The relationship between patient-family caregiver congruence/incongruence in acceptance of illness and family caregivers' anticipatory grief.

OBJECTIVE: Cancer is a family affair that negatively impacts the lives of patients and their family caregivers. This study takes a dyadic perspective to investigate the effect of patient-family caregiver illness acceptance congruence/incongruence on family caregivers' anticipatory grief (AG) and examine whether caregivers' resilience moderates the abovementioned relationship. METHODS: For the study, 304 dyads of advanced lung cancer patients and their family caregivers from three tertiary hospitals in Jinan, Shandong Province, China were recruited. The data were analyzed using polynomial regressions and response surface analyses. RESULTS: Family caregivers' AG was lower when patient-family caregiver illness acceptance was congruent rather than incongruent. Lower patient-caregiver illness acceptance congruence was associated with higher AG in family caregivers compared with higher illness acceptance congruence. Family caregivers reported significantly higher AG only if their illness acceptance was lower than that of their patients. In addition, caregivers' resilience moderated the effects of patient-caregiver illness acceptance congruence/incongruence on family caregivers' AG. CONCLUSIONS: Patient-family caregiver illness acceptance congruence was beneficial to family caregivers' AG; resilience can be a protective factor for buffering the impact of illness acceptance incongruence on family caregivers' AG.

The dyadic effects of personality traits on depression in advanced lung cancer patients and caregivers: The mediating role of acceptance of illness.

OBJECTIVE: This study aimed to explore the intrapersonal and interpersonal effects of three personality traits-neuroticism, extraversion and conscientiousness-on depression and examine whether acceptance of illness mediates the actor and partner effects in advanced lung cancer patients and caregivers using the Actor-Partner Interdependence Mediation Model (APIMeM). METHODS: A total of 304 dyads of advanced lung cancer patients and caregivers were studied. Personality traits, acceptance of illness and depression were measured using 44-item Big Five Inventory, the Acceptance of Illness (AIS) scale and the Patient Health Questionnaire (PHQ-9). RESULTS: The APIMeMs suggested that there were significant actor-actor effects of the three personality traits on depression through their own acceptance of illness. Additionally, significant actor-partner effects of neuroticism and extraversion on depression were also found. Specifically, patients' neuroticism was negatively related to their own acceptance of illness, which increased caregivers' depression, and caregivers' higher extraversion was related to their own higher acceptance of illness, which reduced patients' depression. Furthermore, a significant partner-actor effect was only found in the neuroticism model. Patients' neuroticism was negatively related to caregivers' acceptance of illness, which increased caregivers' depression. CONCLUSION: The three personality traits had both interpersonal and intrapersonal effects on depression in advanced lung cancer patient-caregiver dyads, and acceptance of illness played an important mediating role in these relationships.

Dyadic effects of family-functioning and resilience on quality of life in advanced lung cancer patients and caregivers: An actor-partner interdependence mediation model.

PURPOSE: Lung cancer as a stressful event profoundly impacts the entire family, especially patients and their family caregivers. This study uses a dyadic analysis approach to explore the dyadic effects of family functioning on the quality of life (QoL), and whether resilience acts as a mediator in advanced lung cancer patient-caregiver dyads. METHODS: This was a cross-sectional study, and 287 dyads of advanced lung cancer patients and their caregivers were enrolled. Family-functioning, resilience, and QoL were assessed by the General Functioning subscale of the Family Assessment Device (FAD), the 10-item Connor-Davidson Resilience Scale, and the Short Form-8 (SF-8) Health Survey, respectively. Data were analyzed using the actor-partner interdependence mediation model. RESULTS: This study found that, for patients and caregivers, resilience mediates the actor effects of family-functioning on QoL. That is, family-functioning was positively related to their resilience, which improved QoL. Another important finding is that caregivers' family-functioning had significant indirect effects on patients' QoL through their resilience. CONCLUSIONS: Positive family functioning perceived by patients and caregivers can improve their QoL by developing their own resilience. Furthermore, family-functioning perceived by caregivers can also improve patients' QoL through their resilience. Medical staff should identify vulnerable patients and caregivers with poorer family-functioning and resilience, and make focused intervention to improve the QoL of both lung cancer patients and their family caregivers.