Psychological Distress Among Colorectal Cancer Patient-Caregiver Dyads: Influencing Factors and Dyadic Intervention Preferences-A Mixed Methods Study.

Background: Colorectal cancer imposes substantial psychological distress on patients and spouse caregivers, yet dyadic distress interactions, key influencing factors, and effective interventions remain insufficiently understood.

Aims: To assess psychological distress levels in colorectal cancer patient-caregiver dyads, identify influencing factors, explore dyadic intervention patterns, and gather professional suggestions for prevention and mitigation strategies.

Methods: A mixed-methods study with an explanatory sequential design was conducted. Quantitatively, 259 colorectal cancer patient-caregiver dyads from three tertiary hospitals completed surveys measuring psychological distress, perceived stress, relationship satisfaction, and distress disclosure. Qualitatively, in-depth interviews were conducted with 10 patient-caregiver dyads and 10 healthcare providers using maximum variation sampling.

Results: Both patients and caregivers demonstrated significant psychological distress. For patients, key predictors included relationship satisfaction, distress disclosure, and perceived stress. For caregivers, significant predictors were caregivers' age, caregiving hours, relationship satisfaction, distress disclosure, perceived stress, and patients' relationship satisfaction. A distinctive "mutual protection through concealment" pattern emerged, where both patients and caregivers concealed distress to protect each other. Qualitative findings also identified additional distress triggers (role changes, symptom burden, prolonged caregiving) and protective factors (relationship support, acceptance, and open communication).

Conclusions: Healthcare professionals should address psychological distress in colorectal cancer dyads through targeted interventions, considering dyadic interaction patterns. Interventions should include relationship strengthening, communication skills training, caregiver support with attention to their health status, symptom management education, and strategies addressing the culturally influenced mutual concealment pattern to promote authentic emotional disclosure, reduce psychological distress, and improve quality of life for both patients and caregivers.