Title : Illness perception differences and shared coping among patients with rectal cancer undergoing neoadjuvant chemoradiotherapy and their family caregivers: A qualitative study
Abstract:
Rectal cancer patients undergoing neoadjuvant chemoradiotherapy (nCRT) often experience symptom burden and uncertainty related to treatment outcomes, while family caregivers are deeply involved in disease management and decision-making. Differences in illness perceptions between patients and caregivers may influence communication and shared coping. This study aimed to explore illness perception differences and shared coping experiences among patients with rectal cancer undergoing nCRT and their family caregivers.
A descriptive qualitative study was conducted from March to June 2026 in the radiotherapy department of a tertiary hospital in Zhengzhou, China. Fifteen patient–caregiver dyads were recruited using purposive sampling. Semi-structured interviews were conducted separately with patients and caregivers. Data were analyzed using directed content analysis guided by the Common-Sense Model of Self-Regulation, combined with inductive coding.
Four themes were identified: (1) differences in perception and severity judgment of chemoradiotherapy-related symptoms; (2) coexistence of hope and concerns in disease attribution and treatment expectations; (3) interaction tension arising from differences in illness perceptions; and (4) family role reconstruction and professional support promoting shared coping. Patients tended to evaluate symptoms based on personal tolerance and functional maintenance, whereas caregivers relied more on observable changes and risk prevention. Differences in treatment priorities, symptom management timing, and emotional expression influenced family communication and coping processes.
Patients and family caregivers form an important shared-care unit during nCRT. Nursing interventions should incorporate privacy-sensitive symptom assessment, family-centered treatment explanation, and communication support to facilitate mutual understanding and improve shared coping quality.
