Dyadic relationship experience in Chinese patients with advanced cancer and their spouses: A longitudinal qualitative study.

Objective: To explore the process of dyadic relationship experiences among patients with advanced cancer and their spouses during anti-cancer treatment in China. Methods: A longitudinal, qualitative study using semi-structured interviews with cancer patients and their spouses was conducted within the first six months following cancer diagnosis. A total of 18 cancer patient-spouse dyads were recruited, with 16 dyads completing all follow-ups between March and December 2024. All interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Results: The study collected 96 individual interviews. The thematic framework was developed based on patient-spouse dyads, generating three key themes: relationship crisis at diagnosis, relationship reconfiguration during hospitalization, and relationship adaptation in home care. These were further elaborated through eight subthemes: mutual denial at the moment of diagnosis, communication avoidance by fear of burden, and collaborative struggles in dyadic coping (relationship crisis); collapse of traditional family roles and shared vulnerability as dyadic coping (relationship reconfiguration); and intra-dyadic reciprocal support in daily care, joint help-seeking as a unified front, and post-trauma mutual growth within familism (relationship adaptation). Conclusions: The couple's relational experience evolves dynamically from diagnosis through hospitalisation to home care. These findings provide implications for health care providers to develop effective health guidance that supports a harmonious family atmosphere during transitional care. Culturally tailored, dyad-centred interventions addressing these phase-specific challenges may strengthen mutual support and improve the well-being of both patients and spouses.