A Contemporaneous and Longitudinal Network Analysis of Fear of Disease Progression and Dyadic Self-Care in Stroke Patients and Their Spouses.

Abstract

This is a longitudinal stydy to explore the relationship between fear of disease progression and dyadic self-care in stroke patients and their spouses. Between August 2024 and May 2025, 369 stroke patient-spouse dyads completed two rounds of surveys, including the General Demographic Questionnaire, the Fear of Progression Questionnaire Short Form, the Fear of Progression Questionnaire Short Form/Partner, the Self-Care of Chronic Illness Inventory, and the Caregiver Contribution to Self-Care Chronic Illness Inventory. Contemporaneous and cross-lagged network analyses were used to examine the interaction between these variables in stroke patients and spouses. Contemporaneous networks confirmed: (1) At dimensional level, there is a positive association between patients' self-care behavior and spousal contribution to self-care, as well as a positive association between their mutual fear of disease progression; (2) Spouses' fear of disease progression negatively correlated with their spousal contribution to self-care at dimensional level. Cross-lagged network confirmed bidirectional predictions between: (1) patients' fear of disease progression and their self-care; (2) spouses' fear of disease progression and their contribution to self-care. Patients' fear of disease progression and self-care dimensions predicted corresponding dimensions in spouses. The fear of disease progression and dyadic self-care among stroke patients and their spouses are dyadic phenomena and can predict each other. Stroke rehabilitation is a dynamic dyadic synergy; both partners' behaviours and emotions change together. Future rehabilitation programs should be phased and multi-targeted. In the early phase, focus on disease knowledge and symptom management to alleviate physiological fear. In the later phase, reconstruct social roles and family communication, correct the cognitive biases of spouses regarding patients' self-care behaviours, break negative loops, and promote mutual growth.