Title : Differences in illness perceptions and dyadic coping among patients with rectal cancer undergoing neoadjuvant chemoradiotherapy and their family caregivers: A qualitative study
Abstract:
Objective: To explore differences in illness perceptions and dyadic coping processes between patients with rectal cancer undergoing neoadjuvant chemoradiotherapy andtheir family caregivers, and to provide a reference for family-centered illness perception interventions and coping support.
Methods: A descriptive qualitative study was conducted. From March to June 2026, 15 dyads of patients with rectal cancer undergoing neoadjuvant chemoradiotherapy and their primary family caregivers were purposively selectedfrom the radiotherapy department of a tertiary Grade A hospital in Zhengzhou, China. Semi-structured interviews were conducted. Guided by the Common-Sense Model of Self-Regulation, the interview data were analyzed using directed content analysis combined with inductive coding.
Results: Four themes and twelve subthemes were identified. The themes were: differences in the perception and severity judgment of treatment-related symptoms; coexistence of hope and concerns in illness attribution and treatment expectations; interaction tensions caused by differences in illness perceptions; and role reconstruction and professional support in family dyadic coping. Patients and familycaregivers differed in symptom severity judgment, timing of symptommanagement, treatment goal prioritization, and emotional expression. These differences influencedfamily communication, care decision making, and dyadic coping during neoadjuvant chemoradiotherapy.
Conclusion: Patients with rectal cancer undergoing neoadjuvant chemoradiotherapy and their family caregivers showed both consistency and differences in illness perceptions, particularly regarding symptom severity, treatment expectations, concerns about disease consequences, and emotional expression. Thesedifferences shaped family interactions and dyadic coping processes. Nurses shouldpay attention to patient-caregiver illness perception differences, conduct privacy-sensitive symptom assessment, provide family-involved treatment explanations, and implement dyadic support interventions to promote communication, negotiation, and family coping quality.
Keywords: Rectal Cancer; Neoadjuvant Chemoradiotherapy; Illness Perception; Family Caregiver; Dyadic Coping; Qualitative Study
