Dyadic Coping in Colorectal Cancer Patient-Caregiver Dyads: A Scoping Review of Influencing Factors and Interventions from a Systemic-Transactional Perspective

Abstract

Colorectal cancer is the third most common cancer globally; it affects both patients and their caregivers. Dyadic coping (DC) refers to the process in which partners jointly manage stressors within their relationship. Dyadic coping represents a critical interpersonal process through which patient–caregiver dyads jointly manage cancer-related stress. However, existing evidence on its influencing factors, the shared illness and relational experiences of these dyads, and targeted interventions remains fragmented and lacks systematic theoretical integration. Based on the systemic-transactional theory, this scoping review aims to synthesize evidence on factors influencing DC, dyadic experiences, interventions, and intervention efficacy among colorectal cancer (CRC) patients and their caregivers. Following the JBI scoping review framework and PRISMA-ScR guidelines, nine databases (CNKI, Wanfang, CBM, VIP, PubMed, Web of Science, Cochrane Library, CINAHL, Embase) were systematically searched for studies published between January 1995 and April 2025. In accordance with the PICOS criteria, data from included studies were processed, with study screening, data extraction, and thematic analysis independently completed by two reviewers.

This scoping review included results from a total of 22 articles (10 quantitative, 2 qualitative, 10 intervention studies), with 18 originating from China, reflecting research priorities in high-burden regions. DC-related factors were categorized into individual, relational, and environmental levels based on the systemic-transactional model (STM), including demographic characteristics; disease stage; stoma surgery and treatment-related burden; psychological distress; communication patterns; social support; and cultural values. Four qualitative themes consistent with STM were identified: support systems and interaction (common DC), challenges (stress communication), family adaptation (positive DC), and social resource utilization (environmental context). Interventions were classified into three types: STM-based, dyadic illness management, and relationship-strengthening, all of which improved DC skills, relationship quality, and psychological well-being, with high feasibility and acceptability.

This scoping review synthesized evidence regarding DC in CRC patient-caregiver dyads, clarifying multilevel associated factors, DC experiences, and effective intervention approaches. Cultural differences underscore the necessity of culturally adapted interventions in Chinese clinical settings. Future research should develop culturally appropriate programs, investigate policy-level support, and integrate DC assessment and skills training into routine oncology practice to improve outcomes for both patients and caregivers.