Longitudinal associations between congruence in dyadic care type and health-related quality of life among multiple chronic conditions patient–caregiver dyads

Patient–caregiver (i.e. dyadic) partnerships are essential in the management of multiple chronic conditions, as they can significantly influence emotional adjustment and the overall dynamics of the relationship. This study aims to examine how congruence—defined as patients and caregivers reporting the same dyadic care type (patient-oriented, caregiver-oriented, or collaborative)—predicts mental health-related quality of life (HRQoL) and how specific congruent management approaches contribute to HRQoL in patient-caregiver dyads over 12 months.

Multicenter, observational, longitudinal study. 871 Italian patient–caregiver dyads were recruited. Each dyad comprised a patient aged 65 years or older living with multiple chronic conditions and their family caregiver. Data were collected at baseline (time 0), 6  (time 1), and 12 months (time 2). Mental HRQoL was assessed with the Short Form-12 Mental Component Summary (MCS; scores range 0–100, with higher scores indicating better outcomes). Descriptive statistics and longitudinal mixed effects models with autoregressive errors were used for data analysis.

Patient-oriented congruency was associated with better patient mental HRQoL - (B = 3.17) while caregiver-oriented congruency was associated with worse patient mental HRQoL (B = − 4.36). Becoming a collaborative-congruent dyad was associated with improved mental HRQoL (B = 1.60). There were no significant associations with caregiver mental HRQoL.

The improvement in patient mental HRQoL as a result of becoming a collaborative congruent dyad supports the importance of collaborative management approaches. Nurses can guide dyad members to reflect on their respective roles in managing multiple chronic conditions to enhance their teamwork skills for collaborative approaches.