Interaction between illness cognitions and dyadic coping : a qualitative exploration of stress adaptation in young and middle-aged colorectal cancer patients and their spouses

Abstract

Purpose: To explore the stress adaptation experiences of young and middle-aged couples with colorectal cancer (CRC), specifically examining the interaction between illness cognitions and dyadic coping. Methods: Using purposive sampling, semi-structured interviews were conducted with eight pairs of young and middle-aged CRC couples, along with eight patients and five spouses, at a tertiary hospital in Guangzhou from October 2023 to February 2024. Data were analyzed following the six-stage process outlined in the interpretative phenomenological analysis research guidelines, with coding and organization supported by Nvivo 12.0 software to extract hierarchical themes reflecting the interaction process between illness cognitions and dyadic coping in CRC couples. Results: Three themes emerged: (1) Intrapersonal dynamics: positive illness cognitions facilitated adaptive coping strategies, whereas negative cognitions triggered maladaptive coping behaviors. (2) Dyadic mechanisms: a cross-partner influence was observed where one partner’s illness cognitions affected the other’s coping through specific pathways, including negative resonance, reverse activation, and compensatory adaptive coping. (3) Key moderators: relationship intimacy, communication quality, family resilience, social support, family role identity, and division of labor significantly moderated these interactions. Conclusions: The findings reveal complex bidirectional influences between CRC couples, including compensatory and reverse activation mechanisms. Relationship intimacy, communication quality, family role identity, resilience, and social support play crucial moderating roles in facilitating or hindering adaptive coping. These results underscore the necessity of psychosocial interventions adopting a family systems perspective, focusing on enhancing communication skills, clarifying role division, and strengthening support networks to improve psychological adjustment in cancer-affected families.