Family Resilience and Fear of Disease Recurrence in Elderly OVCF Patients and Spouses: A Cross-Lagged Actor-Partner Interdependence Model Analysis

Aim: This study examines the longitudinal interplay of family resilience and fear of disease recurrence between elderly osteoporotic vertebral compression fracture (OVCF) patients and their spouses using the APIM. Methods: This study employed convenience sampling to recruit 223 elderly OVCF patients with adjacent vertebral fractures and their spouses. Participants were assessed with the Shortened Chinese version of the Family Resilience Assessment Scale and the Fear of Disease Progression Questionnaire-Short Form at three time points (T1: during surgery, T2: before discharge, T3: one month post-discharge). Data were analyzed using equivalence tests and cross-lagged analysis within the Actor-Partner Interdependence Model (APIM) framework. Results: Specifically, patients’ family resilience can negatively predict their fear of disease recurrence in subsequent stages (T1→T2: β=− 0.14, T2→T3: β=− 0.13, both P < 0.01), and spouses’ family resilience can negatively predict their fear of disease recurrence in subsequent stages (T1→T2: β=− 0.12, T2→T3: β=− 0.13, both P < 0.01). Additionally, the main effect of fear of disease recurrence on family resilience in patients and their spouses was significant. The fear of disease recurrence in patients negatively predicted their family resilience in subsequent stages (T1→T2: β=− 0.18, T2→T3: β=− 0.17, P < 0.001), and the spouse’s fear of disease recurrence negatively predicted their family resilience in the first stage (T1→T2: β=− 0.15, P < 0.001, T2→T3: β=− 0.13, P < 0.01). The partner effect of fear of disease recurrence was also significant, indicating that the patient’s fear of disease recurrence could positively predict the spouse’s fear of disease recurrence in subsequent stages (T1→T2: β=0.16, T2→T3: β=0.15, all P < 0.001), whereas the spouse’s fear of disease recurrence could positively predict the patient’s fear of disease recurrence in subsequent stages (T1→T2: β=0.15, P < 0.001, T2→T3: β=0.12, P< 0.01). Conclusion: Healthcare providers should strategically assess and manage family resilience and fear of disease recurrence in elderly OVCF patients and their spouses, leveraging their dyadic interactions to mitigate these fears. Keywords: elderly, OVCF after surgery, refracture, patients, spouse, actor-partner interdependence model, family resilience, fear of disease recurrence, longitudinal studies, cross-lagged analysis, nursing