Actor-partner interdependence mediation model of family resilience between fear of cancer recurrence and social alienation in enterostomy patients and their caregivers

[Objectives] Explore the impact of fear of cancer recurrence (FCR) on social alienation in enterostomy patients and their caregivers, and the mediating role of family resilience. [Methods] A cross-sectional study was conducted on 320 pairs of colorectal cancer patients with enterostomy and their caregivers from the Affiliated Tumor Hospital of Xinjiang Medical University and Bazhou People’s Hospital between January and May 2024. Data were collected using the general information questionnaire, fear of progression questionnaire short form (FoP-Q-SF), fear of progression questionnaires for caregivers (FoP-Q-SF/C), family hardiness index (FHI), and general alienation scale (GAS). and General Alienation Scale. The actor-partner interdependence mediation model (APIM) was analyzed using Mplus 8.3. [Results] From the actor effect, FCR in both patients and caregivers positively predicted their social alienation (β=0.368, P=0.019; β=0.268, P=0.011) and negatively predicted their family resilience (β=-0.465, P<0.001; β=-0.259, P<0.001). Family resilience in patients and caregivers negatively predicted their social alienation (β=-0.152, P=0.023; β=-0.140, P<0.001). From the partner effect, FCR in patients and caregivers did not predict each other’s social alienation (β=0.173, P=0.124; β=0.214, P=0.146). However, FCR in patients and caregivers negatively predicted their partner’s family resilience (β=-0.569, P<0.001; β=-0.323, P=0.01), while family resilience negatively predicted their partner’s social alienation (β=-0.117, P=0.015; β=-0.170, P=0.004). Family resilience mediated the relationship between FCR and social alienation in actor and partner effects. [Conclusion] FCR and social alienation in enterostomy patients and caregivers exhibit actor effects, with family resilience serving as a significant mediator. Healthcare providers should view patients and caregivers as a dyad, monitor their psychological states, and develop interventions to enhance family resilience, thereby mitigating the negative impacts of FCR and reducing social alienation.