Actor and Partner Effects of Dyadic Coping on Stress Among Hemodialysis Patients and Spouses

This study examined the interdependence among dyadic coping, self-efficacy, and stress in Chinese hemodialysis patients and their spouses using the actor-partner interdependence model.

End-stage kidney disease creates major psychological challenges for both patients and their spouses. The systemic transactional model views coping as a shared, dyadic process between partners. However, the specific actor and partner effects of dyadic coping on illness-related stress in hemodialysis couples remain understudied.

A cross-sectional correlational design was used.

A convenience sample of 200 patient-spouse dyads, comprising 400 individuals, was included in the analytic dataset. Participants completed the dyadic coping inventory, hemodialysis stressor scale, and general self-efficacy scale. The actor-partner interdependence model was applied to analyze the dyadic data.

Paired tests showed significant asymmetry in coping, with spouses reporting higher dyadic coping than patients. Self-efficacy was positively correlated with dyadic coping for both patients and spouses. The actor-partner interdependence model analysis revealed significant actor effects: an individual's own dyadic coping predicted lower personal stress. A significant partner effect also emerged, indicating that a spouse's coping was associated with lower patient stress.

These findings confirm the interdependent nature of coping within end-stage kidney disease dyads. Although spouses shoulder a greater share of the coping burden, their efforts effectively alleviate patient distress. Clinical interventions should move from patient-centered to couple-centered approaches that promote shared coping strategies, strengthen resilience, and reduce the risk of caregiver burnout.

The results support routine dyadic psychosocial assessment in hemodialysis care and the development of couple-based interventions. Such programs should build dyadic coping skills and self-efficacy in both partners while offering targeted support to prevent caregiver burnout.

This observational survey study did not include patient, caregiver, or public involvement in the design, conduct, analysis, or manuscript preparation beyond participants' completion of questionnaires.