{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T08:57:45Z","timestamp":1765961865456,"version":"3.38.0"},"reference-count":114,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2025,3]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n Prostate cancer (PCa) is an external stressor that can affect both patients and partners, but dyadic research in this area is limited. This study, guided by the vulnerability-stress-adaptation model, examines how PCa distress affects relationship satisfaction through psychological flexibility and self-esteem.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The study used a cross-sectional design with a total sample size of 314 dyads. The actor-partner interdependence model was applied to examine both actor and partner effects. Covariates were also examined.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n PCa distress negatively predicted psychological flexibility in both patients (\n \n $$\\beta$$<\/jats:tex-math>\n \n \u03b2<\/mml:mi>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula> =\u2009\u2212\u2009.93, p<\/jats:italic>\u2009<\u2009.001) and partners (\n \n $$\\beta$$<\/jats:tex-math>\n \n \u03b2<\/mml:mi>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula> =\u2009\u2212\u20090.70, p<\/jats:italic>\u2009<\u2009.001). Psychological flexibility, in turn, positively predicted self-esteem in both patients (\n \n $$\\beta$$<\/jats:tex-math>\n \n \u03b2<\/mml:mi>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula> = 0.19, p<\/jats:italic>\u2009<\u2009.001) and partners (\n \n $$\\beta$$<\/jats:tex-math>\n \n \u03b2<\/mml:mi>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula> = 0.19, p<\/jats:italic>\u2009<\u2009.001). Self-esteem significantly predicted relationship satisfaction for both patients (\n \n $$\\beta$$<\/jats:tex-math>\n \n \u03b2<\/mml:mi>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula> = 0.22, p<\/jats:italic>\u2009<\u2009.001) and partners (\n \n $$\\beta$$<\/jats:tex-math>\n \n \u03b2<\/mml:mi>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula> = 0.22, p<\/jats:italic>\u2009<\u2009.001). The indirect effects of PCa distress on relationship satisfaction via psychological flexibility and self-esteem were significant for both patients (\n \n $$\\beta$$<\/jats:tex-math>\n \n \u03b2<\/mml:mi>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula> =\u2009\u2212\u2009.093, p<\/jats:italic>\u2009<\u2009.001) and partners (\n \n $$\\beta$$<\/jats:tex-math>\n \n \u03b2<\/mml:mi>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula> =\u2009\u2212\u2009.078, p<\/jats:italic>\u2009<\u2009.001). Additionally, a significant indirect effect of partners\u2019 PCa distress on patients\u2019 relationship satisfaction was observed (\n \n $$\\beta$$<\/jats:tex-math>\n \n \u03b2<\/mml:mi>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula> =\u2009\u2212\u2009.055, p<\/jats:italic>\u2009<\u2009.01).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The findings highlight the critical role of psychological flexibility and self-esteem in mediating the impact of PCa distress on relationship satisfaction for both patients and partners. Tailored interventions aimed at enhancing psychological flexibility to support relationship functioning in couples coping with PCa may be effective.<\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s00520-025-09229-8","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T02:18:06Z","timestamp":1739413086000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Exploring the role of psychological flexibility in relationship functioning among couples coping with prostate cancer: a cross-sectional study"],"prefix":"10.1007","volume":"33","author":[{"given":"Hongen","family":"Ma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Cariola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Gillanders","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"9229_CR1","unstructured":"Ackerman RA, Kenny DA (2016) APIMPowerR: an interactive tool for actor-partner interdependence model power analysis [Computer software]. https:\/\/robert-a-ackerman.shinyapps.io\/APIMPowerRdis\/. 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