Quality of life dynamics in the gastric cancer dyad: an actor-partner interdependence model analysis guiding the development of a family-centered nursing framework.

Abstract

Purpose: To explore the mechanisms linking quality of life (QoL) between postoperative GC patients and their family caregivers, and to construct a family-centered nursing framework.

Methods: 353 patient-caregiver dyads were recruited. Based on a validated theoretical framework, we analyzed factors influencing QoL and used the Actor-Partner Interdependence Model (APIM) to examine bidirectional pathways.

Results: Patient and caregiver QoL were positively correlated (r = 0.287, p < 0.001). Actor effects: Patient QoL was positively predicted by patient health literacy, benefit finding, and positive coping, and negatively by patient negative coping and anxiety/depression. Caregiver QoL was positively predicted by caregiver health literacy and positive coping, and negatively by caregiver benefit finding, negative coping, and anxiety/depression. Partner effects: Caregiver health literacy and positive coping positively predicted patient QoL; caregiver self‑efficacy and benefit finding negatively predicted patient QoL. Patient positive coping positively predicted caregiver QoL, while patient social support negatively predicted caregiver QoL.

Conclusions: This study reveals significant bidirectional interdependence of QoL within GC dyads, uncovers complex negative spillover mechanisms, and provides an empirical basis for identifying high-risk groups and developing balanced, de-burdening interventions. The findings support integrating the patient-caregiver dyad as a holistic unit into disease management frameworks. Gastric cancer and surgery can greatly change the lives of both patients and the family members who care for them. However, care after surgery often focuses mainly on the patient, while the caregiver's needs and influence may be overlooked. This study aimed to understand how quality of life is connected between patients after gastric cancer surgery and their family caregivers. We studied 353 patient-caregiver dyads and looked at how understanding health information, confidence in managing care, finding positive meaning, coping styles, emotional distress, and social support were related to their quality of life. We found that patients and caregivers affected each other. When caregivers had better health knowledge and used more positive ways to cope, patients tended to report better quality of life. When patients used positive coping, caregivers also tended to report better quality of life. However, some forms of support or personal effort were linked with lower quality of life for the other person, suggesting possible hidden burden. These findings show that patients and caregivers should be supported together, not separately.