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March 6, 2026Healthcare0 citationsOpen Access

Distinct Patterns of Dyadic Mental Health in Patients with End-Stage Liver Disease and Their Care Partners

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LHLissi HansenKLKaren S. LyonsNDNathan F. Dieckmann

Key Points

  • The study aims to identify patterns of mental health over time in patient-care partner dyads affected by end-stage liver disease.
  • Adult ESLD patients and their care partners were recruited from liver clinics.
  • Survey data were collected at baseline and at 3, 6, 9, and 12 months.
  • Participants completed various validated scales measuring uncertainty, support, mutuality, and health status.
  • Multilevel and latent growth mixture modeling were utilized for data analysis.
  • Three distinct patterns of dyadic mental health were identified: disparate: patient better, shared mental health, and disparate: care partner better.
  • 25.3% of dyads had better mental health in patients, while 33.87% reported better mental health in care partners.
  • Care-related strain, uncertainty, relationship quality, and social support were significantly associated with these patterns.

Abstract

Background/Objectives: Little research has examined changes over time in mental health within end-stage liver disease (ESLD) patient–care partner dyads. Therefore, the aim of this observational study was to identify patterns of dyadic mental health over time in a sample of ESLD dyads and associations with individual- and dyadic-level characteristics. Methods: Adult men and women with ESLD and their care partners were recruited at liver clinics at two healthcare centers in the U.S. Pacific Northwest. Survey data were collected at the time of study enrollment and at 3, 6, 9, and 12 months. Patients and care partners completed the Mishel Uncertainty in Illness Scale, the Multidimensional Perceived Social Support Scale, the Mutuality Scale, the Short-Form Health Survey, and one religiosity item. Standard summary statistics and multilevel and latent growth mixture modeling were used to analyze the data. Results: In total, 186 dyads were included in the analyses, which revealed three distinct patterns of dyadic mental health: “disparate: patient better” (n = 47 25.3%), “shared mental health” (n = 76 40.86%), and “disparate: care partner better” (n = 63 33.87%). Significant characteristics associated with the patterns included care-related strain, uncertainty, relationship quality, and social support. Conclusions: Clinical implications include greater attention to both members of the dyad, with particular attention to low levels of mental health in patients or care partners as identified by the different patterns. Future research should employ a dyadic approach to address the prevalence of characteristics and identify others to improve the mental health of both members of the dyad.

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Cite This Study

Hansen et al. (2026) studied this question.

synapsesocial.com/papers/69aa7087531e4c4a9ff5a63fhttps://doi.org/10.3390/healthcare14050645
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