Dyadic coping, dyadic coping-based gratitude (DC-G) and perceived stress in patients with diabetes mellitus and their healthy partners in Pakistan: Actor-partner interdependence mediational analysis

Recent approaches toward chronic illness adaptation demonstrate that illness-related stress deteriorates patients' and their partners' mental health and adversely impacts relationship functioning. Drawing on the Systemic Transactional Model, dyadic coping (DC) refers to the support one provides to a stressed partner (DC-self) and support perceived from a partner (DCpartner). Dyadic coping-based gratitude (DC-G) captures thankfulness expressed upon receiving emotional or practical support at self and partner levels. This study tested direct and indirect effects of DC on illness stress through DC-G among 81 Pakistani couples with one diabetic partner. Using Actor-Partner Interdependence Mediation Model (APIMeM), findings revealed that DC significantly and negatively predicted illness stress at actor and partner levels. DC-Gself significantly mediated the DC-self and illness stress relationship, whereas DC-G-partner did not. Findings underscore the relational nature of chronic illness stress adaptation and highlight gratitude-focused couple interventions for mitigating illness-related stress in Pakistani cultural context.