People living with Alzheimer's disease (PLWD) often face unmet care needs, which may arise as caregivers and PLWD differ in their perceptions of PLWD's needs. To understand how these discrepancies vary by caregivers' perspective taking (i.e., their ability to understand PLWD's thoughts and feelings), we conducted a sequential mixed-methods study with 67 couples managing Alzheimer's disease. Both spouses completed semi-structured interviews to describe PLWD's needs and discussed how they communicated about needs. Caregivers' perspective taking was negatively associated with discrepancies in PLWD's needs. Thematic analysis of a subgroup parallel sample demonstrated that, when caregivers reported high perspective taking, couples described navigating PLWD's needs through open dialogue and caregivers adopted respectful communication practices. When caregivers reported low perspective taking, couples described misaligned expectations and communication efforts; caregivers initiated communication to identify PLWD needs and acknowledged employing insensitive language. Findings can inform interventions to improve the quality of dementia care and promote health.

Objective: To examine associations between (in)congruence within parent dyads' adverse childhood experiences (ACEs) and children's behavior problems. Background: Despite evidence that both parents influence child health, studies on multigenerational consequences of ACEs have focused on one parent. Yet many children have two parents exposed to ACEs. Fathers' and mothers' ACEs may intersect, and their shared, or differing, experience of ACEs may have implications for children's health and development. Methods: Participants were 400 father-mother dyads from a cohort study. Parents reported on their own home-based (i.e., abuse, household dysfunction) and community-based (i.e., discrimination, community violence) ACEs. Fathers reported on children's behavior problems. Three dyadic variables for parent ACEs were created in a structural equation model: parent-dyad ACE average, absolute magnitude of incongruence in ACEs, and direction of incongruence in ACEs. Ordinary least squares regressions examined associations between dyadic ACEs variables and children's behavior problems. Separate models were estimated for home- and community-based ACEs. Results: Greater incongruence in parental community-based ACEs was associated with behavior problems in children (B = 1.04, p < .05). Conclusion: Dissimilar experiences of parental community-based ACEs may have implications for children.Implications To support the development of couple-level interventions, research should examine pathways of transmission (i.e., coparenting quality).

BACKGROUND:Young adult (YA) breast and gynecologic cancer (BGC) survivors commonly experience sexual and reproductive health (SRH) distress after cancer, with far-reaching consequences for relational functioning, health outcomes, and quality of life. Despite this burden, the dyadic experience and relational patterns of SRH distress in this population have not been well characterized. AIMS:The objectives of this study were to characterize dyadic profiles of SRH distress and to examine the association with other individual and interpersonal characteristics. METHODS:This study employed dyadic Latent Profile Analysis (LPA) in STATA/SE to identify distinct SRH distress profiles across 79 survivor-partner couples, with measures of reproductive and sexual distress as LPA indicators. Following profile identification, we used ANOVA and chi-square tests to examine how these dyadic profiles differed across characteristics. RESULTS:Three dyadic profiles emerged: low-distress (30.4%), moderate-distress (43.0%), and high-distress (26.6%). Low-distress couples had significantly higher levels of dyadic coping, constructive communication, and open discussion of SRH concerns along with the highest rates of sexual activity. In contrast, high-distress couples demonstrated poorer coping and communication and significantly lower sexual activity. Moderate-distress dyads fell between these extremes. Comparisons across these profiles showed no significant differences in demographic or cancer characteristics. CONCLUSIONS:Findings underscore the central role of relationship processes, including dyadic coping and communication, and their potential as modifiable intervention targets for YA BGC survivor couples experiencing SRH distress. Identifying distinct couples' profiles of SRH distress may facilitate more precise identification of high-need dyads and guide the development of tailored interventions. TRIAL REGISTRATION:NCT04806724.

Background/Objectives: Little research has examined changes over time in mental health within end-stage liver disease (ESLD) patient-care partner dyads. Therefore, the aim of this observational study was to identify patterns of dyadic mental health over time in a sample of ESLD dyads and associations with individual- and dyadic-level characteristics. Methods: Adult men and women with ESLD and their care partners were recruited at liver clinics at two healthcare centers in the U.S. Pacific Northwest. Survey data were collected at the time of study enrollment and at 3, 6, 9, and 12 months. Patients and care partners completed the Mishel Uncertainty in Illness Scale, the Multidimensional Perceived Social Support Scale, the Mutuality Scale, the Short-Form Health Survey, and one religiosity item. Standard summary statistics and multilevel and latent growth mixture modeling were used to analyze the data. Results: In total, 186 dyads were included in the analyses, which revealed three distinct patterns of dyadic mental health: "disparate: patient better" (n = 47 [25.3%]), "shared mental health" (n = 76 [40.86%]), and "disparate: care partner better" (n = 63 [33.87%]). Significant characteristics associated with the patterns included care-related strain, uncertainty, relationship quality, and social support. Conclusions: Clinical implications include greater attention to both members of the dyad, with particular attention to low levels of mental health in patients or care partners as identified by the different patterns. Future research should employ a dyadic approach to address the prevalence of characteristics and identify others to improve the mental health of both members of the dyad.

Background: Coping with the challenges of Alzheimer's disease and related dementias is a shared experience, impacting individuals living with the disease, their care partners, and their relationship. As the number of people affected by dementia continues to rise, so does the demand for evidence-based psychosocial interventions that support the well-being of both members of the dyad. However, the current dyadic dementia intervention (DDI) landscape remains limited in scope and rigor, often lacking strong relational theoretical underpinnings and clear mechanisms of action. Objective: To address this gap, a four-hour workshop was offered at the 2024 Gerontological Society of America Annual Scientific Meeting to equip researchers with the knowledge, confidence, and skills necessary to conduct methodologically rigorous DDI studies. Methods: The first hour of the workshop included didactic presentations on dyadic theory, intervention design, statistics, and dementia-specific considerations. Attendees then participated in small-group, problem-based experiential activities, applying the learned content to their own research projects with individualized feedback from workshop leaders. Results: Participants, primarily from the disciplines of nursing, psychology, and the social sciences, reported significant improvements in perceived knowledge and confidence from pre- to post-workshop and rated the experience as highly satisfactory. Conclusions: These findings suggest that a workshop combining didactic instruction with experiential, problem-based learning is both feasible and effective in strengthening researchers’ self-efficacy and skills to advance DDI research.

BACKGROUND AND OBJECTIVES:Tele-Savvy, a psychoeducation program for dementia care partners, was designed to improve caregiver mastery (e.g., confidence). While the program focused on care partner's outcomes, there were potential benefits to the quality of the relationship between the person living with dementia and the care partner. RESEARCH DESIGN AND METHODS:This secondary data analysis examined the dyadic relationship quality (i.e., positive interaction and dyadic strain) as reported by 261 care partners from baseline to 6 months postintervention across three treatment arms of the clinical trial: Active group who immediately received Tele-Savvy (n = 96), a Healthy Living attention control group (n = 111), and a Waitlist Control group (n = 54), which care partners received Tele-Savvy after 6 months. RESULTS:In the Tele-Savvy group, care partners reported significant improvements in positive interactions and reduction in dyadic strain over time compared with the care partners in both the Healthy Living and Waitlist Control groups. After all groups received Tele-Savvy, all care partners improved their positive interaction with the person living with dementia and experienced less dyadic strain over time. DISCUSSION AND IMPLICATIONS:The focus of Tele-Savvy is not on improving the quality of dyadic relationships. Our results suggest that interventions focused on the care partner's self-efficacy have the potential to improve the dyadic relationship from the perspective of the care partner, and interventions should include dyadic measures even if from the perspective of one member of the dyad. CLINICAL TRIAL REGISTRATION NUMBER:NCT03033875.

IntroductionCancer survivors and intimate care partners coping with cancer may each experience loneliness that impacts their health, but research within couples and potential benefit of interventions is scarce. METHODS: We added the Cancer Loneliness (CL) scale to measures of anxiety, depressive symptoms, pain and social and physical function mid-way through the Exercising Together trial (NCT03630354) in couples coping with breast (BC; n = 44) or prostate cancer (PC; n = 75). The prevalence of CL scores >1 indicated at least some loneliness and we ran correlations between CL and measures of social, physical and mental health. Within PC couples we explored the potential benefits of different types of dyadic exercise programs (supervised, group partnered exercise, supervised separate groups of survivors or partners, or unsupervised independent exercise) on CL over 6 months.Results96% of breast cancer survivors (BCS) and 77% of prostate cancer survivors (PCS) reported CL at baseline. CL was positively associated with anxiety (rho = 0.44, 0.77), depressive symptoms (rho = 0.60, 0.67) and pain (rho = 0.34, 0.23) and inversely associated with social functioning (rho = −0.54, −0.55) among BCS and PCS, respectively (all p < 0.01). CL was inversely associated with physical functioning in BCS (rho = −0.35), but not PCS. Among care partners, 74%–77% of care partners for each BCS and PCS reported CL related to their partner’s cancer at baseline. CL was positively associated with anxiety (rho = 0.43, 0.30) and depressive symptoms (rho = 0.62, 0.45) among BC and PC care partners, respectively (all p < 0.01). CL was inversely associated with social functioning in BC partners only (rho = −0.45, p < 0.01), but not with physical functioning in either group. Within PC couples, there was a significant (inverse) interaction between change in CL over six-months of exercise and baseline loneliness. Declines in CL for both PCS and care partners were steepest in the exercise program where they trained with other PCS or care partners.ConclusionRelationships may not offer enough social support to avoid feelings of loneliness associated with cancer that in turn affects the physical, emotional and social health of each partner. However, exercise may help rebuild connection within the couple and be an avenue for informal social support that together could reduce loneliness.Clinical Trial Registration[clinicaltrials.gov]: identifier, [NCT03630354].

Over the past two decades, dyadic health science has grown rapidly to focus on dyads across the lifespan in health and illness contexts. There have been increasing numbers of dyadic theories developed and a wide spectrum of dyadic methods (both quantitative and qualitative) employed to address questions centered on the interpersonal context of health, health behaviors, and wellbeing. Family nurse scholars have unique expertise to contribute to the field of dyadic health science and optimize dyadic health. The purpose of this paper is to provide an overview of theories and methods of dyadic health science and to highlight examples of dyadic health research conducted by family nurse researchers. The paper concludes with a call for family nurse researchers to continue to advance dyadic health science that guides nursing practice in diverse health care settings.

Prostate cancer can make men feel socially isolated, even from friends and family, leading to feelings of loneliness that negatively impact their health and quality of life. Group-based exercise shows promise in addressing the social, emotional, and physical needs of men with prostate cancer.

Alzheimer's disease and related dementias (ADRD) affect persons living with dementia (PLWD) and care partners, often disrupting emotional well-being and relationship dynamics. Despite growing evidence of dyadic interdependence in dementia care, most psychosocial interventions remain individually focused, missing an opportunity to improve relational and health outcomes. Dyadic dementia interventions (DDIs) aim to support both members of the dyad through shared communication, coping, and mutual support. The primary objective of this review is to introduce the guiding principles of the CONFIDE-ADRD Roybal Center at Massachusetts General Hospital, as these provide a useful roadmap for advancing scalable, theory driven, and person-centered DDIs. We explore the promise and challenges of DDIs, including inconsistent application of theory, measurement difficulties, and barriers to recruiting dyads from a broad range of populations with disparities. Drawing from chronic illness models and dementia-specific programs, we propose a roadmap for building scalable, theory-driven DDIs grounded in mechanistic science. We introduce CONFIDE-ADRD as a national initiative providing funding, training, and expert consultation to accelerate DDI development. The Center's 14 guiding principles support person-centered, context-sensitive intervention design that targets both individual and relational mechanisms of change. As dementia care becomes increasingly relational and dynamic, robust dyadic approaches are critical to reducing care burden, strengthening relationships, and improving outcomes for both PLWD and care partners. Readers are encouraged to engage with CONFIDE-ADRD's resources and contribute to the advancement of dyadic dementia care research.