{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T06:58:33Z","timestamp":1780901913091,"version":"3.54.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Guided by the Dyadic Coping Theory (DCT), this study aimed to investigate dyadic interrelationships between unmet supportive care needs (USCNs) and depression in colorectal cancer (CRC) patient-spousal caregiver dyads.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using an explanatory sequential mixed-methods design, 200 CRC patient-caregiver dyads completed quantitative surveys. The Actor-Partner Interdependence Model (APIM) analyzed dyadic data. Subsequently, 10 dyads participated in semi-structured interviews, analyzed using reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients reported significantly higher USCNs and depression. APIM revealed significant actor effects (unfulfilled needs predicted intrapersonal depression) but non-significant partner effects. Qualitative findings explained this phenomenon: couples employed \u201cprotective buffering\u201d to conceal unfulfilled needs, inadvertently causing emotional isolation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The interrelationship between USCNs and depression in CRC dyads is driven by intrapersonal internalization rather than direct interpersonal transmission. Mutual protective buffering hinders open communication rather than directly transmitting distress. Care must transition to a dyad-centered approach, implementing couple-based communication interventions to dismantle protective buffering and alleviate mutual distress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1831478","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T06:13:05Z","timestamp":1780899185000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The dyadic paradox of unmet supportive care needs and depression in colorectal cancer couples: an explanatory sequential mixed-methods study"],"prefix":"10.3389","volume":"17","author":[{"given":"Yuan","family":"Ruan","sequence":"first","affiliation":[{"name":"Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengcheng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhao","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Jiangnan University","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Sun","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]},{"name":"Affiliated Hospital of Jiangnan University","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1037\/0893-3200.20.3.485","article-title":"The relationship between dyadic coping and marital quality: a 2-year longitudinal study","volume":"20","author":"Bodenmann","year":"2006","journal-title":"J. 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Psychol."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"102732","DOI":"10.1016\/j.ejon.2024.102732","article-title":"Perception and coping with self-perceived burden among colorectal cancer patients and their caregivers: a qualitative study","volume":"74","author":"Chen","year":"2025","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"8751","DOI":"10.3390\/curroncol29110689","article-title":"Colorectal cancer and onset of anxiety and depression: a systematic review and meta-analysis","volume":"29","author":"Cheng","year":"2022","journal-title":"Curr. Oncol."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1759","DOI":"10.1002\/pon.3210","article-title":"Trajectories of psychological distress after colorectal cancer","volume":"22","author":"Dunn","year":"2013","journal-title":"Psychooncology"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1016\/j.socscimed.2009.01.004","article-title":"Getting through' not 'going under': a qualitative study of gender and spousal support after diagnosis with colorectal cancer","volume":"68","author":"Emslie","year":"2009","journal-title":"Soc. Sci. Med."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"571","DOI":"10.3389\/fpsyg.2019.00571","article-title":"Dyadic coping in couples: a conceptual integration and a review of the empirical literature","volume":"10","author":"Falconier","year":"2019","journal-title":"Front. Psychol."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1093\/annonc\/mdi210","article-title":"Anxiety, depression, and quality of life in caregivers of patients with cancer in late palliative phase","volume":"16","author":"Grov","year":"2005","journal-title":"Ann. Oncol."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"E132","DOI":"10.1097\/NCC.0000000000000785","article-title":"Symptom experiences in colorectal cancer survivors after cancer treatments: a systematic review and meta-analysis","volume":"43","author":"Han","year":"2020","journal-title":"Cancer Nurs."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1007\/s00520-006-0148-0","article-title":"Life after cancer: couples' and partners' psychological adjustment and supportive care needs","volume":"15","author":"Hodgkinson","year":"2007","journal-title":"Support Care Cancer"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.12102\/j.issn.1009-6493.2022.09.010","article-title":"Analysis on the status and influencing factors of supportive care needs of colorectal cancer survivors","volume":"36","author":"Hu","year":"2022","journal-title":"CNR"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"338","DOI":"10.3928\/00220124-20240328-03","article-title":"Quantitative, qualitative, mixed methods, and triangulation research simplified","volume":"55","author":"Kawar","year":"2024","journal-title":"J. Contin. Educ. Nurs."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1037\/a0019651","article-title":"Detecting, measuring, and testing dyadic patterns in the actor-partner interdependence model","volume":"24","author":"Kenny","year":"2010","journal-title":"J. Fam. Psychol."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"151477","DOI":"10.1016\/j.soncn.2023.151477","article-title":"Dyadic effects of psychological health on quality of life in patients with colorectal cancer and caregivers: a systematic review and meta-analysis","volume":"39","author":"Kim","year":"2023","journal-title":"Semin. Oncol. Nurs."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1037\/0003-066X.63.6.518","article-title":"Culture and social support","volume":"63","author":"Kim","year":"2008","journal-title":"Am. Psychol."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1452","DOI":"10.1111\/fare.12644","article-title":"Determine power and sample size for the simple and mediation actor\u2013partner interdependence model","volume":"71","author":"Ledermann","year":"2022","journal-title":"Fam. Relat."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.ejon.2016.09.004","article-title":"The Chinese version of hospital anxiety and depression scale: psychometric properties in Chinese cancer patients and their family caregivers","volume":"25","author":"Li","year":"2016","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.ejon.2013.09.003","article-title":"A literature review on the mutual impact of the spousal caregiver\u2013cancer patients dyads: \u2018communication\u2019, \u2018reciprocal influence\u2019, and \u2018caregiver\u2013patient congruence\u2019","volume":"18","author":"Li","year":"2014","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e13341","DOI":"10.1111\/ecc.13341","article-title":"Validating the Chinese version of the Cancer survivors\u2019 partners unmet needs measure (C-CaSPUN) and exploring unmet needs in Chinese cancer survivor\u2013family caregiver dyads","volume":"30","author":"Li","year":"","journal-title":"Eur. J. Cancer Care"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"101772","DOI":"10.1016\/j.ejon.2020.101772","article-title":"Psychometric properties of the Chinese version of the cancer survivors\u2019 unmet needs measure","volume":"46","author":"Li","year":"","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2552","DOI":"10.1093\/annonc\/mdx350","article-title":"Mapping unmet supportive care needs, quality-of-life perceptions and current symptoms in cancer survivors across the Asia-Pacific region: results from the international STEP study","volume":"28","author":"Molassiotis","year":"2017","journal-title":"Ann. Oncol."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"276","DOI":"10.4103\/apjon.apjon_52_20","article-title":"Identifying the unmet supportive care needs, with concomitant influencing factors, in family caregivers of cancer patients in China","volume":"8","author":"Niu","year":"2021","journal-title":"Asia Pac. J. Oncol. Nurs."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/s0277-9536(99)00281-6","article-title":"Couples' patterns of adjustment to colon cancer","volume":"50","author":"Northouse","year":"2000","journal-title":"Soc. Sci. Med."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.ejon.2022.102143","article-title":"Experiences and needs of partners as informal caregivers of patients with major low anterior resection syndrome: a qualitative study","volume":"58","author":"Pape","year":"2022","journal-title":"Eur. J. Oncol. 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