The mediating role of perceived spousal support in the association between psychological crisis and psychological distress among breast cancer patients and their spouses: a longitudinal study based on an actor-partner interdependence mediation model with cross-lagged analysis.

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Τίτλος:	The mediating role of perceived spousal support in the association between psychological crisis and psychological distress among breast cancer patients and their spouses: a longitudinal study based on an actor-partner interdependence mediation model with cross-lagged analysis.
Συγγραφείς:	Yu X; Department of Breast Surgery, Huzhou Central Hospital, The Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China., Ding Y; Department of Breast Surgery, Huzhou Central Hospital, The Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China., Wang Z; Department of Breast Surgery, Huzhou Central Hospital, The Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China., Wang H; Department of Breast Surgery, Huzhou Central Hospital, The Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China., Ming Z; Department of Breast Surgery, Huzhou Central Hospital, The Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China., Ni X; Department of Breast Surgery, Huzhou Central Hospital, The Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China., Yu Y; Department of Breast Surgery, Huzhou Central Hospital, The Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China.
Πηγή:	Frontiers in public health [Front Public Health] 2026 Sep 30; Vol. 14, pp. 1937978. Date of Electronic Publication: 2026 Sep 30 (Print Publication: 2026).
Τύπος έκδοσης:	Journal Article
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Frontiers Editorial Office Country of Publication: Switzerland NLM ID: 101616579 Publication Model: eCollection Cited Medium: Internet ISSN: 2296-2565 (Electronic) Linking ISSN: 22962565 NLM ISO Abbreviation: Front Public Health Subsets: MEDLINE
Imprint Name(s):	Original Publication: Lausanne : Frontiers Editorial Office
Ιατρικοί όροι (MeSH):	Spouses/psychology , Spouses/statistics & numerical data , Breast Neoplasms/psychology , Stress, Psychological/psychology , Psychological Distress* , Social Support*, Humans ; Female ; Longitudinal Studies ; Middle Aged ; Male ; Adult ; Family Support ; Aged
Περίληψη:	Aim: Grounded in the Actor-Partner Interdependence Mediation Model (APIMeM), this study aimed to investigate the longitudinal dyadic interactions between psychological crisis and psychological distress among breast cancer patients and their spouses, and to examine the mediating mechanism of perceived spousal support. Methods: A convenience sample of 265 breast cancer patients and their spouses was recruited. Participants completed the Triage Assessment Form (TAF), the Distress Thermometer (DT), and the Perceived Spousal Support Scale for Breast Cancer Patients at three time points: pre-chemotherapy (T1), mid-chemotherapy (T2), and post-chemotherapy (T3). Measurement invariance testing and the Actor-Partner Interdependence Cross-Lagged Model (APIM-CLPM) were employed to identify pathways. Subsequently, an APIMeM incorporating actor-mediator-outcome and partner-mediator-outcome paths was constructed. A bias-corrected non-parametric percentile Bootstrap method (5,000 samples) was used to test the significance of the mediating effects. Missing data were handled using full information maximum likelihood (FIML) estimation. Results: After excluding 7 dropouts, data from 258 couples were analyzed. The reasons for dropout included relocation (n = 2), voluntary withdrawal without providing a reason (n = 3), and severe treatment-related complications requiring a change in treatment protocol (n = 2). (1) Significant actor effects were observed for both psychological crisis and distress: T1 psychological crisis positively predicted T2 psychological distress in both patients (β = 0.15) and spouses (β = 0.13, p < 0.01), while T1 psychological distress positively predicted T2 psychological crisis in patients (β = 0.18) and spouses (β = 0.16, p < 0.001). (2) Perceived spousal support significantly mediated the path from psychological crisis to psychological distress: the indirect effect was 0.06 (95% CI: 0.02-0.11) for patients and 0.05 (95% CI: 0.01-0.09) for spouses. (3) Significant partner mediating effects were found: patient T1 psychological crisis was associated with exacerbated spouse T3 psychological through the pathway of reduced spouse T2 perceived support (indirect effect = 0.04, 95% CI: 0.01-0.08). Conclusion: Perceived spousal support acts as a critical mediator linking psychological crisis to psychological distress. Clinical interventions should adopt a dyadic perspective, focusing on enhancing the quality of perceived support to interrupt the negative cycle of crisis and distress and alleviate psychological suffering in both patients and spouses. (Copyright © 2026 Yu, Ding, Wang, Wang, Ming, Ni and Yu.)
Competing Interests:	The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
References:	J Psychosom Res. 2024 Jun;181:111668. (PMID: 38640771) Health Soc Work. 2006 May;31(2):117-27. (PMID: 16776029) Cancer. 2024 Apr 15;130(S8):1368-1370. (PMID: 38525946) Front Psychol. 2019 Nov 15;10:2584. (PMID: 31803117) Eur J Oncol Nurs. 2025 Oct;78:102959. (PMID: 40849971) Psychooncology. 2023 Feb;32(2):229-236. (PMID: 36434675) J Natl Cancer Cent. 2022 Jun 22;2(3):155-161. (PMID: 39036454) J Adv Nurs. 2022 Mar;78(3):750-764. (PMID: 34363625) Front Psychol. 2024 Jul 10;15:1420125. (PMID: 39055990) World J Surg Oncol. 2026 Feb 03;24(1):. (PMID: 41630011) Healthcare (Basel). 2022 Oct 12;10(10):. (PMID: 36292463) Zhonghua Yu Fang Yi Xue Za Zhi. 2008 Nov;42(11):782-5. (PMID: 19176133) Psychooncology. 2024 Mar;33(3):e6314. (PMID: 38459736) Br J Health Psychol. 2025 Feb;30(1):. (PMID: 39629868) Cancer Nurs. 2021 Nov-Dec 01;44(6):E458-E466. (PMID: 34694087) Asia Pac J Oncol Nurs. 2025 Feb 06;12:100664. (PMID: 40331005) BMC Psychiatry. 2024 Nov 29;24(1):860. (PMID: 39614210) Health Psychol. 2010 Mar;29(2):169-80. (PMID: 20230090) J Psychosoc Oncol. 2024;42(5):604-621. (PMID: 38240291) Psychooncology. 2023 Apr;32(4):610-618. (PMID: 36670514) Arch Gynecol Obstet. 2023 Mar;307(3):919-925. (PMID: 35732979) Womens Health (Lond). 2024 Jan-Dec;20:17455057241276232. (PMID: 39287572) Asia Pac J Oncol Nurs. 2025 Dec 08;13:100829. (PMID: 41541191) J Nepal Health Res Counc. 2024 Dec 19;22(3):502-508. (PMID: 39923162) Dement Neuropsychol. 2024 Sep 23;18:e20240145. (PMID: 39318379) Front Psychol. 2019 Mar 19;10:404. (PMID: 30941068) Health Psychol. 2015 May;34(5):486-95. (PMID: 25730611) Chin Med J (Engl). 2024 Oct 20;137(20):2429-2436. (PMID: 39238088) Am J Surg. 2024 Nov;237:115895. (PMID: 39208502) Annu Rev Psychol. 1997;48:243-67. (PMID: 9046561) Support Care Cancer. 2021 Sep;29(9):5425-5433. (PMID: 33709185) Breast. 2024 Aug;76:103762. (PMID: 38924994) Eur J Oncol Nurs. 2024 Jun;70:102565. (PMID: 38615513) Front Pharmacol. 2020 Apr 15;11:445. (PMID: 32351390) Int J Mol Sci. 2021 Oct 06;22(19):. (PMID: 34639152) Support Care Cancer. 2025 Oct 18;33(11):966. (PMID: 41108417)
Contributed Indexing:	Keywords: actor-partner interdependence model; breast cancer; cross-lagged analysis; longitudinal study; mediation analysis; nursing; patient; perceived spousal support
Entry Date(s):	Date Created: 20261015 Date Completed: 20261015 Latest Revision: 20261016
Update Code:	20261016
PubMed Central ID:	PMC13661539
DOI:	10.3389/fpubh.2026.1937978
PMID:	42876596
Βάση Δεδομένων:	MEDLINE

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ISSN:	2296-2565
DOI:	10.3389/fpubh.2026.1937978