Incongruent symptom perceptions and its associations with negative mood, intimate relationship and quality of life in colorectal cancer dyads: a dyadic analysis

Purpose The primary objective of this study was to explore the existence and identify predictors of incongruent perceptions of pain, fatigue, and sleep disturbance, and to examine their associations with negative mood, intimate relationship, and quality of life in colorectal cancer patient- caregiver dyads. Methods 271 colorectal cancer dyads completed questionnaires designed to assess a range of outcomes, including patient symptoms (pain, fatigue, sleep disturbance), negative mood, intimate relationship, and quality of life. Pearson’s correlation, multiple linear regression analysis and structural equation modeling were used to analyze the data. Results There were significant disparities in incongruent perceptions of sleep disturbance between patients and caregivers ( t =-3.241, p < 0.001). For incongruent sleep disturbance, regression analysis showed patient education level (B=-1.014, p = 0.001) and caregiver education level (B=-1.140, p < 0.001) demonstrated significant negative associations. Longer patient diagnosis duration (B=-1.876, p = 0.010) was negatively associated. Caregiver religious affiliation (B=-1.611, p = 0.027) and marital status (B= -3.097, p = 0.001) showed negative associations. Patient gender (B= 1.361, p = 0.037) and caregiver gender (B = 1.803, p = 0.004) exhibited positive associations. Dyadic relationship type (B = 1.568, p = 0.043) was positively associated. The analysis revealed that incongruent perceptions of sleep disturbance exhibited a significant correlation with the quality of life and negative mood of both individuals within colorectal cancer patient-caregiver dyads. The model fit estimates were as follows: χ2/df = 1.570, GFI = 0.967, CFI = 0.957, IFI = 0.922, RMSEA = 0.036, SRMR = 0.053. Pathway analysis demonstrated that incongruent perceptions of sleep disturbance exerted a significantly direct effect on the quality of life of both individuals in colorectal cancer patient-caregiver dyads, albeit in opposite directions (B=-0.238, p < 0.001; B = 0.358, p < 0.001, respectively). Furthermore, the analysis revealed an actor-partner mediating effect of incongruent perceptions of sleep disturbance, negative mood, intimate relationship, and quality of life. Conclusion The findings of the present study indicated that incongruent perceptions of sleep disturbance were associated with negative mood, low intimate relationship satisfaction, and low quality of life. The individual attributes of patients (gender, educational level and time since diagnosis) and caregivers (gender, educational level, religious beliefs and marital status), as well as dyadic factors such as relationship, could predict patient-caregiver concordance on assessing patients’ symptoms. It is recommended that healthcare providers should reinforce patient-caregiver dyadic symptom education to reduce incongruent perceptions of sleep disturbance in colorectal cancer dyads with a view to enhancing their quality of life. More sleep management and substantial emotional support should be provided by family caregivers and healthcare providers.