AI Insight
This study of 308 acute leukemia patient-caregiver pairs in China found that patients and caregivers follow different psychological pathways affecting their quality of life. For patients, negative coping strategies fully explained the relationship between perceiving their illness as threatening and reduced quality of life, while caregivers' threat perceptions directly impaired their quality of life regardless of coping style. Family resilience improved patient quality of life but showed no significant effect on caregiver quality of life, indicating that the two members of each dyad experience and respond to the cancer diagnosis differently.
Why it matters
These findings suggest that psychosocial interventions for acute leukemia families should be tailored differently for patients versus caregivers, with patients benefiting from coping skills training to reduce avoidance behaviors, while caregivers may need interventions directly addressing their perception of threat and emotional burden. The study highlights the need for dyadic care approaches that recognize the distinct psychological needs of both family members.
Understand the Science
ObjectivesThis study used a dyadic approach to examine the association between cognitive appraisal and quality of life (QoL), and to test whether negative coping and family resilience mediate this association in dyads of acute leukemia (AL) patients and their primary family caregivers.MethodsThree hundred and eight AL patient-caregiver dyads were recruited from five hospitals in China. QoL was measured using the Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) for patients and the 12-Item Short-Form Health Survey (SF-12) for primary family caregivers. Cognitive appraisal, negative coping, and family resilience were assessed using the Cognitive Appraisal of Health Scale (CAHS), the Trait Coping Style Questionnaire (TCSQ), and the Family Hardiness Index (FHI), respectively. The Actor-Partner Interdependence Mediation Model (APIMeM) was performed in R to examine direct and indirect effects.ResultsPatients’ QoL was significantly correlated with their own positive coping (r = 0.523, p < 0.01), family resilience (r = 0.489, p < 0.01), and negative coping (r = −0.466, p < 0.01), and with caregivers’ QoL (r = 0.237, p < 0.01), family resilience (r = 0.436, p < 0.01), and negative coping (r = −0.234, p < 0.01). In the APIMeM, negative coping fully mediated the association between patients’ threat appraisal and their QoL, whereas caregivers’ threat appraisal was directly associated with poorer QoL. Family resilience from either dyad member predicted better patient QoL. Actor effects predominated, with patients’ threat appraisal predicting caregivers’ negative coping as a cross-dyad pathway.ConclusionAcute leukemia patients and their primary family caregivers demonstrate divergent stress-coping pathways. For patients, mitigating maladaptive coping such as avoidance and resignation may protect QoL, whereas caregivers may benefit from interventions directly targeting threat perception and emotional burden. Family resilience shows a distinct pattern. It exerts protective effects on patient QoL but not on caregiver QoL, pointing to the need for tailored dyadic psychosocial care.