Objective Prostate cancer (PCa) is an external stressor that can affect both patients and partners, but dyadic research in this area is limited. This study, guided by the vulnerability-stress-adaptation model, examines how PCa distress affects relationship satisfaction through psychological flexibility and self-esteem. Methods The study used a cross-sectional design with a total sample size of 314 dyads. The actor-partner interdependence model was applied to examine both actor and partner effects. Covariates were also examined. Results PCa distress negatively predicted psychological flexibility in both patients (<InlineEquation ID="IEq1"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="520_2025_9229_Article_IEq1.gif" Format="GIF" Height="17" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">$\beta$</EquationSource> <EquationSource Format="MATHML"><math> <mi>β</mi> </math></EquationSource> </InlineEquation> = − .93, p < .001) and partners (<InlineEquation ID="IEq2"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="520_2025_9229_Article_IEq2.gif" Format="GIF" Height="17" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">$\beta$</EquationSource> <EquationSource Format="MATHML"><math> <mi>β</mi> </math></EquationSource> </InlineEquation> = − 0.70, p < .001). Psychological flexibility, in turn, positively predicted self-esteem in both patients (<InlineEquation ID="IEq3"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="520_2025_9229_Article_IEq3.gif" Format="GIF" Height="17" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">$\beta$</EquationSource> <EquationSource Format="MATHML"><math> <mi>β</mi> </math></EquationSource> </InlineEquation> = 0.19, p < .001) and partners (<InlineEquation ID="IEq4"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="520_2025_9229_Article_IEq4.gif" Format="GIF" Height="17" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">$\beta$</EquationSource> <EquationSource Format="MATHML"><math> <mi>β</mi> </math></EquationSource> </InlineEquation> = 0.19, p < .001). Self-esteem significantly predicted relationship satisfaction for both patients (<InlineEquation ID="IEq5"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="520_2025_9229_Article_IEq5.gif" Format="GIF" Height="17" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">$\beta$</EquationSource> <EquationSource Format="MATHML"><math> <mi>β</mi> </math></EquationSource> </InlineEquation> = 0.22, p < .001) and partners (<InlineEquation ID="IEq6"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="520_2025_9229_Article_IEq6.gif" Format="GIF" Height="17" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">$\beta$</EquationSource> <EquationSource Format="MATHML"><math> <mi>β</mi> </math></EquationSource> </InlineEquation> = 0.22, p < .001). The indirect effects of PCa distress on relationship satisfaction via psychological flexibility and self-esteem were significant for both patients (<InlineEquation ID="IEq7"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="520_2025_9229_Article_IEq7.gif" Format="GIF" Height="17" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">$\beta$</EquationSource> <EquationSource Format="MATHML"><math> <mi>β</mi> </math></EquationSource> </InlineEquation> = − .093, p < .001) and partners (<InlineEquation ID="IEq8"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="520_2025_9229_Article_IEq8.gif" Format="GIF" Height="17" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">$\beta$</EquationSource> <EquationSource Format="MATHML"><math> <mi>β</mi> </math></EquationSource> </InlineEquation> = − .078, p < .001). Additionally, a significant indirect effect of partners’ PCa distress on patients’ relationship satisfaction was observed (<InlineEquation ID="IEq9"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="520_2025_9229_Article_IEq9.gif" Format="GIF" Height="17" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">$\beta$</EquationSource> <EquationSource Format="MATHML"><math> <mi>β</mi> </math></EquationSource> </InlineEquation> = − .055, p < .01). Conclusion The findings highlight the critical role of psychological flexibility and self-esteem in mediating the impact of PCa distress on relationship satisfaction for both patients and partners. Tailored interventions aimed at enhancing psychological flexibility to support relationship functioning in couples coping with PCa may be effective.

Exploring the role of psychological flexibility in relationship functioning among couples coping with prostate cancer: a cross-sectional study

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2025年2月13日

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Hongen Ma,
Laura Cariola,
David Gillanders

摘要

Objective

Prostate cancer (PCa) is an external stressor that can affect both patients and partners, but dyadic research in this area is limited. This study, guided by the vulnerability-stress-adaptation model, examines how PCa distress affects relationship satisfaction through psychological flexibility and self-esteem.

Methods

The study used a cross-sectional design with a total sample size of 314 dyads. The actor-partner interdependence model was applied to examine both actor and partner effects. Covariates were also examined.

Results

PCa distress negatively predicted psychological flexibility in both patients ( $\beta$ $β$ = − .93, p < .001) and partners ( $\beta$ $β$ = − 0.70, p < .001). Psychological flexibility, in turn, positively predicted self-esteem in both patients ( $\beta$ $β$ = 0.19, p < .001) and partners ( $\beta$ $β$ = 0.19, p < .001). Self-esteem significantly predicted relationship satisfaction for both patients ( $\beta$ $β$ = 0.22, p < .001) and partners ( $\beta$ $β$ = 0.22, p < .001). The indirect effects of PCa distress on relationship satisfaction via psychological flexibility and self-esteem were significant for both patients ( $\beta$ $β$ = − .093, p < .001) and partners ( $\beta$ $β$ = − .078, p < .001). Additionally, a significant indirect effect of partners’ PCa distress on patients’ relationship satisfaction was observed ( $\beta$ $β$ = − .055, p < .01).

Conclusion

The findings highlight the critical role of psychological flexibility and self-esteem in mediating the impact of PCa distress on relationship satisfaction for both patients and partners. Tailored interventions aimed at enhancing psychological flexibility to support relationship functioning in couples coping with PCa may be effective.