An Actor-Partner Interdependence Mediation Model for Assessing the Association Between Dyadic Coping and Post-traumatic Growth in Dyads of Patients With Stroke and Their Spouses: Cross-Sectional Study

An Actor-Partner Interdependence Mediation Model for Assessing the Association Between Dyadic Coping and Post-traumatic Growth in Dyads of Patients With Stroke and Their Spouses: Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article An Actor-Partner Interdependence Mediation Model for Assessing the Association Between Dyadic Coping and Post-traumatic Growth in Dyads of Patients With Stroke and Their Spouses: Cross-Sectional Study Huimin Yuan, Jianhui You, Jinshu Huang, Wenwen Zhao, Xiangyun Jin, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7822549/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 02 Apr, 2026 Read the published version in BMC Psychology → Version 1 posted 15 You are reading this latest preprint version Abstract Objective This study aims to explore the dyadic associations between dyadic and post-traumatic growth in dyads of patients with stroke and their spouses, and the mediating role of intimate relationships in these associations. Design A cross-sectional descriptive study was conducted from October 2023 to May 2024. Methods This study adopted a purpose-sampling method. A total of 215 stroke patients and their spouses from a tertiary hospital in China were selected as study subjects. The General Information Questionnaire, Dyadic Coping Inventory, Marital Adjustment and Prediction Test, and Post-traumatic Growth Inventory were used; the data were analyzed using the actor-partner interdependence mediation model. Results The results showed that the dyadic coping of stroke patients and their spouses was significantly related to intimate relationships and post-traumatic growth. In addition, the dyadic coping of stroke patients and their spouses had significant actor effects and partner effects on the post-traumatic growth through intimate relationships. Conclusions The dyadic coping of stroke patients and their spouses could produce actor and partner effects on the post-traumatic growth through the mediation of intimate relationships, which provided empirical support for improving the level of post-traumatic growth among patients and spouses at the dyadic level. Stroke patients Spouses Dyadic coping Intimate relationships Post-traumatic growth Actor-Partner Interdependence Model Figures Figure 1 Figure 2 Figure 3 Introduction Stroke, also known as cerebrovascular accident, is an acute focal injury to the central nervous system that occurs locally due to cerebrovascular disease, which is divided into two categories: hemorrhagic and ischemic[ 1 ]. Stroke is common in people over 40 years of age and is characterised by high incidence, disability, and mortality. It has become one of the prominent problems affecting public health worldwide [ 2 ]. 2019 Global Burden of Disease data [ 3 ] shows that the age-standardised incidence, prevalence, and mortality rates of stroke are 276.7/100,000 person-years, 2022.0/100,000 person-years, and 153.9/100,000 person-years, respectively. Studies have found that risk factors for cerebrovascular disease include pre-existing conditions (hypertension, diabetes, dyslipidemia, and atrial fibrillation, etc.) and behavioural risk factors (smoking and alcohol consumption, etc.)[ 4 ]. In recent years, the number of strokes will continue to increase in the future, and the clinical burden will increase due to the accelerated industrialisation and ageing of the population, the increased prevalence of underlying chronic diseases, and poorly managed health behaviours. By now, stroke has become a focus of public health attention. Stroke-induced somatic dysfunctions such as hemiparesis, aphasia, sensory deficits, diplopia, and decreased libido not only impede the patient's return to the family and society, but also greatly affect the intimate relationship between couples. Stroke, as a traumatic event, is unpredictable, uncontrollable, and life-threatening. A review of the literature shows that 17.5% of stroke patients experience post-traumatic stress disorder (PTSD)[ 5 ], which is mainly characterised by extreme avoidance of situations related to the traumatic experience, selective amnesia, hypervigilance, increased agitation, and anxiety, which not only brings great psychological pain, but also seriously impairs their physical and mental health and quality of life. In addition, studies have shown that stroke caregivers experience intense post-traumatic stress[ 6 ], which can impede the patient's recovery process by interfering with their ability to care. The level of health between the patient and the spouse is interdependent, i.e., the couple is one in the disease, and the mental health and resilience of the spouse predict clinical events in stroke patients[ 7 ]. Therefore, focusing on the mental health status of stroke spouses is essential for the physical and psychological recovery of patients. With the rise of positive psychology, researchers have found that couples, after experiencing traumatic events, can overcome negative illness experiences and transform them into positive psychological inertia, and redefine their life plans based on affirmation of the value of life, i.e., Post-traumatic Growth (PTG)[ 8 ]. Post-traumatic growth is a dynamic, multi-dimensional phenomenon that is both a process and outcome. Many factors influence posttraumatic growth, including sociodemographic characteristics, type of illness, psychological condition, social support, and coping styles[ 9 ]. Of these, coping styles have the most substantial effect on the psychological regulation of stress. Proactive coping styles can alleviate stress and regulate individuals' positive state of mind in the face of stressful events, thus improving post-traumatic growth[ 10 ]. Related studies have shown that the posttraumatic growth of patients and their spouses can interact with each other, but the mechanism of how they interact remains unclear [ 11 ]. Therefore, finding the mechanism of posttraumatic growth interaction between stroke patients and their spouses to provide the best evidence support for healthcare professionals to develop interventions to promote the mental health of couples is an urgent issue. In recent years, research on coping has shifted from an individual perspective to a binary perspective, known as dichotomous coping. Dyadic coping (DC) is the shared response and decision-making of partners in an intimate relationship in the face of binary stress[ 12 ]. Systemic Transactional Model(STM) divides dyadic coping into positive dichotomy coping (including stress communication, mutual support, coping together, and agency coping) and negative dichotomy, and emphasises that couples can adjust their binary stress through positive dyadic coping to improve physical and mental health while enhancing intimacy [ 12 ]. Studies have shown that dyadic coping is an essential predictor of post-traumatic growth, with positive dyadic coping associated with higher levels of PTG. In comparison, negative dyadic coping is associated with lower levels of PTG. Therefore, enhancing the dualistic coping ability of couples may be one of the effective ways to improve the post-traumatic growth level of stroke patients and their spouses [ 13 ]. In addition, couples can restore a state of balance in their intimate relationships by enhancing cohesion and well-being through positive binary coping [ 14 ]. As a resource and strategy, intimacy is another significant predictor of post-traumatic growth, meeting the need for love and companionship in marriage and supporting each other through painful disease processes [ 15 ]. Intimacy refers to the interdependence that arises between the partners in dealing with stressful events together. The cancer adaptive intimacy model proposed by Manne et al. suggests that couples' communication affects couples' psychological adjustment through intimacy, and emphasises the decisive significance of marital intimacy in the psychological adjustment process [ 16 ]. According to reports, marital intimacy increases after patients and their spouses experience traumatic events and overcome difficulties in disease treatment[ 17 ]. Avila found in their study of cancer patients that the more intimate interactions between spouses, the better they could meet each other's physical and emotional needs. The emotional security that resulted not only helped the couple continue their lives, but also allowed them to grow in ways they had never experienced before[ 18 ]. Mavandadi conducted a study on couples of Parkinson's disease patients and found that higher relationship quality was associated with fewer psychological disturbances and higher levels of PTG [ 19 ]. Therefore, enhancing the intimacy between spouses may be one of the effective ways to improve the PTG levels of stroke patients and their spouses. Coping styles can strengthen relationship functioning. Research has confirmed that dual coping is a predictor of intimate relationships, and positive dual coping is of great significance for improving satisfaction in intimate relationships. In contrast, negative dual coping is negatively correlated with satisfaction in intimate relationships[ 20 ]. In addition, among stroke patients and their spouses, intimacy can predict the level of PTG for both parties[ 21 ]. A survey of breast cancer patients conducted by Shi et al. showed that intimate relationships play a partial mediating role in dual coping and PTG. Positive dual coping positively correlates with intimate relationships, while intimate relationships are negatively correlated with PTG[ 22 ]. However, there have been no reports on the relationship between dual coping, intimate relationships, and post-traumatic growth in stroke patients and their spouses. Therefore, this study aims to explore the relationship between the three. In summary, this study is based on the system interaction model. It constructs the Actor-Partner Interdependence Mediation Model (APIMeM) [ 23 ] to explore whether intimate relationships mediate in the dual coping and post-traumatic growth of stroke patients and their spouses. As an analytical method for binary data, APIMeM can simultaneously test the interrelationship between binary variables, analysing how an individual's independent variables influence both their dependent variables and the dependent variables of their partner. This includes three effects: the actor effect (the influence of an individual's independent variables on their dependent variables), the partner effect (the impact of a partner's independent variables on an individual's dependent variables), and the mediation effect (the mechanism by which an independent variable influences a dependent variable through a mediating variable). The following hypotheses are proposed: Hypothesis 1 (H1): Positive dyadic coping has a positive subject-object effect on intimate relationships; negative dyadic coping has an adverse subject-object effect on intimate relationships. Hypothesis 2 (H2): Positive dyadic coping and post-traumatic growth have positive subject and object effects; negative dyadic coping and post-traumatic growth have negative subject and object effects. Hypothesis 3 (H3): There is a subject effect and an object effect between intimate relationships and post-traumatic growth. Hypothesis 4 (H4): Intimate relationships have a subject-object mediating effect between positive dichotomous coping and post-traumatic growth, as well as between negative dichotomous coping and post-traumatic growth. For details, see Fig. 1 . Methods Participants This study employed a cross-sectional study design using convenience sampling. The study population consisted of stroke patients and their spouses admitted to the rehabilitation departments of two tertiary-level hospitals in Liaoning Province, China, from October 2023 to May 2024. The inclusion criteria for patients were as follows: (1) diagnosed according to the Chinese Stroke Association guidelines for the clinical management of cerebrovascular disorders [ 24 ] and confirmed by cranial CT or MRI; (2) married and living with their spouse; (3) stable vital signs, conscious, and capable of reading and writing after rehabilitation treatment; (4) spouse was the primary caregiver during the illness; (5) aware of the condition and voluntarily participated in the study. Patient exclusion criteria were as follows: (1) Concurrent significant organ dysfunction or other severe chronic diseases; (2) History of mental illness; (3) Recent exposure to other significant traumatic events (e.g., car accidents, loss of a loved one). Spouse inclusion criteria are as follows: (1) Married and living with the spouse; (2) Assumes primary caregiving responsibilities, with caregiving time ≥ 4 hours per day; (3) Aware of the patient's condition and has regular communication and understanding abilities, capable of participating in basic medical decisions and caregiving; (4) Aware of the condition and voluntarily participates in the study. Exclusion criteria for spouses are as follows: (1) Those with other major illnesses, such as malignant tumours or severe heart failure; (2) History of mental illness; (3) Recent exposure to other significant traumatic events (e.g., car accidents, loss of a family member, etc.). Finally, 215 pairs of questionnaires were received, so the effective recovery rate was 97.73% Data Collection This study employed a questionnaire survey method to collect data. Before completing the questionnaire, participants were fully informed of the study's purpose, significance, voluntary nature, and confidentiality, thereby gaining patients' and their spouses' trust and cooperation. Uniform instructions were provided to explain the questionnaire's requirements, guiding patients and their spouses to complete it independently. If patients or their spouses could not complete the questionnaire due to visual impairments or educational limitations, researchers or family members could assist by asking questions. After completion, the survey was collected on-site and checked for completeness. Any omissions were addressed immediately to ensure the validity of the study. Measures Demographic and Clinical Characteristics Researchers designed a general information survey form based on the literature review and expert guidance. It included demographic information such as age, gender, educational attainment, careers, length of marriage, living conditions, and average monthly income; and disease-related information such as type of disease, total duration of illness, number of recurrences, and residual functional impairment. The Dyadic Coping Inventory(DCI) The Dyadic Coping Inventory (DCI) was developed by Bodenmann et al. in 2008 [25] . The Chinese version was translated by Chinese scholars Xu et al. [ 26 ] and is used to evaluate the quality of dual coping in intimate partners. DCI comprises six dimensions: stress communication, supportive coping, empowering coping, collaborative coping, negative coping, and coping quality evaluation, with 37 items. The first four dimensions represent positive dichotomous coping, the negative coping dimension represents negative dichotomous coping, and coping quality evaluation is not included in the total score. The scale uses a 5-point Likert scale, with scores ranging from “very rarely” to “very frequently,” corresponding to 1 to 5 points, respectively. The total score ranges from 35 to 175 points. A score below 111 indicates a low level of dual coping, 111–145 indicates an average level, and above 145 indicates a high level. The Cronbach’s α coefficient for the scale ranges from 0.74 to 0.93, with individual dimension coefficients ranging from 0.51 to 0.80. Short Marital Adjustment and Prediction Test(MAT) The Locke-Wallace Marriage Adjustment Test (MAT) was initially developed by Locke and Wallace (1959)[ 27 ] and translated into Chinese by Chinese scholar Wang Zhiming (1999) [ 28 ] to assess the quality of intimate relationships between patients and their spouses. The scale consists of four dimensions: marital consistency, marital satisfaction, emotional expression, and marital cohesion, with 15 items. Each item is assigned a score corresponding to the response, and the questionnaire score is the sum of the scores for all items. The total score ranges from 2 to 158 points, with 2–90 points indicating dissatisfaction, 91–110 points indicating moderate satisfaction, 111–130 points indicating satisfaction, and 131–158 points indicating high satisfaction. The Cronbach’s α coefficient for this scale is 0.90. Post-traumatic Growth Inventory(PTGI) PTGI, translated into Mandarin Chinese by Professor Wang et al. [ 29 ], is used to assess the level of post-traumatic growth in trauma survivors. The scale comprises five dimensions: life insights, new possibilities, personal strength, relationships with others, and self-transformation, with 20 items. It employs a 6-point Likert scale, ranging from “I have not experienced any such changes at all since this incident” to “I have experienced a great deal of such changes,” scored from 0 to 5, respectively. The total score ranges from 0 to 100, with higher scores indicating greater post-traumatic growth. A score below 60 indicates a low level of post-traumatic growth, a score of 60 or above but below 66 indicates a moderate level of post-traumatic growth, and a score of 66 or above indicates a high level of post-traumatic growth. The Cronbach’s α coefficient for the scale is 0.874, with Cronbach’s α coefficients for each dimension ranging from 0.611 to 0.796. Statistical Analyses Data were organised and analysed using SPSS 25.0 and Amos 24.0 software. A P-value < 0.05 indicates statistically significant differences. Descriptive statistics: Descriptive statistical analysis was conducted on the general demographic characteristics, dyadic responses, intimate relationships, and post-traumatic growth of stroke patients and their spouses. The data in this study followed a normal distribution, so the mean and standard deviation were used for description. Univariate analysis/t-test: After grouping each variable in the general data according to different criteria, the scores for binary coping, intimate relationships, and post-traumatic growth were calculated separately for stroke patients and their spouses. Univariate analysis of variance or independent samples t-test was used to compare the differences in binary coping, intimate relationships, and post-traumatic growth scores between stroke patients and their spouses. For groups with statistically significant differences in the one-way ANOVA, LSD tests were conducted for further pairwise comparisons, and paired t-tests were used to compare whether there were substantial differences in the variable scores between stroke patients and their spouses. Correlation analysis: Correlation analysis was conducted between dyadic coping, intimate relationships, and post-traumatic growth. Pearson correlation analysis was used in this study. Construction of the subject-object interdependence mediation model: The subject-object interdependence mediation model for stroke patients and their spouses was constructed using Amos 24.0 software. Data fitting and correction were performed using the maximum likelihood method, (with model fit indices: X²/DF 0.90, Tucker-Lewis Index (TLI) > 0.90, Comparative Fit Index (CFI) > 0.90, Root Mean Square Error of Approximation (RMSEA) < 0.08 as standards;). The mediating effect was tested using the Bootstrap method, with 5,000 repeated samples. The existence of the mediating effect was determined based on whether the regression coefficients were significant and whether the Bootstrap 95% confidence interval (CI) included 0. Ethical Considerations This study was approved by the Ethics Committee of China Medical University [(2023)122] and conducted by the principles of the Declaration of Helsinki. Before conducting the survey, participants were fully informed of the purpose, significance, content, and duration of the study, ensuring that patients and their families had the freedom to choose whether to participate or withdraw, and that their interests would not be compromised. Participants voluntarily agreed to participate in the study and signed informed consent forms. The survey questionnaire did not include questions regarding patients' names or home addresses. All questions related to patients' and their spouses' privacy and personal safety were handled by confidentiality principles, and all data regarding study participants were restricted to internal personnel involved. Results General information on stroke patients and their spouses The age of the stroke patients in this study: 15 cases (7.0%) were 30–39 years old, 39 cases (18.1%) were 40–49 years old, 45 cases (20.9%) were 50–59 years old, and 116 cases (54.0%) were ≥ 60 years old; the age of their spouses was 13 cases (6.0%) were 30–39 years old, 37 cases (17.2%) were 40–49 years old, 50 cases (23.3%) were 50–59 years old ( 23.3%), 115 cases (53.5%) aged ≥ 60 years; the patients had 175 ischemic strokes (81.4%) and 40 hemorrhagic strokes (18.6%). For details, see Table 1 . Table 1 General information on stroke patients and spouses Variant Clusters Patients (n = 215) Spouses (n = 215) Frequency (n) Percentage (%) Frequency (n) Percentage (%) Age (years) 30 ~ 39 15 7 13 6 40 ~ 49 39 18.1 37 17.2 50 ~ 59 45 20.9 50 23.3 ≥ 60 116 54 115 53.5 Gender Male 170 79.1 45 20.9 Female 45 20.9 170 79.1 Educational attainment Primary and below 18 8.4 22 10.2 Junior high school 77 35.8 70 32.6 High school or junior college 57 26.5 63 29.3 Bachelor's degree or college 58 27 52 24.2 Graduate students and above 5 2.3 8 3.7 Careers Incumbency 61 28.4 64 29.8 Out of work 13 6 16 7.4 Retirement/pension 106 49.3 103 47.9 (sth. or sb) else 35 16.3 32 14.9 Length of marriage (years) ≤ 10 12 5.6 - - 11 ~ 20 36 16.7 - - 21 ~ 30 40 18.6 - - > 30 127 59.1 - - Living conditions Cities and towns 173 80.5 - - Countryside 42 19.5 - - Average monthly income (yuan) 5000 45 21 - - Type of disease Ischemic 175 81.4 - - Hemorrhagic 40 18.6 - - Total duration of illness 1 year 53 24.7 - - Number of recurrences Fashion collection 204 94.9 - - ≥ 2 times 11 5.1 - - Residual functional impairment (number) 1 96 44.7 - - 2 105 48.8 - - 3 14 6.5 - - Note: "-" means that the spouse has the same or no information as the patient C: Jianhui You The Scores and Differences in the Study Variables in the Dyadic Group The DC score of patients with stroke was 112.91 ± 7.82, which was lower than that of their spouses(112.98 ± 7.31). The MAT score of patients with stroke was 110.12 ± 9.95, which was higher than that of their spouses(107.57 ± 8.13), with a statistically significant difference between them(P < 0.05). The PTG score of patients with stroke was 55.33 ± 7.14, which was lower than that of their spouses(55.62 ± 5.73). For details, see Table 2 . Correlations of dimensions of dichotomous coping, intimate relationship, and posttraumatic growth in stroke patients and spouses Pearson correlation analysis was performed on five dimensions of stroke patients and spouses: total dichotic coping score, positive dicary coping, negative dicary coping, intimate relationship score, and post-traumatic growth, and the results showed that all other variables were positively correlated with each variable, except for the negative correlations between patients and spouses. The results of the correlation analyses are detailed in Table 3. Table 3: Correlations of dimensions of dyadic coping, intimate relationship, and posttraumatic growth in stroke patients and their spouses Variable Spouses 1 2 3 4 5 6 7 8 9 Patients 1 0.833 * 0.277 * -0.136 * 0.394 * 0.459 * 0.357 * 0.322 * 0.325 * 0.383 * 2 0.580* 0.499 * -0.218 * 0.509 * 0.510 * 0.389 * 0.501 * 0.52 * 0.504 * 3 -0.511 * -0.316 * 0.245 * -0.415 * -0.481 * -0.323 * -0.407 * -0.379 * -0.439 * 4 0.434 * 0.714 ** -0.356 * 0.707 * 0.578 * 0.601 * 0.587 * 0.631 * 0.629 * 5 0.414 * 0.521 * -0.263 * 0.589 * 0.583 * 0.424 * 0.56 * 0.539 * 0.608 * 6 0.429 * 0.701 * -0.295 * 0.69 * 0.579 * 0.647 * 0.597 * 0.673 * 0.685 * 7 0.413 * 0.307 * -0.252 * 0.425 * 0.457 * 0.251 * 0.507 * 0.382 * 0.425 * 8 0.469 * 0.219 * -0.185 * 0.347 * 0.393 * 0.225 * 0.434 * 0.310 * 0.371 * 9 0.396 * 0.666 * -0.296 * 0.601 * 0.457 * 0.584 * 0.575 * 0.617 * 0.562 * Note: *P < 0.01 1 Dyadic coping 2 Positive dyadic coping 3 Negative dyadic coping 4 Intimate relationships 5 Relationship with others 6 Newly available capability 7 Personal strength 8 Self-transformation 9 Life lessons C: Jianhui You Analysis of Actor-Object Interdependent Mediating Effects of Intimate Relationship on Dyadic Coping and Post-Traumatic Growth in Stroke Patients and Spouses Analysis of Actor-Object Interdependent Mediating Effects of Intimate Relationships between Positive Dyadic Coping and Post-Traumatic Growth in Stroke Patients and Their Spouses In this study, Amos 24.0 software was used to construct an actor-object interdependent mediation model to explore the relationship between positive dyadic coping, intimate relationships, and post-traumatic growth in stroke patients and their spouses, as well as to fit and correct the data using the maximum likelihood ratio method[ 30 ], and to test whether intimate relationships is a dyadic mediator between dyadic coping and posttraumatic growth by the bias-corrected percentile Bootstrape method—presence of a dyadic mediating effect. The model consisted of three pairs of variables and two pairs of error terms: two predictor variables (positive dichotomous coping of the patient and spouse), two outcome variables (posttraumatic growth of the patient and spouse), and two potential mediator variables (intimate relationship of the patient and spouse). The results showed that the model fit index X 2 /df = 3.576, IFI = 0.934, TLI = 0.908, CFI = 0.933, and RMSEA = 0.08, indicating that the model fit well. The positive dyadic coping of patients and their spouses had a positive predictive effect on their intimate relationship (β = 0.356, P < 0.001 and β = 0.723, P < 0.001), i.e., it verified the existence of the subject effect between positive dyadic coping and intimate relationship in Hypothesis 1 . The predictive effects of patients' positive dyadic coping on their spouses' intimate relationship and spouses' positive dyadic coping on patients' intimate relationship were also both The object effect between positive dyadic coping and intimate relationships in Hypothesis 1 was found to be significant (β = 0.101, P = 0.028 and β = 0.536, P < 0.001, respectively). The positive dyadic coping of patients and their spouses positively predicted their post-traumatic growth (β = 0.060, P < 0.001 and β = 0.159, P < 0.001, respectively), which confirmed the pos it ive dyadic coping effect in Hypothesis 2 (β = 0. 06 0, P 0.001 and β = 0.159, P 0.001, respectively). The subject effect between positive dyadic coping and posttraumatic growth in Hypothesis 2 exists. The predictive effects of patients' positive dyadic coping on their spouses' posttraumatic growth and spouses' positive dyadic coping on patients' posttraumatic growth are also significant (β = 0.159, P < 0.001 and β = 0.037, P = 0.045), i.e., the object effect between positive dyadic coping and posttraumatic growth in Hypothesis 2 is validated. Existed; the intimate relationship between patients and their spouses had a positive predictive effect on their posttraumatic growth (β = 0.578, P < 0.001 and β = 0.436, P < 0.001), i.e., the subject effect between intimate relationship and posttraumatic growth in Hypothesis 3 was validated. The object effect of spousal intimate relationship on the patients' posttraumatic growth was validated (β = 0.016, P = 0.003), i.e., the object effect between spousal intimate relationship and patient posttraumatic growth in Hypothesis 3 was verified, but the object effect of patient intimate relationship on spousal posttraumatic growth was not established. See Fig. 2 for details. Bootstrap test results showed that intimate relationship mediated the relationship between both stroke patients and their spouses' positive dyadic coping on their posttraumatic growth ( β = 0.225, 95% CI = 0.150 to 0.311 and β = 0.296, 95% CI 0.222 to 0.374). It also mediated the relationship between the stroke patients' spouses' positive dyadic use of their spouses' positive dyadic coping on the patients' posttraumatic growth ( β = 0.428, 95% CI = 0.327 ~ 0.545). See Table 4 for details. Table 4 Effects of Intimate Relationship on Subject-Object Interdependent Mediation Models between Positive Dyadic Coping and Posttraumatic Growth Effect (scientific phenomenon) β 95% CI P Actor effect Patients Total effect 0.448 0.34 0.551 0.001 Direct effect 0.223 0.126 0.333 < 0.001 Indirect effect 0.225 0.150 0.311 0.001 (Patient Positive Dyadic Coping→ Patient Intimate relationship→ Patient Post-Traumatic Growth) (Patient Positive Dyadic Coping→ Spousal Intimate relationship→ Patient Post-Traumatic Growth) Spouses Total effect 0.862 0.768 0.893 0.001 Direct effect 0.545 0.447 0.637 < 0.001 Indirect effect 0.296 0.222 0.374 0.001 (Positive Dyadic Coping for Spouses→ Spousal Intimate relationship→ Spousal Post-Traumatic Growth) (Positive Dyadic Coping for Spouses→ Patient Intimate relationship→ Spouse Post-Traumatic Growth) Object effect Patients Total effect 0.555 0.43 0.672 0.001 Direct effect 0.127 0.009 0.272 0.035 Indirect effect 0.428 0.327 0.545 0.001 (Positive Dyadic Coping for Spouses→ Spousal Intimate relationship→ Patient Post-Traumatic Growth) (Positive Dyadic Coping for Spouses→ Patient Intimate relationship→ Patient Post-Traumatic Growth) Patients Total effect 0.153 0.072 0.236 0.021 Direct effect 0.123 0.044 0.203 0.002 Indirect effect 0.030 -0.017 0.085 0.431 (Patient Positive Dyadic Coping→ Patient Intimate relationship→ Spouse Post-Traumatic Growth) (Patient Positive Dyadic Coping→ Spouse Intimate relationship→ Spouse Post-Traumatic Growth) Analysis of subject-object interdependent mediating effects of intimate relationship between negative dyadic coping and posttraumatic growth in stroke patients and their spouses In this study, Amos 24.0 software was used to construct a subject-object interdependent mediation model to explore the dichotomous relationship between negative dyadic coping, intimate relationship, and posttraumatic growth in stroke patients and their spouses, as well as to fit and correct the data using the maximum likelihood ratio method, and to test whether intimate relationship is a dyadic mediator between dyadic coping and posttraumatic growth by the bias-corrected percentile Bootstrape method—presence of a dyadic mediating effect. The model consisted of three pairs of variables and two pairs of error terms: two predictor variables (patient-spouse negative dyadic coping), two outcome variables (patient-spouse posttraumatic growth), and two potential mediator variables (patient-spouse intimate relationship). The results showed that the model fit index X 2 /df = 3.410, IFI = 0.932, TLI = 0.901, CFI = 0.932, and RMSEA = 0.08, indicating that the model fit well. The negative dyadic coping of patients and their spouses had a negative predictive effect on their intimate relationship ( β = -0.350, P = 0.001 and β = -0.169, P = 0.002), i.e., it verified the existence of the subject effect between negative dyadic coping and intimate relationship in Hypothesis 1 . Moreover, the predictive effects of the negative dyadic coping of patients on their spouses' intimate relationship and the negative dyadic coping of spouses on the intimate relationship of the patients were also both significant ( β = -0.374, P = 0.001 and β = -0.270, P < 0.001), i.e., the object effect between negative dyadic coping and intimate relationships in Hypothesis 1 was verified; the patient's negative dyadic coping negatively predicted their own posttraumatic growth (β= -0.165, P = 0.001), i.e., the subject effect between negative dyadic coping and posttraumatic growth in Hypothesis 2 was verified. The patient's negative dyadic coping negatively predicted their spouse's intimate relationships and spouse's negative dyadic coping on the patient's intimate relationships. The subject effect between negative dyadic coping and posttraumatic growth existed. The predictive effect of patients' negative dyadic coping on their spouses' posttraumatic growth was also significant (β=-0.144, P < 0.001), i.e., it verified the existence of object effect between negative dyadic coping and posttraumatic growth in Hypothesis 2 . Patients' and their spouses' intimate relationship had a positive predictive effect on their posttraumatic growth (β = 0.682, P = 0.001 and β = 0.724, P < 0.001), i.e., the subject effect between intimate relationships and posttraumatic growth in Hypothesis 3 was established; the predictive effect of the patient's intimate relationship on their spouse's posttraumatic growth and the spouse's intimate relationship on the patient's posttraumatic growth was significant (β = 0.151, P = 0.001 and β = 0.218, P = 0.002), i.e., Hypothesis 3 was verified that there is an intimate relationship and posttraumatic growth there is an object effect between. See Fig. 3 for details. Bootstrap tests showed that intimate relationship mediated the relationship between both stroke patients and their spouses' negative dyadic coping on their post-traumatic growth ( β = -0.319, 95% CI = -0.342~ -0.209 and β = -0.165, 95% CI = -0.261 to -0.07); and mediated the relationship between both stroke patient's spouse's negative dyadic coping on patient's post-traumatic posttraumatic growth and stroke patients' negative dyadic coping on spouses' posttraumatic growth mediated ( β = -0.221, 95% CI = -0.342 to -0.125 and β = -0.323, 95% CI = -0.417 to -0.214). See Table 5 for details. Table 5 Effects of Intimate Relationships on Subject-Object Interdependent Mediation Models between Negative Dyadic Coping and Posttraumatic Growth Effect β 95% CI P Actor effect Patients Total effect -0.484 -0.485 0.067 0.452 Direct effect -0.165 -0.249 -0.075 0.001 Indirect effect -0.319 -0.342 -0.209 0.001 (Patient Negative Dyadic Coping→ Patient Intimate relationship→ Patient Post-Traumatic Growth) (Patient Negative Dichotomous Coping→ Spousal Intimate relationship→ Patient Post-Traumatic Growth) Spouses Total effect -0.135 -0.244 -0.006 0.002 Direct effect 0.030 -0.039 0.100 0.373 Indirect effect -0.165 -0.261 -0.07 0.001 (Spousal Negative Dichotomous Coping→ Spousal Intimate relationship→ Spousal Post-Traumatic Growth) (Spouse Negative Dyadic Coping→ Patient Intimate relationship→ Spouse Post-Traumatic Growth) Object effect Patients Total effect -0.231 -0.339 -0.119 0.001 Direct effect -0.010 -0.095 0.057 0.655 Indirect effect -0.221 -0.342 -0.125 < 0.001 (Spousal Negative Dichotomous Coping→ Spousal Intimate relationship→ Patient Post-Traumatic Growth) (Spouse Negative Dyadic Coping→ Patient Intimate relationship→ Patient Post-Traumatic Growth) Spouses Total effect -0.463 -0.587 -0.214 < 0.001 Direct effect -0.140 -0.213 -0.072 < 0.001 Indirect effect -0.323 -0.417 -0.214 < 0.001 (Patient Negative Dichotomous Coping→ Patient Intimate relationship→ Spouse Post-Traumatic Growth) (Patient Negative Dichotomous Coping→ Spouse Intimate relationship→ Spouse Post-Traumatic Growth) Dicussion The Mediating Role of Intimate Relationships in Subject-Object Interdependence Between Positive Dyadic Coping and Post-Traumatic Growth in Stroke Patients and Their Spouses The results of this study showed a subject-mediated effect of intimate relationship between positive dyadic coping and posttraumatic growth in stroke patients and their spouses, the positive dyadic coping of stroke patients and their spouses positively predicted their posttraumatic growth through their intimate relationship, which is consistent with the findings of Suo et al[ 11 ], who noted that intimate relationship in breast cancer patients and their spouses mediated the positive dyadic coping effect on positive predictive effect on post-traumatic growth. According to STM[ 15 ]and APIMeM[ 31 ], couples' coping styles, marital relationship, and psychological adjustment interact with each other, and the higher the level of intimate relationship, the stronger its buffering role in stroke couples' stressful communication and supportive coping on positive psychological growth. Specifically, at the individual level, the use of open and constructive communication reduces the painful experience of the disease, enhances intimate relationship satisfaction over time, protectively buffers against the significant psychological blow of the sudden illness, and then adjusts the psychological state to adapt to the disease and explores the positive changes in the coping process, rethinks the value of life, and ultimately achieves post-traumatic growth. Psychotherapy is an effective strategy for exploring post-traumatic positive change. Caregivers can use mobile health technology to adopt interventions such as couples' psychoeducation and acceptance and commitment therapy to accept and acknowledge suffering in a relationship of trust and rapport, and to alleviate subjects' symptoms of anxiety and depression, thus improving the quality of the intimate relationship between the stroke patient and his/her spouse and helping them to establish higher-level goals and beliefs to achieve growth. The results of this study showed that there was an object-mediated effect of intimate relationship in stroke patients between spousal positive dyadic coping and patient's posttraumatic growth, and spousal intimate relationship between patient's positive dyadic coping and patient's posttraumatic growth, which was similar to the results of the studies conducted by Suo et al[ 11 ]., Lee et al.[ 32 ]. Once again, it verifies that stroke is a couple's disease, which is in line with the shared coping theory[ 33 ]. Stroke treatment and rehabilitation is a continuum, with both partners' health status interacting, and couples benefit from the process when individuals do their best to mobilise all resources to enhance their resilience. Positive dyadic coping is an essential resource for individuals to provide emotional support to each other, which not only contributes to their satisfaction with the marital relationship, but also their spouse's satisfaction, and thus is key to improving each other's post-traumatic growth. Studies have shown[ 34 ] that by encouraging both spouses to actively participate in the disease treatment process actively, enhancing spousal communication and exchanges, and facilitating joint confrontation, mutual understanding, and positive adjustment of the marital relationship can be achieved to improve mental health. The key to enhancing post-traumatic growth of stroke patients and their spouses is to promote positive dyadic coping to enhance the supportiveness and satisfaction of the intimate relationship. Therefore, caregivers should treat husband and wife as one, pay attention to the impact of one party's emotional changes on the other party's health status, encourage both parties to actively participate in the disease treatment process, and strengthen education to support effective communication on stroke-related issues; learn from mature psychological intervention strategies for couples in foreign countries, and combine them with China's national conditions to develop targeted dyadic training programs to help patients and spouses adapt to the new roles and responsibilities, alleviate psychological distress and reduce psychological burdens for both parties, and help patients and spouses adjust to new roles and responsibilities, and reduce psychological burdens. This will help patients and spouses adapt to their new roles and responsibilities, alleviate their psychological distress, reduce their psychological burdens, enhance their cohesion, and ensure the harmony and stability of their intimate relationships, thus promoting their post-traumatic growth. The Mediating Role of Intimate Relationship in Subject-Object Interdependence Between Negative Coping and Posttraumatic Growth in Stroke Patients and Their Spouses The results of this study showed that intimate relationship has a subject-mediated effect between negative dyadic coping and posttraumatic growth in stroke patients and spouses, i.e., negative dyadic coping in stroke patients and their spouses can predict their posttraumatic growth through their own intimate relationship, i.e., intimate relationship may be an intrinsic cause influencing posttraumatic growth in stroke patients and spouses. Similar to the findings of Meier [ 35 ]and Regan[ 36 ]. Negative dyadic coping, which includes topic diversion, hostility, avoidance, and blame, is detrimental to the stability of family relationships and quality of life when individuals try to hide their illness-related concerns to protect their partners from anxiety, and reduces the individual's resilience to the illness and hinders their own and their spouses' growth experience[ 16 ]. To analyse the reasons, post-stroke body image changes, sexual dysfunction, and medication-induced adverse reactions cause patients to produce higher levels of negative disease perception, which hides their emotional needs, resists intimate behaviors of their spouses, and manifests itself in avoidant communication and other negative behaviors, a series of manifestations that all adversely affect intimate relationships, which further play a role in the stroke patients' and their spouses[ 37 ]. A study of newly diagnosed gynecologic cancer patients and their spouses demonstrated the effectiveness and importance of a couple-centred "self-expression" intervention in enhancing couple affect, developing family resilience, and promoting posttraumatic growth. Therefore, future research should capitalise on the critical role of couple intimate relationships in enhancing post-traumatic growth, and caregivers should change the traditional view that when assessing a patient's psychological status, it is important to consider the patient and the spouse as a whole, rather than just an individual-oriented focus—adopting a dichotomous approach that focuses on the interactions and interactions between the couple, clarifying the differences in communication experiences between the patient and their spouse, and developing individualised interventions at the dichotomous level to create a supportive family communication environment to improve the quality of the couple to promote the level of post-traumatic growth of both the patient and their spouse. The results of this study showed that there was an object-mediated effect of the stroke patient-spouse intimate relationship between negative dyadic coping of spouses and post-traumatic growth of patients, and the stroke patient-spouse intimate relationship between negative dyadic coping of spouses and post-traumatic growth of patients. According to STM, negative coping between spouses is an interactive process. Negative dyadic coping such as hostile coping (distancing, ridiculing, or minimising the severity of partner's stress), ambivalent coping (one partner reluctantly supports the other), and superficial coping (asking about the partner's feelings without listening or providing support that lacks empathy) not only exacerbate the effects of stress on the other partner's negative emotions, but also decrease the partner's ratings of satisfaction with the intimate relationship relationship and act as a mediator variable in affecting the partners' s psychological condition. It has been found that a good intimate relationship between couples can reduce the burden of caregiving on the spouse, promote the patient's disease regression and prognosis, enhance personal strength, and improve the quality of life for both the patient and the spouse[ 38 ]. It follows that caregivers should be aware of the importance of maintaining the couple's relationship during times of stress, identifying potential negative behaviours early and improving the ability of stroke patients and their spouses to recognise negative dyadic coping. For couples with poor dyadic coping skills and average marital quality, there is a need to promote positive marital relationships and consider how the couple relationship can become a supportive system in its own right, promoting intrafamilial cohesion and resilience, improving communication patterns and promoting mutual support. Limitations This study also has certain limitations. First of all, this study used a convenience sampling method; all study participants were from only one hospital, and the sample was not representative, which limited the generalizability of the study's results to some extent. Secondly, this study is a cross-sectional investigation, and the causal relationship between the variables cannot be inferred. Finally, based on the literature review, this study only investigated the two variables of binary coping and intimacy. It explored the mechanism of their influence on stroke patients and their spouses, and did not include other relevant psychosocial factors in the analysis. Therefore, in the future, a large-sample, multicenter longitudinal survey should be used to validate the results of this study, include more relevant positive psychosocial variables, and explore the relationship and mechanism between these variables and post-traumatic growth. Conclusions The dyadic coping of stroke patients and their spouses can have participant and partner effects on post-traumatic growth through the mediation of intimate relationships, which provides empirical support for improving PTG in patients and spouses at the dyadic level. This finding suggests that future research should focus on the level of binary coping between stroke patients and their spouses, fully consider and solve the problems of both parties in the process of disease treatment, improve intimacy, reduce the burden of binary psychology, and improve PTG levels. Abbreviations Name Abbreviations Post-traumatic stress disorder PTSD Post-traumatic Growth PTG Dyadic coping DC Systemic Transactional Model STM Actor-Partner Interdependence Mediation Model APIMeM Declarations Ethics approval and consent to participate: This study was approved by the Ethics Committee of China Medical University [(2023)122] and conducted by the principles of the Declaration of Helsinki. Informed consent: This study has obtained informed consent from all participants. Consent for publication: Not Applicable” in this section. Availability of data and materials: The datasets generated and/or analyzed during the current study are publicly available. Competing Interests: No, I declare that the authors have no competing interests as defined by BMC, or other interests that might be perceived to influence the results and/or discussion reported in this paper. Funding: No, this research did not receive funding. Authors' contributions: YHM (first author) participated in study design, data collection and analysis, and manuscript writing. ZWW participated in data collection and data analysis. HJS participated in reviewing the research design manuscript. JXY participated in data analysis. YJH (corresponding author) participated in study design, data analysis, manuscript editing, and review. 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16:32:58","extension":"html","order_by":14,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":162180,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7822549/v1/b1a4d86a71d534562101e54b.html"},{"id":98423853,"identity":"bd7378c2-a826-496c-af90-ba7adce0d14b","added_by":"auto","created_at":"2025-12-17 16:32:42","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":85095,"visible":true,"origin":"","legend":"\u003cp\u003eHypothesized model pathways for dyadic coping, intimacy, and posttraumatic growth（PTG） in stroke patients and their spouses.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7822549/v1/7ed67d8045f55ffbd4989766.png"},{"id":97990360,"identity":"4644c63f-0ff5-4fd5-bd55-f424a159c625","added_by":"auto","created_at":"2025-12-11 14:28:37","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":101679,"visible":true,"origin":"","legend":"\u003cp\u003eActor-object mediating effects of patient and spousal intimate relationships between positive dyadic coping and post-traumatic growth\u003c/p\u003e\n\u003cp\u003eNote: solid lines represent significant paths, dashed lines represent non-significant paths; e: error terms; ***p\u0026lt; 0.001\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7822549/v1/5c25f46db0d36268e9c40863.png"},{"id":97990364,"identity":"55283440-8d90-441e-ba04-11b0dba0ca3c","added_by":"auto","created_at":"2025-12-11 14:28:37","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":109942,"visible":true,"origin":"","legend":"\u003cp\u003eActor-object mediating effects of patient and spousal intimate relationships between negative dyadic coping and post-traumatic growth\u003c/p\u003e\n\u003cp\u003eNote: solid lines represent significant paths, dashed lines represent non-significant paths; e: error terms; ***p\u0026lt; 0.001\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7822549/v1/ec4afaf7690c5ee445602ac2.png"},{"id":106343888,"identity":"ef8f2b7f-ba96-4a73-b45a-27fd1db4a458","added_by":"auto","created_at":"2026-04-07 16:10:26","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1930460,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7822549/v1/c16cec70-4ce6-4c18-9094-218c6037dec0.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"An Actor-Partner Interdependence Mediation Model for Assessing the Association Between Dyadic Coping and Post-traumatic Growth in Dyads of Patients With Stroke and Their Spouses: Cross-Sectional Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eStroke, also known as cerebrovascular accident, is an acute focal injury to the central nervous system that occurs locally due to cerebrovascular disease, which is divided into two categories: hemorrhagic and ischemic[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Stroke is common in people over 40 years of age and is characterised by high incidence, disability, and mortality. It has become one of the prominent problems affecting public health worldwide [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. 2019 Global Burden of Disease data [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] shows that the age-standardised incidence, prevalence, and mortality rates of stroke are 276.7/100,000 person-years, 2022.0/100,000 person-years, and 153.9/100,000 person-years, respectively. Studies have found that risk factors for cerebrovascular disease include pre-existing conditions (hypertension, diabetes, dyslipidemia, and atrial fibrillation, etc.) and behavioural risk factors (smoking and alcohol consumption, etc.)[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. In recent years, the number of strokes will continue to increase in the future, and the clinical burden will increase due to the accelerated industrialisation and ageing of the population, the increased prevalence of underlying chronic diseases, and poorly managed health behaviours. By now, stroke has become a focus of public health attention.\u003c/p\u003e\u003cp\u003eStroke-induced somatic dysfunctions such as hemiparesis, aphasia, sensory deficits, diplopia, and decreased libido not only impede the patient's return to the family and society, but also greatly affect the intimate relationship between couples. Stroke, as a traumatic event, is unpredictable, uncontrollable, and life-threatening. A review of the literature shows that 17.5% of stroke patients experience post-traumatic stress disorder (PTSD)[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], which is mainly characterised by extreme avoidance of situations related to the traumatic experience, selective amnesia, hypervigilance, increased agitation, and anxiety, which not only brings great psychological pain, but also seriously impairs their physical and mental health and quality of life. In addition, studies have shown that stroke caregivers experience intense post-traumatic stress[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], which can impede the patient's recovery process by interfering with their ability to care. The level of health between the patient and the spouse is interdependent, i.e., the couple is one in the disease, and the mental health and resilience of the spouse predict clinical events in stroke patients[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Therefore, focusing on the mental health status of stroke spouses is essential for the physical and psychological recovery of patients.\u003c/p\u003e\u003cp\u003eWith the rise of positive psychology, researchers have found that couples, after experiencing traumatic events, can overcome negative illness experiences and transform them into positive psychological inertia, and redefine their life plans based on affirmation of the value of life, i.e., Post-traumatic Growth (PTG)[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Post-traumatic growth is a dynamic, multi-dimensional phenomenon that is both a process and outcome. Many factors influence posttraumatic growth, including sociodemographic characteristics, type of illness, psychological condition, social support, and coping styles[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Of these, coping styles have the most substantial effect on the psychological regulation of stress. Proactive coping styles can alleviate stress and regulate individuals' positive state of mind in the face of stressful events, thus improving post-traumatic growth[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Related studies have shown that the posttraumatic growth of patients and their spouses can interact with each other, but the mechanism of how they interact remains unclear [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Therefore, finding the mechanism of posttraumatic growth interaction between stroke patients and their spouses to provide the best evidence support for healthcare professionals to develop interventions to promote the mental health of couples is an urgent issue.\u003c/p\u003e\u003cp\u003eIn recent years, research on coping has shifted from an individual perspective to a binary perspective, known as dichotomous coping. Dyadic coping (DC) is the shared response and decision-making of partners in an intimate relationship in the face of binary stress[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Systemic Transactional Model(STM) divides dyadic coping into positive dichotomy coping (including stress communication, mutual support, coping together, and agency coping) and negative dichotomy, and emphasises that couples can adjust their binary stress through positive dyadic coping to improve physical and mental health while enhancing intimacy [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Studies have shown that dyadic coping is an essential predictor of post-traumatic growth, with positive dyadic coping associated with higher levels of PTG. In comparison, negative dyadic coping is associated with lower levels of PTG. Therefore, enhancing the dualistic coping ability of couples may be one of the effective ways to improve the post-traumatic growth level of stroke patients and their spouses [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In addition, couples can restore a state of balance in their intimate relationships by enhancing cohesion and well-being through positive binary coping [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAs a resource and strategy, intimacy is another significant predictor of post-traumatic growth, meeting the need for love and companionship in marriage and supporting each other through painful disease processes [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Intimacy refers to the interdependence that arises between the partners in dealing with stressful events together. The cancer adaptive intimacy model proposed by Manne et al. suggests that couples' communication affects couples' psychological adjustment through intimacy, and emphasises the decisive significance of marital intimacy in the psychological adjustment process [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. According to reports, marital intimacy increases after patients and their spouses experience traumatic events and overcome difficulties in disease treatment[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Avila found in their study of cancer patients that the more intimate interactions between spouses, the better they could meet each other's physical and emotional needs. The emotional security that resulted not only helped the couple continue their lives, but also allowed them to grow in ways they had never experienced before[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Mavandadi conducted a study on couples of Parkinson's disease patients and found that higher relationship quality was associated with fewer psychological disturbances and higher levels of PTG [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Therefore, enhancing the intimacy between spouses may be one of the effective ways to improve the PTG levels of stroke patients and their spouses.\u003c/p\u003e\u003cp\u003eCoping styles can strengthen relationship functioning. Research has confirmed that dual coping is a predictor of intimate relationships, and positive dual coping is of great significance for improving satisfaction in intimate relationships. In contrast, negative dual coping is negatively correlated with satisfaction in intimate relationships[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In addition, among stroke patients and their spouses, intimacy can predict the level of PTG for both parties[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. A survey of breast cancer patients conducted by Shi et al. showed that intimate relationships play a partial mediating role in dual coping and PTG. Positive dual coping positively correlates with intimate relationships, while intimate relationships are negatively correlated with PTG[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. However, there have been no reports on the relationship between dual coping, intimate relationships, and post-traumatic growth in stroke patients and their spouses. Therefore, this study aims to explore the relationship between the three.\u003c/p\u003e\u003cp\u003eIn summary, this study is based on the system interaction model. It constructs the Actor-Partner Interdependence Mediation Model (APIMeM) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] to explore whether intimate relationships mediate in the dual coping and post-traumatic growth of stroke patients and their spouses. As an analytical method for binary data, APIMeM can simultaneously test the interrelationship between binary variables, analysing how an individual's independent variables influence both their dependent variables and the dependent variables of their partner. This includes three effects: the actor effect (the influence of an individual's independent variables on their dependent variables), the partner effect (the impact of a partner's independent variables on an individual's dependent variables), and the mediation effect (the mechanism by which an independent variable influences a dependent variable through a mediating variable). The following hypotheses are proposed:\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 1\u003c/strong\u003e\u003cp\u003e(H1): Positive dyadic coping has a positive subject-object effect on intimate relationships; negative dyadic coping has an adverse subject-object effect on intimate relationships.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 2\u003c/strong\u003e\u003cp\u003e(H2): Positive dyadic coping and post-traumatic growth have positive subject and object effects; negative dyadic coping and post-traumatic growth have negative subject and object effects.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 3\u003c/strong\u003e\u003cp\u003e(H3): There is a subject effect and an object effect between intimate relationships and post-traumatic growth.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 4\u003c/strong\u003e\u003cp\u003e(H4): Intimate relationships have a subject-object mediating effect between positive dichotomous coping and post-traumatic growth, as well as between negative dichotomous coping and post-traumatic growth. For details, see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eParticipants\u003c/h2\u003e\u003cp\u003eThis study employed a cross-sectional study design using convenience sampling. The study population consisted of stroke patients and their spouses admitted to the rehabilitation departments of two tertiary-level hospitals in Liaoning Province, China, from October 2023 to May 2024. The inclusion criteria for patients were as follows: (1) diagnosed according to the Chinese Stroke Association guidelines for the clinical management of cerebrovascular disorders [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] and confirmed by cranial CT or MRI; (2) married and living with their spouse; (3) stable vital signs, conscious, and capable of reading and writing after rehabilitation treatment; (4) spouse was the primary caregiver during the illness; (5) aware of the condition and voluntarily participated in the study. Patient exclusion criteria were as follows: (1) Concurrent significant organ dysfunction or other severe chronic diseases; (2) History of mental illness; (3) Recent exposure to other significant traumatic events (e.g., car accidents, loss of a loved one). Spouse inclusion criteria are as follows: (1) Married and living with the spouse; (2) Assumes primary caregiving responsibilities, with caregiving time\u0026thinsp;\u0026ge;\u0026thinsp;4 hours per day; (3) Aware of the patient's condition and has regular communication and understanding abilities, capable of participating in basic medical decisions and caregiving; (4) Aware of the condition and voluntarily participates in the study. Exclusion criteria for spouses are as follows: (1) Those with other major illnesses, such as malignant tumours or severe heart failure; (2) History of mental illness; (3) Recent exposure to other significant traumatic events (e.g., car accidents, loss of a family member, etc.). Finally, 215 pairs of questionnaires were received, so the effective recovery rate was 97.73%\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eThis study employed a questionnaire survey method to collect data. Before completing the questionnaire, participants were fully informed of the study's purpose, significance, voluntary nature, and confidentiality, thereby gaining patients' and their spouses' trust and cooperation. Uniform instructions were provided to explain the questionnaire's requirements, guiding patients and their spouses to complete it independently. If patients or their spouses could not complete the questionnaire due to visual impairments or educational limitations, researchers or family members could assist by asking questions. After completion, the survey was collected on-site and checked for completeness. Any omissions were addressed immediately to ensure the validity of the study.\u003c/p\u003e\n\u003ch3\u003eMeasures\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003eDemographic and Clinical Characteristics\u003c/h2\u003e\u003cp\u003eResearchers designed a general information survey form based on the literature review and expert guidance. It included demographic information such as age, gender, educational attainment, careers, length of marriage, living conditions, and average monthly income; and disease-related information such as type of disease, total duration of illness, number of recurrences, and residual functional impairment.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eThe Dyadic Coping Inventory(DCI)\u003c/h3\u003e\n\u003cp\u003eThe Dyadic Coping Inventory (DCI) was developed by Bodenmann et al. in 2008\u003csup\u003e[25]\u003c/sup\u003e. The Chinese version was translated by Chinese scholars Xu et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] and is used to evaluate the quality of dual coping in intimate partners. DCI comprises six dimensions: stress communication, supportive coping, empowering coping, collaborative coping, negative coping, and coping quality evaluation, with 37 items. The first four dimensions represent positive dichotomous coping, the negative coping dimension represents negative dichotomous coping, and coping quality evaluation is not included in the total score. The scale uses a 5-point Likert scale, with scores ranging from \u0026ldquo;very rarely\u0026rdquo; to \u0026ldquo;very frequently,\u0026rdquo; corresponding to 1 to 5 points, respectively. The total score ranges from 35 to 175 points. A score below 111 indicates a low level of dual coping, 111\u0026ndash;145 indicates an average level, and above 145 indicates a high level. The Cronbach\u0026rsquo;s α coefficient for the scale ranges from 0.74 to 0.93, with individual dimension coefficients ranging from 0.51 to 0.80.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eShort Marital Adjustment and Prediction Test(MAT)\u003c/h2\u003e\u003cp\u003eThe Locke-Wallace Marriage Adjustment Test (MAT) was initially developed by Locke and Wallace (1959)[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] and translated into Chinese by Chinese scholar Wang Zhiming (1999) [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] to assess the quality of intimate relationships between patients and their spouses. The scale consists of four dimensions: marital consistency, marital satisfaction, emotional expression, and marital cohesion, with 15 items. Each item is assigned a score corresponding to the response, and the questionnaire score is the sum of the scores for all items. The total score ranges from 2 to 158 points, with 2\u0026ndash;90 points indicating dissatisfaction, 91\u0026ndash;110 points indicating moderate satisfaction, 111\u0026ndash;130 points indicating satisfaction, and 131\u0026ndash;158 points indicating high satisfaction. The Cronbach\u0026rsquo;s α coefficient for this scale is 0.90.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003ePost-traumatic Growth Inventory(PTGI)\u003c/h3\u003e\n\u003cp\u003ePTGI, translated into Mandarin Chinese by Professor Wang et al. [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], is used to assess the level of post-traumatic growth in trauma survivors. The scale comprises five dimensions: life insights, new possibilities, personal strength, relationships with others, and self-transformation, with 20 items. It employs a 6-point Likert scale, ranging from \u0026ldquo;I have not experienced any such changes at all since this incident\u0026rdquo; to \u0026ldquo;I have experienced a great deal of such changes,\u0026rdquo; scored from 0 to 5, respectively. The total score ranges from 0 to 100, with higher scores indicating greater post-traumatic growth. A score below 60 indicates a low level of post-traumatic growth, a score of 60 or above but below 66 indicates a moderate level of post-traumatic growth, and a score of 66 or above indicates a high level of post-traumatic growth. The Cronbach\u0026rsquo;s α coefficient for the scale is 0.874, with Cronbach\u0026rsquo;s α coefficients for each dimension ranging from 0.611 to 0.796.\u003c/p\u003e\n\u003ch3\u003eStatistical Analyses\u003c/h3\u003e\n\u003cp\u003eData were organised and analysed using SPSS 25.0 and Amos 24.0 software. A P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicates statistically significant differences. Descriptive statistics: Descriptive statistical analysis was conducted on the general demographic characteristics, dyadic responses, intimate relationships, and post-traumatic growth of stroke patients and their spouses. The data in this study followed a normal distribution, so the mean and standard deviation were used for description. Univariate analysis/t-test: After grouping each variable in the general data according to different criteria, the scores for binary coping, intimate relationships, and post-traumatic growth were calculated separately for stroke patients and their spouses. Univariate analysis of variance or independent samples t-test was used to compare the differences in binary coping, intimate relationships, and post-traumatic growth scores between stroke patients and their spouses. For groups with statistically significant differences in the one-way ANOVA, LSD tests were conducted for further pairwise comparisons, and paired t-tests were used to compare whether there were substantial differences in the variable scores between stroke patients and their spouses. Correlation analysis: Correlation analysis was conducted between dyadic coping, intimate relationships, and post-traumatic growth. Pearson correlation analysis was used in this study. Construction of the subject-object interdependence mediation model: The subject-object interdependence mediation model for stroke patients and their spouses was constructed using Amos 24.0 software. Data fitting and correction were performed using the maximum likelihood method, (with model fit indices: X\u0026sup2;/DF\u0026thinsp;\u0026lt;\u0026thinsp;5; Inflated Fit Index (IFI)\u0026thinsp;\u0026gt;\u0026thinsp;0.90, Tucker-Lewis Index (TLI)\u0026thinsp;\u0026gt;\u0026thinsp;0.90, Comparative Fit Index (CFI)\u0026thinsp;\u0026gt;\u0026thinsp;0.90, Root Mean Square Error of Approximation (RMSEA)\u0026thinsp;\u0026lt;\u0026thinsp;0.08 as standards;). The mediating effect was tested using the Bootstrap method, with 5,000 repeated samples. The existence of the mediating effect was determined based on whether the regression coefficients were significant and whether the Bootstrap 95% confidence interval (CI) included 0.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eEthical Considerations\u003c/h2\u003e\u003cp\u003e This study was approved by the Ethics Committee of China Medical University [(2023)122] and conducted by the principles of the Declaration of Helsinki. Before conducting the survey, participants were fully informed of the purpose, significance, content, and duration of the study, ensuring that patients and their families had the freedom to choose whether to participate or withdraw, and that their interests would not be compromised. Participants voluntarily agreed to participate in the study and signed informed consent forms. The survey questionnaire did not include questions regarding patients' names or home addresses. All questions related to patients' and their spouses' privacy and personal safety were handled by confidentiality principles, and all data regarding study participants were restricted to internal personnel involved.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eGeneral information on stroke patients and their spouses\u003c/h2\u003e\u003cp\u003eThe age of the stroke patients in this study: 15 cases (7.0%) were 30\u0026ndash;39 years old, 39 cases (18.1%) were 40\u0026ndash;49 years old, 45 cases (20.9%) were 50\u0026ndash;59 years old, and 116 cases (54.0%) were \u0026ge;\u0026thinsp;60 years old; the age of their spouses was 13 cases (6.0%) were 30\u0026ndash;39 years old, 37 cases (17.2%) were 40\u0026ndash;49 years old, 50 cases (23.3%) were 50\u0026ndash;59 years old ( 23.3%), 115 cases (53.5%) aged\u0026thinsp;\u0026ge;\u0026thinsp;60 years; the patients had 175 ischemic strokes (81.4%) and 40 hemorrhagic strokes (18.6%). For details, see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eGeneral information on stroke patients and spouses\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariant\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClusters\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePatients (n\u0026thinsp;=\u0026thinsp;215)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSpouses (n\u0026thinsp;=\u0026thinsp;215)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (n)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eFrequency (n)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30\u0026thinsp;~\u0026thinsp;39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e40\u0026thinsp;~\u0026thinsp;49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50\u0026thinsp;~\u0026thinsp;59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e23.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e116\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e115\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e53.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e170\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e79.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e170\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e79.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducational attainment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePrimary and below\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eJunior high school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e32.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh school or junior college\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e26.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e29.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBachelor's degree or college\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e24.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGraduate students and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCareers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIncumbency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e29.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOut of work\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetirement/pension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e106\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e49.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e103\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e47.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e(sth. or sb) else\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLength of marriage (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11\u0026thinsp;~\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u0026thinsp;~\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e127\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiving conditions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCities and towns\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e173\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e80.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCountryside\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAverage monthly income (yuan)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;1000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1000\u0026thinsp;~\u0026thinsp;3000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3000\u0026thinsp;~\u0026thinsp;5000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e48.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;5000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eType of disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIschemic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e175\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e81.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHemorrhagic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal duration of illness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;1 month\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026thinsp;~\u0026thinsp;3 months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 months 01 day\u0026thinsp;~\u0026thinsp;6 months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6 months 01 days\u0026thinsp;~\u0026thinsp;1 year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;1 year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNumber of recurrences\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFashion collection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e204\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e94.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;2 times\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResidual functional impairment (number)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e44.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e48.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cp\u003eNote: \u0026quot;-\u0026quot; means that the spouse has the same or no information as the patient\u003c/p\u003e\n\u003cp\u003eC: Jianhui You\u003c/p\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eThe Scores and Differences in the Study Variables in the Dyadic Group\u003c/h2\u003e\u003cp\u003eThe DC score of patients with stroke was 112.91\u0026thinsp;\u0026plusmn;\u0026thinsp;7.82, which was lower than that of their spouses(112.98\u0026thinsp;\u0026plusmn;\u0026thinsp;7.31). The MAT score of patients with stroke was 110.12\u0026thinsp;\u0026plusmn;\u0026thinsp;9.95, which was higher than that of their spouses(107.57\u0026thinsp;\u0026plusmn;\u0026thinsp;8.13), with a statistically significant difference between them(P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The PTG score of patients with stroke was 55.33\u0026thinsp;\u0026plusmn;\u0026thinsp;7.14, which was lower than that of their spouses(55.62\u0026thinsp;\u0026plusmn;\u0026thinsp;5.73). For details, see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cimg 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\" width=\"609\" height=\"430\"\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eCorrelations of dimensions of dichotomous coping, intimate relationship, and posttraumatic growth in stroke patients and spouses\u003c/b\u003e\u003c/p\u003e\u003cp\u003ePearson correlation analysis was performed on five dimensions of stroke patients and spouses: total dichotic coping score, positive dicary coping, negative dicary coping, intimate relationship score, and post-traumatic growth, and the results showed that all other variables were positively correlated with each variable, except for the negative correlations between patients and spouses. The results of the correlation analyses are detailed in Table\u0026nbsp;3.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e\u003ccolgroup cols=\"12\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"11\" nameend=\"c12\" namest=\"c2\"\u003e\u003cp\u003eTable\u0026nbsp;3: Correlations of dimensions of dyadic coping, intimate relationship, and posttraumatic growth in stroke patients and their spouses\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSpouses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003ePatients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.833\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.277\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.136\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.394\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.459\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.357\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.322\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.325\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.383\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.580*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.499\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.218\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.509\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.510\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.389\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.501\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.52\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.504\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.511\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.316\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.245\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-0.415\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.481\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e-0.323\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e-0.407\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e-0.379\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e-0.439\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.434\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.714\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.356\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.707\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.578\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.601\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.587\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.631\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.629\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.414\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.521\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.263\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.589\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.583\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.424\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.56\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.539\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.608\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.429\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.701\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.295\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.69\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.579\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.647\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.597\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.673\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.685\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.413\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.307\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.252\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.425\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.457\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.251\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.507\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.382\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.425\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.469\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.219\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.185\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.347\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.393\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.225\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.434\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.310\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.371\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.396\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.666\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.296\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.601\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.457\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.584\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.575\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.617\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.562\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"12\"\u003eNote: \u003cem\u003e*P\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"12\"\u003e\u003csup\u003e1\u003c/sup\u003e Dyadic coping \u003csup\u003e2\u003c/sup\u003e Positive dyadic coping \u003csup\u003e3\u003c/sup\u003e Negative dyadic coping \u003csup\u003e4\u003c/sup\u003e Intimate relationships \u003csup\u003e5\u003c/sup\u003e Relationship with others\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"12\"\u003e\u003csup\u003e6\u003c/sup\u003e Newly available capability \u003csup\u003e7\u003c/sup\u003e Personal strength \u003csup\u003e8\u003c/sup\u003e Self-transformation \u003csup\u003e9\u003c/sup\u003e Life lessons\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"12\"\u003eC: Jianhui You\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eAnalysis of Actor-Object Interdependent Mediating Effects of Intimate Relationship on Dyadic Coping and Post-Traumatic Growth in Stroke Patients and Spouses\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eAnalysis of Actor-Object Interdependent Mediating Effects of Intimate Relationships between Positive Dyadic Coping and Post-Traumatic Growth in Stroke Patients and Their Spouses\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn this study, Amos 24.0 software was used to construct an actor-object interdependent mediation model to explore the relationship between positive dyadic coping, intimate relationships, and post-traumatic growth in stroke patients and their spouses, as well as to fit and correct the data using the maximum likelihood ratio method[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], and to test whether intimate relationships is a dyadic mediator between dyadic coping and posttraumatic growth by the bias-corrected percentile Bootstrape method\u0026mdash;presence of a dyadic mediating effect. The model consisted of three pairs of variables and two pairs of error terms: two predictor variables (positive dichotomous coping of the patient and spouse), two outcome variables (posttraumatic growth of the patient and spouse), and two potential mediator variables (intimate relationship of the patient and spouse).\u003c/p\u003e\u003cp\u003eThe results showed that the model fit index \u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003cem\u003e/df\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.576, \u003cem\u003eIFI\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.934, \u003cem\u003eTLI\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.908, \u003cem\u003eCFI\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.933, and \u003cem\u003eRMSEA\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.08, indicating that the model fit well. The positive dyadic coping of patients and their spouses had a positive predictive effect on their intimate relationship (β\u0026thinsp;=\u0026thinsp;0.356, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001 and β\u0026thinsp;=\u0026thinsp;0.723, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), i.e., it verified the existence of the subject effect between positive dyadic coping and intimate relationship in Hypothesis \u003cspan refid=\"FPar1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The predictive effects of patients' positive dyadic coping on their spouses' intimate relationship and spouses' positive dyadic coping on patients' intimate relationship were also both The object effect between positive dyadic coping and intimate relationships in Hypothesis \u003cspan refid=\"FPar1\" class=\"InternalRef\"\u003e1\u003c/span\u003e was found to be significant (β\u0026thinsp;=\u0026thinsp;0.101, P\u0026thinsp;=\u0026thinsp;0.028 and β\u0026thinsp;=\u0026thinsp;0.536, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001, respectively). The positive dyadic coping of patients and their spouses positively predicted their post-traumatic growth (β\u0026thinsp;=\u0026thinsp;0.060, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001 and β\u0026thinsp;=\u0026thinsp;0.159, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001, respectively), which confirmed the pos\u003cem\u003eit\u003c/em\u003eive dyadic coping effect in Hypothesis \u003cspan refid=\"FPar2\" class=\"InternalRef\"\u003e2\u003c/span\u003e (β\u0026thinsp;=\u0026thinsp;0.\u003cem\u003e06\u003c/em\u003e0, P 0.001 and β\u0026thinsp;=\u0026thinsp;0.159, P 0.001, respectively). The subject effect between positive dyadic coping and posttraumatic growth in Hypothesis \u003cspan refid=\"FPar2\" class=\"InternalRef\"\u003e2\u003c/span\u003e exists. The predictive effects of patients' positive dyadic coping on their spouses' posttraumatic growth and spouses' positive dyadic coping on patients' posttraumatic growth are also significant (β\u0026thinsp;=\u0026thinsp;0.159, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001 and β\u0026thinsp;=\u0026thinsp;0.037, P\u0026thinsp;=\u0026thinsp;0.045), i.e., the object effect between positive dyadic coping and posttraumatic growth in Hypothesis \u003cspan refid=\"FPar2\" class=\"InternalRef\"\u003e2\u003c/span\u003e is validated. Existed; the intimate relationship between patients and their spouses had a positive predictive effect on their posttraumatic growth (β\u0026thinsp;=\u0026thinsp;0.578, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001 and β\u0026thinsp;=\u0026thinsp;0.436, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), i.e., the subject effect between intimate relationship and posttraumatic growth in Hypothesis \u003cspan refid=\"FPar3\" class=\"InternalRef\"\u003e3\u003c/span\u003e was validated. The object effect of spousal intimate relationship on the patients' posttraumatic growth was validated (β\u0026thinsp;=\u0026thinsp;0.016, P\u0026thinsp;=\u0026thinsp;0.003), i.e., the object effect between spousal intimate relationship and patient posttraumatic growth in Hypothesis \u003cspan refid=\"FPar3\" class=\"InternalRef\"\u003e3\u003c/span\u003e was verified, but the object effect of patient intimate relationship on spousal posttraumatic growth was not established. See Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e for details.\u003c/p\u003e\u003cp\u003eBootstrap test results showed that intimate relationship mediated the relationship between both stroke patients and their spouses' positive dyadic coping on their posttraumatic growth (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.225, \u003cem\u003e95% CI\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.150 to 0.311 and \u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.296, \u003cem\u003e95% CI\u003c/em\u003e 0.222 to 0.374). It also mediated the relationship between the stroke patients' spouses' positive dyadic use of their spouses' positive dyadic coping on the patients' posttraumatic growth (\u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.428, \u003cem\u003e95% CI\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.327\u0026thinsp;~\u0026thinsp;0.545). See Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e4\u003c/span\u003e for details.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eEffects of Intimate Relationship on Subject-Object Interdependent Mediation Models between Positive Dyadic Coping and Posttraumatic Growth\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eEffect (scientific phenomenon)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e\u003cem\u003e95% CI\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eActor effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003ePatients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eTotal effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.448\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.551\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eDirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.223\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.126\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.333\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.225\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.150\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.311\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Patient Positive Dyadic Coping\u0026rarr; Patient Intimate relationship\u0026rarr; Patient Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Patient Positive Dyadic Coping\u0026rarr; Spousal Intimate relationship\u0026rarr; Patient Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eSpouses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eTotal effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.862\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.768\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.893\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eDirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.545\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.447\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.637\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eIndirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.296\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.222\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.374\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Positive Dyadic Coping for Spouses\u0026rarr; Spousal Intimate relationship\u0026rarr; Spousal Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Positive Dyadic Coping for Spouses\u0026rarr; Patient Intimate relationship\u0026rarr; Spouse Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eObject effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003ePatients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eTotal effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.555\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.672\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eDirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.127\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.009\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.272\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.035\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eIndirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.428\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.327\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.545\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Positive Dyadic Coping for Spouses\u0026rarr; Spousal Intimate relationship\u0026rarr; Patient Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Positive Dyadic Coping for Spouses\u0026rarr; Patient Intimate relationship\u0026rarr; Patient Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003ePatients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eTotal effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.153\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.236\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.021\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eDirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.123\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.044\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.203\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eIndirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.030\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.017\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.085\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.431\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Patient Positive Dyadic Coping\u0026rarr; Patient Intimate relationship\u0026rarr; Spouse Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Patient Positive Dyadic Coping\u0026rarr; Spouse Intimate relationship\u0026rarr; Spouse Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eAnalysis of subject-object interdependent mediating effects of intimate relationship between negative dyadic coping and posttraumatic growth in stroke patients and their spouses\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn this study, Amos 24.0 software was used to construct a subject-object interdependent mediation model to explore the dichotomous relationship between negative dyadic coping, intimate relationship, and posttraumatic growth in stroke patients and their spouses, as well as to fit and correct the data using the maximum likelihood ratio method, and to test whether intimate relationship is a dyadic mediator between dyadic coping and posttraumatic growth by the bias-corrected percentile Bootstrape method\u0026mdash;presence of a dyadic mediating effect. The model consisted of three pairs of variables and two pairs of error terms: two predictor variables (patient-spouse negative dyadic coping), two outcome variables (patient-spouse posttraumatic growth), and two potential mediator variables (patient-spouse intimate relationship).\u003c/p\u003e\u003cp\u003eThe results showed that the model fit index \u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003cem\u003e/df\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.410, \u003cem\u003eIFI\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.932, \u003cem\u003eTLI\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.901, \u003cem\u003eCFI\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.932, and \u003cem\u003eRMSEA\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.08, indicating that the model fit well. The negative dyadic coping of patients and their spouses had a negative predictive effect on their intimate relationship (\u003cem\u003eβ\u003c/em\u003e= -0.350, \u003cem\u003eP\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001 and \u003cem\u003eβ\u003c/em\u003e= -0.169, \u003cem\u003eP\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.002), i.e., it verified the existence of the subject effect between negative dyadic coping and intimate relationship in Hypothesis \u003cspan refid=\"FPar1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Moreover, the predictive effects of the negative dyadic coping of patients on their spouses' intimate relationship and the negative dyadic coping of spouses on the intimate relationship of the patients were also both significant (\u003cem\u003eβ\u003c/em\u003e = -0.374, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001 and \u003cem\u003eβ\u003c/em\u003e = -0.270, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), i.e., the object effect between negative dyadic coping and intimate relationships in Hypothesis \u003cspan refid=\"FPar1\" class=\"InternalRef\"\u003e1\u003c/span\u003e was verified; the patient's negative dyadic coping negatively predicted their own posttraumatic growth (β= -0.165, \u003cem\u003eP\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001), i.e., the subject effect between negative dyadic coping and posttraumatic growth in Hypothesis \u003cspan refid=\"FPar2\" class=\"InternalRef\"\u003e2\u003c/span\u003e was verified. The patient's negative dyadic coping negatively predicted their spouse's intimate relationships and spouse's negative dyadic coping on the patient's intimate relationships. The subject effect between negative dyadic coping and posttraumatic growth existed. The predictive effect of patients' negative dyadic coping on their spouses' posttraumatic growth was also significant (β=-0.144, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), i.e., it verified the existence of object effect between negative dyadic coping and posttraumatic growth in Hypothesis \u003cspan refid=\"FPar2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Patients' and their spouses' intimate relationship had a positive predictive effect on their posttraumatic growth (β\u0026thinsp;=\u0026thinsp;0.682, P\u0026thinsp;=\u0026thinsp;0.001 and β\u0026thinsp;=\u0026thinsp;0.724, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), i.e., the subject effect between intimate relationships and posttraumatic growth in Hypothesis \u003cspan refid=\"FPar3\" class=\"InternalRef\"\u003e3\u003c/span\u003e was established; the predictive effect of the patient's intimate relationship on their spouse's posttraumatic growth and the spouse's intimate relationship on the patient's posttraumatic growth was significant (β\u0026thinsp;=\u0026thinsp;0.151, P\u0026thinsp;=\u0026thinsp;0.001 and β\u0026thinsp;=\u0026thinsp;0.218, P\u0026thinsp;=\u0026thinsp;0.002), i.e., Hypothesis \u003cspan refid=\"FPar3\" class=\"InternalRef\"\u003e3\u003c/span\u003e was verified that there is an intimate relationship and posttraumatic growth there is an object effect between. See Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e for details.\u003c/p\u003e\u003cp\u003eBootstrap tests showed that intimate relationship mediated the relationship between both stroke patients and their spouses' negative dyadic coping on their post-traumatic growth (\u003cem\u003eβ\u003c/em\u003e= -0.319, \u003cem\u003e95% CI\u003c/em\u003e= -0.342~ -0.209 and \u003cem\u003eβ\u003c/em\u003e= -0.165, \u003cem\u003e95% CI\u003c/em\u003e= -0.261 to -0.07); and mediated the relationship between both stroke patient's spouse's negative dyadic coping on patient's post-traumatic posttraumatic growth and stroke patients' negative dyadic coping on spouses' posttraumatic growth mediated (\u003cem\u003eβ\u003c/em\u003e= -0.221, \u003cem\u003e95% CI = -0.342 to\u003c/em\u003e -0.125 and \u003cem\u003eβ\u003c/em\u003e= -0.323, \u003cem\u003e95% CI\u003c/em\u003e= -0.417 to -0.214). See Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e5\u003c/span\u003e for details.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e Effects of Intimate Relationships on Subject-Object Interdependent Mediation Models between Negative Dyadic Coping and Posttraumatic Growth\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eEffect\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e\u003cem\u003e95% CI\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eActor effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003ePatients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eTotal effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.484\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.485\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.067\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.452\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eDirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.165\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.249\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.075\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.319\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.342\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.209\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Patient Negative Dyadic Coping\u0026rarr; Patient Intimate relationship\u0026rarr; Patient Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Patient Negative Dichotomous Coping\u0026rarr; Spousal Intimate relationship\u0026rarr; Patient Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eSpouses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eTotal effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.135\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.244\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.006\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eDirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.030\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.039\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.373\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eIndirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.165\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.261\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Spousal Negative Dichotomous Coping\u0026rarr; Spousal Intimate relationship\u0026rarr; Spousal Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Spouse Negative Dyadic Coping\u0026rarr; Patient Intimate relationship\u0026rarr; Spouse Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eObject effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003ePatients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eTotal effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.231\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.339\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.119\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eDirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.095\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.057\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.655\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eIndirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.221\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.342\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Spousal Negative Dichotomous Coping\u0026rarr; Spousal Intimate relationship\u0026rarr; Patient Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Spouse Negative Dyadic Coping\u0026rarr; Patient Intimate relationship\u0026rarr; Patient Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eSpouses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eTotal effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.463\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.587\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.214\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eDirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.213\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eIndirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.323\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.417\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.214\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Patient Negative Dichotomous Coping\u0026rarr; Patient Intimate relationship\u0026rarr; Spouse Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e(Patient Negative Dichotomous Coping\u0026rarr; Spouse Intimate relationship\u0026rarr; Spouse Post-Traumatic Growth)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Dicussion","content":"\u003cp\u003e\u003cb\u003eThe Mediating Role of Intimate Relationships in Subject-Object Interdependence Between Positive Dyadic Coping and Post-Traumatic Growth in Stroke Patients and Their Spouses\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe results of this study showed a subject-mediated effect of intimate relationship between positive dyadic coping and posttraumatic growth in stroke patients and their spouses, the positive dyadic coping of stroke patients and their spouses positively predicted their posttraumatic growth through their intimate relationship, which is consistent with the findings of Suo et al[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], who noted that intimate relationship in breast cancer patients and their spouses mediated the positive dyadic coping effect on positive predictive effect on post-traumatic growth. According to STM[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]and APIMeM[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], couples' coping styles, marital relationship, and psychological adjustment interact with each other, and the higher the level of intimate relationship, the stronger its buffering role in stroke couples' stressful communication and supportive coping on positive psychological growth. Specifically, at the individual level, the use of open and constructive communication reduces the painful experience of the disease, enhances intimate relationship satisfaction over time, protectively buffers against the significant psychological blow of the sudden illness, and then adjusts the psychological state to adapt to the disease and explores the positive changes in the coping process, rethinks the value of life, and ultimately achieves post-traumatic growth. Psychotherapy is an effective strategy for exploring post-traumatic positive change. Caregivers can use mobile health technology to adopt interventions such as couples' psychoeducation and acceptance and commitment therapy to accept and acknowledge suffering in a relationship of trust and rapport, and to alleviate subjects' symptoms of anxiety and depression, thus improving the quality of the intimate relationship between the stroke patient and his/her spouse and helping them to establish higher-level goals and beliefs to achieve growth.\u003c/p\u003e\u003cp\u003eThe results of this study showed that there was an object-mediated effect of intimate relationship in stroke patients between spousal positive dyadic coping and patient's posttraumatic growth, and spousal intimate relationship between patient's positive dyadic coping and patient's posttraumatic growth, which was similar to the results of the studies conducted by Suo et al[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]., Lee et al.[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Once again, it verifies that stroke is a couple's disease, which is in line with the shared coping theory[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Stroke treatment and rehabilitation is a continuum, with both partners' health status interacting, and couples benefit from the process when individuals do their best to mobilise all resources to enhance their resilience. Positive dyadic coping is an essential resource for individuals to provide emotional support to each other, which not only contributes to their satisfaction with the marital relationship, but also their spouse's satisfaction, and thus is key to improving each other's post-traumatic growth. Studies have shown[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] that by encouraging both spouses to actively participate in the disease treatment process actively, enhancing spousal communication and exchanges, and facilitating joint confrontation, mutual understanding, and positive adjustment of the marital relationship can be achieved to improve mental health. The key to enhancing post-traumatic growth of stroke patients and their spouses is to promote positive dyadic coping to enhance the supportiveness and satisfaction of the intimate relationship. Therefore, caregivers should treat husband and wife as one, pay attention to the impact of one party's emotional changes on the other party's health status, encourage both parties to actively participate in the disease treatment process, and strengthen education to support effective communication on stroke-related issues; learn from mature psychological intervention strategies for couples in foreign countries, and combine them with China's national conditions to develop targeted dyadic training programs to help patients and spouses adapt to the new roles and responsibilities, alleviate psychological distress and reduce psychological burdens for both parties, and help patients and spouses adjust to new roles and responsibilities, and reduce psychological burdens. This will help patients and spouses adapt to their new roles and responsibilities, alleviate their psychological distress, reduce their psychological burdens, enhance their cohesion, and ensure the harmony and stability of their intimate relationships, thus promoting their post-traumatic growth.\u003c/p\u003e\u003cp\u003e\u003cb\u003eThe Mediating Role of Intimate Relationship in Subject-Object Interdependence Between Negative Coping and Posttraumatic Growth in Stroke Patients and Their Spouses\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe results of this study showed that intimate relationship has a subject-mediated effect between negative dyadic coping and posttraumatic growth in stroke patients and spouses, i.e., negative dyadic coping in stroke patients and their spouses can predict their posttraumatic growth through their own intimate relationship, i.e., intimate relationship may be an intrinsic cause influencing posttraumatic growth in stroke patients and spouses. Similar to the findings of Meier [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]and Regan[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Negative dyadic coping, which includes topic diversion, hostility, avoidance, and blame, is detrimental to the stability of family relationships and quality of life when individuals try to hide their illness-related concerns to protect their partners from anxiety, and reduces the individual's resilience to the illness and hinders their own and their spouses' growth experience[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. To analyse the reasons, post-stroke body image changes, sexual dysfunction, and medication-induced adverse reactions cause patients to produce higher levels of negative disease perception, which hides their emotional needs, resists intimate behaviors of their spouses, and manifests itself in avoidant communication and other negative behaviors, a series of manifestations that all adversely affect intimate relationships, which further play a role in the stroke patients' and their spouses[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. A study of newly diagnosed gynecologic cancer patients and their spouses demonstrated the effectiveness and importance of a couple-centred \"self-expression\" intervention in enhancing couple affect, developing family resilience, and promoting posttraumatic growth. Therefore, future research should capitalise on the critical role of couple intimate relationships in enhancing post-traumatic growth, and caregivers should change the traditional view that when assessing a patient's psychological status, it is important to consider the patient and the spouse as a whole, rather than just an individual-oriented focus\u0026mdash;adopting a dichotomous approach that focuses on the interactions and interactions between the couple, clarifying the differences in communication experiences between the patient and their spouse, and developing individualised interventions at the dichotomous level to create a supportive family communication environment to improve the quality of the couple to promote the level of post-traumatic growth of both the patient and their spouse.\u003c/p\u003e\u003cp\u003eThe results of this study showed that there was an object-mediated effect of the stroke patient-spouse intimate relationship between negative dyadic coping of spouses and post-traumatic growth of patients, and the stroke patient-spouse intimate relationship between negative dyadic coping of spouses and post-traumatic growth of patients. According to STM, negative coping between spouses is an interactive process. Negative dyadic coping such as hostile coping (distancing, ridiculing, or minimising the severity of partner's stress), ambivalent coping (one partner reluctantly supports the other), and superficial coping (asking about the partner's feelings without listening or providing support that lacks empathy) not only exacerbate the effects of stress on the other partner's negative emotions, but also decrease the partner's ratings of satisfaction with the intimate relationship relationship and act as a mediator variable in affecting the partners' s psychological condition. It has been found that a good intimate relationship between couples can reduce the burden of caregiving on the spouse, promote the patient's disease regression and prognosis, enhance personal strength, and improve the quality of life for both the patient and the spouse[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. It follows that caregivers should be aware of the importance of maintaining the couple's relationship during times of stress, identifying potential negative behaviours early and improving the ability of stroke patients and their spouses to recognise negative dyadic coping. For couples with poor dyadic coping skills and average marital quality, there is a need to promote positive marital relationships and consider how the couple relationship can become a supportive system in its own right, promoting intrafamilial cohesion and resilience, improving communication patterns and promoting mutual support.\u003c/p\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eThis study also has certain limitations. First of all, this study used a convenience sampling method; all study participants were from only one hospital, and the sample was not representative, which limited the generalizability of the study's results to some extent. Secondly, this study is a cross-sectional investigation, and the causal relationship between the variables cannot be inferred. Finally, based on the literature review, this study only investigated the two variables of binary coping and intimacy. It explored the mechanism of their influence on stroke patients and their spouses, and did not include other relevant psychosocial factors in the analysis. Therefore, in the future, a large-sample, multicenter longitudinal survey should be used to validate the results of this study, include more relevant positive psychosocial variables, and explore the relationship and mechanism between these variables and post-traumatic growth.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe dyadic coping of stroke patients and their spouses can have participant and partner effects on post-traumatic growth through the mediation of intimate relationships, which provides empirical support for improving PTG in patients and spouses at the dyadic level. This finding suggests that future research should focus on the level of binary coping between stroke patients and their spouses, fully consider and solve the problems of both parties in the process of disease treatment, improve intimacy, reduce the burden of binary psychology, and improve PTG levels.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eName\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbbreviations\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003ePost-traumatic stress disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003ePTSD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003ePost-traumatic Growth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003ePTG\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eDyadic coping\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eDC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eSystemic Transactional Model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eSTM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eActor-Partner Interdependence Mediation Model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eAPIMeM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThis study was approved by the Ethics Committee of China Medical University [(2023)122] and conducted by the principles of the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent:\u003c/strong\u003e This study has obtained informed consent from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eNot Applicable\u0026rdquo; in this section.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eThe datasets generated and/or analyzed during the current study are publicly available.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u0026nbsp;\u003c/strong\u003eNo, I declare that the authors have no competing interests as defined by BMC, or other interests that might be perceived to influence the results and/or discussion reported in this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e No, this research did not receive funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u003c/strong\u003e YHM (first author) participated in study design, data collection and analysis, and manuscript writing. ZWW participated in data collection and data analysis. HJS participated in reviewing the research design manuscript. JXY participated in data analysis. YJH (corresponding author) participated in study design, data analysis, manuscript editing, and review.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e This work was supported by the Qilu Medical University.We are grateful to Ming Wang fot his valuabl discussions and insights.We also thank Haiping Zhao for her assistance with the statistical analysis. We appreciate the constructive feedback from the anonymous reviewers which greatly improved the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eFeigin VL, et al. World Stroke Organisation: Global Stroke Fact Sheet 2025. Int J Stroke. 2025;20(2):132\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGlobal. regional, and national burden of stroke and its risk factors, 1990\u0026ndash;2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol, 2021. 20(10): pp. 795\u0026ndash;820.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMa Q, et al. Temporal trend and attributable risk factors of stroke burden in China, 1990\u0026ndash;2019: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health. 2021;6(12):e897\u0026ndash;906.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBirhanu MM, et al. Risk factors for incident cardiovascular events among adults in low- and middle-income countries: A systematic review and meta-analysis of prospective cohort studies. Prev Med. 2022;158:107036.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eJanssen EPJ, et al. Prevalence of posttraumatic stress disorder after stroke: A systematic literature review. J Psychosom Res. 2024;187:111914.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMcCurley JL, et al. Preventing Chronic Emotional Distress in Stroke Survivors and Their Informal Caregivers. Neurocrit Care. 2019;30(3):581\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLester EG, et al. Understanding the interplay between lifestyle factors and emotional distress for hemorrhagic stroke survivors and their informal caregivers: Protocol for a mixed methods dyadic natural history study. PLoS ONE. 2022;17(1):e0261635.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhang Y, et al. The relationship between dyadic coping and post-traumatic growth in breast cancer patients and spouses: based on potential profile analysis. BMC Psychiatry. 2024;24(1):860.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHuang X, et al. Trajectories of posttraumatic growth in young and middle-aged stroke patients and their predictive effects on mental health. Ann Palliat Med. 2021;10(9):9435\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTomita M, et al. Structural equation modelling of the relationship between posttraumatic growth and psychosocial factors in women with breast cancer. Psychooncology. 2017;26(8):1198\u0026ndash;204.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSuo R, et al. The effects of dyadic coping and marital satisfaction on posttraumatic growth among breast cancer couples. Support Care Cancer. 2021;29(9):5425\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBar-Kalifa E, Randall AK, Perelman Y. Daily dyadic coping during COVID-19 among Israeli couples. Emotion. 2022;22(8):1713\u0026ndash;22.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDuan X, et al. Effects of dyadic coping on post-traumatic growth in patients and couples with breast cancer: an analysis based on the actor-partner interdependence model. Support Care Cancer. 2024;33(1):62.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFalconier MK, et al. Dyadic coping and relationship satisfaction: A meta-analysis. Clin Psychol Rev. 2015;42:28\u0026ndash;46.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZemp M, et al. Couple relationship education: A randomized controlled trial of professional contact and self-directed tools. J Fam Psychol. 2017;31(3):347\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eManne S, Badr H. Intimacy and relationship processes in couples' psychosocial adaptation to cancer. Cancer. 2008;112(11 Suppl):2541\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMoore AM, et al. A prospective study of posttraumatic growth as assessed by self-report and family caregiver in the context of advanced cancer. Psychooncology. 2011;20(5):479\u0026ndash;87.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e\u0026Aacute;vila M, et al. Attachment and posttraumatic growth after breast cancer: A dyadic approach. Psychooncology. 2017;26(11):1929\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMavandadi S, et al. Benefit finding and relationship quality in Parkinson's disease: a pilot dyadic analysis of husbands and wives. J Fam Psychol. 2014;28(5):728\u0026ndash;34.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBadr H, et al. Dyadic psychosocial intervention for advanced lung cancer patients and their family caregivers: results of a randomized pilot trial. Cancer. 2015;121(1):150\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTerrill AL et al. Intimate Relationships and Stroke: Piloting a Dyadic Intervention to Improve Depression. Int J Environ Res Public Health, 2022. 19(3).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShi G, et al. Relationships between dyadic coping, intimate relationship and post-traumatic growth in patients with breast cancer: A cross-sectional study. J Adv Nurs. 2021;77(12):4733\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eJin X, et al. An Actor-Partner Interdependence Mediation Model for Assessing the Association Between Health Literacy and mHealth Use Intention in Dyads of Patients With Chronic Heart Failure and Their Caregivers: Cross-Sectional Study. JMIR Mhealth Uhealth. 2025;13:e63805.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLiu L, et al. Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of ischaemic cerebrovascular diseases. Stroke Vasc Neurol. 2020;5(2):159\u0026ndash;76.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFalconier MK, Nussbeck F, Bodenmann G. Dyadic coping in Latino couples: validity of the Spanish version of the Dyadic Coping Inventory. Anxiety Stress Coping. 2013;26(4):447\u0026ndash;66.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eXu F, et al. Validation of the Dyadic Coping Inventory with Chinese couples: Factorial structure, measurement invariance, and construct validity. Psychol Assess. 2016;28(8):e127\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLocke HJ, Wallace KM. Short marital adjustment and prediction tests: Their reliability and validity. Marriage Family Living. 1959;21(3):251\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWang XD, Wang XL, Ma H. Manual of mental health rating scale. Chin Mental Health J Press., 1999: pp. 159\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWang J, Chen Y, Wang YB, Liu XH. Revision of the post-traumatic growth inventory and testing its reliability and validity. J Nurs Sci. 2011;26(14):26\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSharif SP, Mostafiz I, Guptan V. A systematic review of structural equation modelling in nursing research. Nurse Res. 2019;26(2):28\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYuliana S, et al. Associations among disability, depression, anxiety, stress, and quality of life between stroke survivors and their family caregivers: An Actor-Partner Interdependence Model. J Adv Nurs. 2023;79(1):135\u0026ndash;48.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLee M, et al. Posttraumatic growth in breast cancer survivors and their husbands based on the actor-partner interdependence model. Psychooncology. 2017;26(10):1586\u0026ndash;92.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWeitkamp K, Bodenmann G. Couples Coping Together: A Scoping Review of the Quantitative and Qualitative Evidence and Conceptual Work Across Three Decades. Front Psychol. 2022;13:876455.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVan Schoors M, et al. Couples Dealing With Pediatric Blood Cancer: A Study on the Role of Dyadic Coping. Front Psychol. 2019;10:402.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMeier C, et al. Dyadic coping, quality of life, and psychological distress among chronic obstructive pulmonary disease patients and their partners. Int J Chron Obstruct Pulmon Dis. 2011;6:583\u0026ndash;96.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRegan TW, et al. Cross-sectional relationships between dyadic coping and anxiety, depression, and relationship satisfaction for patients with prostate cancer and their spouses. Patient Educ Couns. 2014;96(1):120\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSong YY, et al. Dyadic effects of rumination and self-disclosure on posttraumatic growth in newly diagnosed gynecological cancer couples: an actor-partner interdependence modeling approach. Support Care Cancer. 2022;30(6):5167\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eXia WU, Sijia LSZHOU, et al. Study on the impact of intimate relationship between colorectal cancer patients and family primary caregivers on quality of life based on subject-object reciprocity model. Chin Family Med. 2020;23(17):2120\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Stroke patients, Spouses, Dyadic coping, Intimate relationships, Post-traumatic growth, Actor-Partner Interdependence Model","lastPublishedDoi":"10.21203/rs.3.rs-7822549/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7822549/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eThis study aims to explore the dyadic associations between dyadic and post-traumatic growth in dyads of patients with stroke and their spouses, and the mediating role of intimate relationships in these associations.\u003c/p\u003e\u003ch2\u003eDesign\u003c/h2\u003e\u003cp\u003eA cross-sectional descriptive study was conducted from October 2023 to May 2024.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis study adopted a purpose-sampling method. A total of 215 stroke patients and their spouses from a tertiary hospital in China were selected as study subjects. The General Information Questionnaire, Dyadic Coping Inventory, Marital Adjustment and Prediction Test, and Post-traumatic Growth Inventory were used; the data were analyzed using the actor-partner interdependence mediation model.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe results showed that the dyadic coping of stroke patients and their spouses was significantly related to intimate relationships and post-traumatic growth. In addition, the dyadic coping of stroke patients and their spouses had significant actor effects and partner effects on the post-traumatic growth through intimate relationships.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThe dyadic coping of stroke patients and their spouses could produce actor and partner effects on the post-traumatic growth through the mediation of intimate relationships, which provided empirical support for improving the level of post-traumatic growth among patients and spouses at the dyadic level.\u003c/p\u003e","manuscriptTitle":"An Actor-Partner Interdependence Mediation Model for Assessing the Association Between Dyadic Coping and Post-traumatic Growth in Dyads of Patients With Stroke and Their Spouses: Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-11 14:28:32","doi":"10.21203/rs.3.rs-7822549/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-02-09T05:53:41+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-05T12:00:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"85781109639752596171972357953128491738","date":"2026-02-05T09:00:27+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-29T20:22:39+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-27T20:16:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"319058817696642744349362810920144259134","date":"2026-01-22T19:07:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"262391476693015608159351363255971891753","date":"2026-01-20T17:38:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-14T09:02:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"45195941381359750098654125270795981858","date":"2025-12-09T02:15:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"18232948763855174088821396576234756493","date":"2025-12-07T15:45:33+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-07T01:05:57+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-04T11:15:46+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-25T07:01:32+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-23T05:43:55+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2025-11-23T05:40:23+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3a8b7aac-3b07-4e98-b16d-fafb7897fd1a","owner":[],"postedDate":"December 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-04-07T16:06:50+00:00","versionOfRecord":{"articleIdentity":"rs-7822549","link":"https://doi.org/10.1186/s40359-026-04497-3","journal":{"identity":"bmc-psychology","isVorOnly":false,"title":"BMC Psychology"},"publishedOn":"2026-04-02 15:58:49","publishedOnDateReadable":"April 2nd, 2026"},"versionCreatedAt":"2025-12-11 14:28:32","video":"","vorDoi":"10.1186/s40359-026-04497-3","vorDoiUrl":"https://doi.org/10.1186/s40359-026-04497-3","workflowStages":[]},"version":"v1","identity":"rs-7822549","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7822549","identity":"rs-7822549","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}