Relationship between dyadic coping and quality of life among women of childbearing age with cancer and their spouses: mediating roles of fertility concerns and self-disclosure based on the actor-partner interdependence mediation model

Purpose

To explore the influence of dyadic coping (DC) strategies on the quality of life (QoL) of women of childbearing age with cancer and their spouses, considering fertility concerns and self-disclosure as mediators.

Methods

A total of 302 couples (patients and spouses) were recruited from five tertiary hospitals in China between March and October 2023. Data were collected using the self-designed information scale and standardized scales (Dyadic Coping Inventory, COMPI-Fertility Problem Stress Scales-Short Form, Distress Disclosure Index, World Health Organization Quality of Life Scale-BREF) and analyzed via Actor-Partner Interdependence Mediation Model (APIMeM).

Results

Patients reported a mean QoL score of 54.58 ± 6.81, while spouses scored 56.23 ± 7.24. Both partners' DC strategies positively correlated with their own QoL. Spouses' DC indirectly influenced patients' QoL through patients' fertility concerns (β = 0.028, P = 0.020) and their own QoL via spouses' fertility concerns (β = 0.052, P = 0.002). Patients’ DC mediated their own QoL through self-disclosure (β = 0.028, P = 0.018).

Conclusions

This study highlights the bidirectional relational dynamics of DC in cancer-affected couples. While DC strategies directly enhance individual QoL, spouses' coping behaviors indirectly shape partners' well-being through fertility-related distress, whereas patients’ DC primarily influences their own QoL via communication processes. These findings emphasize DC as a relational process requiring couple-centered interventions to address interdependent coping needs, rather than isolated individual approaches.