Coping with family function changes: A qualitative study of couples facing advanced lung cancer.

Objective: This study aimed to explore the experiences of couples with advanced lung cancer in coping with changes in their family functioning. Methods: This study included patients with advanced lung disease and their spouses who were hospitalized in a tertiary hospital in Shanghai, China. Data were collected through interviews that focused on three key areas: (1) patient coping, (2) spousal coping, and (3) dyadic coping. Semi-structured qualitative interviews were conducted in Chinese and analyzed using Braun-Clarke thematic analysis. Results: A total of 15 couples participated in the study (12 male and 3 female patients). The average age of the patients was 63.73 years, and that of their partners was 63.20 years. Marriage duration ranged from 25 to 53 years. Three distinct themes emerged from the data: individual patient coping was expressed in four areas: struggle, acceptance of reality, cherishing the present and regaining hope, and rebuilding family life; spousal coping was expressed in three areas: acceptance and understanding of the patient, providing active support, and adjusting roles and sharing of family responsibilities; and dyadic coping was expressed in three areas: cognitive consistency of changes in family functioning, stress communication, and family adjustment and adaptation based on shared cognition. A relationship diagram of patients with advanced lung cancer and their spouses in coping with post-cancer changes in family functioning was constructed. Conclusions: Post-cancer coping with changes in family functioning in couples with advanced lung cancer is a continuous developmental and gradual evolutionary process, and there is a close relationship between the two that influences each other. Early assistance for couples to form consistent cognition and communicate effectively with the stress caused by the disease can help improve the family functioning of both partners and, in turn, improve the quality of life of patients. Therefore, it is recommended that clinicians conduct family- or couple-centered intervention studies aimed at improving the post-cancer quality of life of patients with advanced lung cancer.