Abstract:

Objective To explore the impact of dyadic coping on fear of progression in patients with hematological tumors and their spouses based on the Actor-Partner Interdependence Model（APIM），and to provide references for clinical intervention. Methods By the convenient sampling method，136 pairs of hematological tumor patients and their spouses were selected from October 2023 to January 2024 in 5 tertiary hospitals in Shandong Province. A general information questionnaire，Dyadic Coping Inventory，Fear of Progression Questionnaire Short Form，and Fear of Progression Questionnaire Short Form/Partner Version were used to conduct the investigation. Amos 24.0 software was used to establish the APIM for dyadic coping with fear of progression. Results A total of 280 survey questionnaires were distributed，and 272 valid questionnaires were collected，including 136 from patients and their spouses，with an effective rate of 97.14%. The dyadic coping scores of hematological tumors patients and their spouses were （129.50±20.58） and （132.71±15.70），respectively，while the fear of progression scores were（31.71±3.13） and （29.01±3.05），respectively. Regarding the actors’ effects，the level of dyadic coping strategies of patients and their spouses can both predict their own fear of progression，and are negatively correlated（β₁=-0.52，β₂=-0.41；P<0.001）. Regarding the partners’ effects，the degree of fear of progression in patients is negatively correlated with the dyadic coping level of their spouses（β=-0.19，P<0.001）. Conclusion There is an interactive effect between the fear of progression and the level of dyadic coping between hematological tumor patients and their spouses. This suggests that clinical nursing staff should pay attention to the evaluation of fear of progression in patients with hematological tumors and their spouses，and effectively reduce the level of fear of progression on both sides.

Key words: Hematological Tumors, Spouse, Dyadic Coping, Fear of Progression, Actor-Partner Interdepen-dence Model, Nursing Care

摘要：

目的 基于主客体互倚模型探究血液肿瘤患者及其配偶二元应对对恐惧疾病进展的影响，为临床干预提供参考依据。方法 采用便利抽样法，于2023年10月—2024年1月选取在山东省5所三级甲等医院住院的140例血液肿瘤患者及其配偶作为调查对象，采用一般资料调查表、二元应对量表、恐惧疾病进展简化量表和配偶恐惧疾病进展简化量表进行调查，应用AMOS 24.0软件构建二元应对对恐惧疾病进展的主客体互倚模型。结果 共发放280份调查问卷，回收有效问卷272份，其中患者及其配偶各136份，有效问卷回收率为97.14%。血液肿瘤患者及其配偶的二元应对得分分别为（129.50±20.58）、（132.71±15.70）分，恐惧疾病进展得分分别为（31.71±3.13）、（29.01±3.05）分。主体效应方面，患者及其配偶的二元应对水平均可预测自身的恐惧疾病进展程度，均呈负相关（β₁=-0.52，β₂=-0.41；P<0.001）；客体效应方面，患者的恐惧疾病进展程度受配偶的二元应对水平影响，呈负相关（β=-0.19，P<0.001）。结论 血液肿瘤患者及其配偶的恐惧疾病进展与两者二元应对水平存在交互影响，提示医护人员应重视血液肿瘤患者及其配偶的恐惧疾病进展的评估，积极探索以二元应对为视角的干预方案，有效降低双方恐惧疾病进展的程度。

关键词: 血液肿瘤, 配偶, 二元应对, 恐惧疾病进展, 主客体互倚模型, 护理