evidence quality of the outcome measures were below satisfactory standards. Prior SRs/MAs revealed several limitations such as lack of pre-published protocols or research objectives, failure to report excluded studies and insufficient details on funding sources for individual studies.
Dyadic interventions may prove advantageous for the physical health and dyadic adjustment of cancer dyads. Nevertheless, the reported results of dyadic interventions on the psychological health of patient–caregiver dyads affected by cancer are inconsistent. Thus, rigorous and comprehensive studies are requisite to establish reliable evidence for conclusive determinations.
The findings of this overview can guide healthcare practitioners when considering the use of dyadic interventions for cancer dyads. Moreover, these findings have the potential to enhance the integration of these approaches into clinical practice.
Our paper presents an overview of systematic reviews, and therefore, such specific details may not be relevant to our study.
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