Dyadic Effects of Attachment on Illness Acceptance in Patients with Breast Cancer and Spousal Caregivers: Sense of Coherence As a Mediator

Attachment styles have been found to play a significant role in adjustment to cancer. Couples often cope with breast cancer through an interdependent approach to the disease rather than just acting as individuals, and a sense of coherence is an important factor that influences these relationships. This study examined how attachment styles and sense of coherence impact illness acceptance in couples facing breast cancer within a dyadic perspective. Data were analyzed from 145 women with recently diagnosed breast cancer and their 145 partners, who attended clinic appointments related to medical treatment. They completed self-report measures of attachment, sense of coherence, and illness acceptance. Higher secure attachment and low insecure attachment scores were associated with a higher sense of coherence and better illness acceptance both in women and partners. Results of actor-partner interdependence mediation models indicated that most associations between attachment styles and illness acceptance were mediated by sense of coherence within both intrapersonal (actor-actor) and interpersonal (actor-partner) effects. The interdependence in attachment and sense of coherence brought noticeable benefits to couples' illness acceptance when facing breast cancer. In line with the salutogenic model, these relationships predominantly depended on the mediational function of comprehensibility, manageability, and meaningfulness, which determined cognitive and emotional reactions that influenced both patients' and spouses' acceptance of the disease.