Actor–Partner Effects on Dyadic Adjustment, Relationship Satisfaction, and Well-Being after Spinal Cord Injury

Importance Spinal cord injury (SCI) extends beyond the injured individual to intimate partners, often altering shared occupations, relational roles, and well-being. Understanding dyadic processes is critical for occupational therapy practice. Objective To examine associations among dyadic adjustment, relationship satisfaction, and well-being in SCI dyads using an actor–partner interdependence model. Design Cross-sectional dyadic study using baseline data from an intervention trial (SupportGroove). Setting Health care institutions and community-based settings. Participants Eighty-two community-dwelling SCI–partner dyads (164 adults; mean ages: SCI, 50.1 ± 15.7; partners, 48.5 ± 14.5 years), 3 months to 5 years postinjury. Outcomes and Measures Self-report; Revised Dyadic Adjustment Scale, Couples Satisfaction Index-4, and Neuro-QoL Positive Affect and Well-Being. Results Dyadic adjustment was significantly and positively associated with relationship satisfaction among SCI participants ( β = 0.66, standard error [SE] = 0.09, p < .001), indicating a large effect. A similar significant positive association was observed among partners ( β = 0.47, SE = 0.11, p < .001), reflecting a medium effect size. Additionally, partners’ relationship satisfaction was significantly and positively related to their own well-being ( β = 0.35, SE = 0.14, p = .010), with a medium effect. No other structural equation model paths reached statistical significance ( p > .05). Conclusions and Relevance Dyadic adjustment influences how both members of the SCI dyad perceive their relationship. However, relationship satisfaction contributes to well-being primarily for partners rather than for individuals with SCI. These findings support a dyadic approach to occupational therapy and rehabilitation that considers relationship functioning and well-being in both members of the dyad.