Associations between dyadic coping, mutuality, and quality of life among maintenance hemodialysis patients and caregivers: an actor-partner interdependence mediation model.

Abstract

Purpose: Maintenance hemodialysis patients and their caregivers is experiencing poor quality of life. The dyadic illness management theory has linked dyadic coping and mutuality to quality of life. This study explored the effects of dyadic coping on mental/ physical quality of life and the mediating role of mutuality in these relationships among maintenance hemodialysis patients and their caregivers.

Methods: A cross-sectional study was conducted with 302 patient-caregiver dyads recruited from four blood purification centers in Jinan, Qingdao, Yantai, and Zaozhuang, China, between May 2024 and November 2024. Data were collected using a sociodemographic characteristics questionnaire, the dyadic coping inventory, the mutuality scale, and the 12-item short-form health survey. Data analysis was performed using the actor-partner interdependence mediation model.

Results: The findings revealed that in terms of actor effects, dyadic coping directly impacted mental and physical quality of life in maintenance hemodialysis patients and mental quality of life in caregivers (p < 0.01). The relationships were mediated through their own mutuality (p < 0.05). In terms of partner effects, caregivers' dyadic coping directly impacted maintenance hemodialysis patients' mental and physical quality of life (p < 0.05), with mutuality of both maintenance hemodialysis patients and their caregivers serving as a mediator (p < 0.05).

Conclusion: The study confirms the significant dyadic relationships between dyadic coping, mutuality, and mental/ physical quality of life among maintenance hemodialysis patients and their caregivers. The findings suggest that it is essential to develop effective dyadic interventions based on dyadic coping strategies or mutuality to improve mental and physical quality of life for both members.