Analysis of the actor-partner interdependence mediation model for self-disclosure between social support and benefit finding among stroke patients and their caregivers.
Zhu S, Ban N, et al. • Frontiers in public health • 2026
Self-disclosure mediates the relationship between social support and benefit finding among stroke patients and their caregivers, with actor and partner interdependence effects both demonstrated.
Key Findings
Results
Patients' own social support indirectly influenced their own benefit finding through their own self-disclosure (actor effect).
The indirect path from patients' social support to their benefit finding via self-disclosure was statistically significant (β = 0.106, 95% CI = 0.055–0.156).
This represents an actor effect within the Actor-Partner Interdependence Mediation Model (APIMeM).
Bootstrap resampling with 5,000 repetitions was used to estimate the 95% confidence interval with bias correction.
Data were collected from 278 stroke patient-caregiver dyads at a Grade III Level A hospital in Lianyungang City, Jiangsu Province, China.
Results
Caregivers' own social support indirectly influenced their own benefit finding through their own self-disclosure (actor effect).
The indirect path from caregivers' social support to their own benefit finding via self-disclosure was statistically significant (β = 0.072, 95% CI = 0.029–0.115).
This represents a caregiver actor effect within the APIMeM framework.
Bootstrap resampling with 5,000 repetitions was used for bias-corrected confidence interval estimation.
Assessment tools included the Social Support Rating Scale, the Distress Disclosure Index, and the Benefit Finding Scale.
Results
Caregivers' social support indirectly influenced patients' benefit finding through patients' self-disclosure (partner effect).
The indirect partner effect path from caregivers' social support to patients' benefit finding via patients' self-disclosure was statistically significant (β = 0.058, 95% CI = 0.015–0.102).
This cross-person mediation effect indicates that caregiver resources can shape patient psychological outcomes.
The partner effect from patients' social support to caregivers' benefit finding via caregivers' self-disclosure was not reported as statistically significant.
The study used a cross-sectional design with convenience sampling of 278 patient-caregiver pairs.
Results
The study confirmed an actor-partner interdependence mediating effect among social support, self-disclosure, and benefit finding in stroke patient-caregiver dyads.
Both actor effects (patients and caregivers independently) and at least one partner effect (caregiver-to-patient) were statistically significant.
The APIMeM framework was used to simultaneously model both within-person and cross-person mediation pathways.
Data analysis was performed using SPSS 27.0 and Mplus 8.3 software.
The study population consisted of 278 pairs recruited via convenience sampling from a single Grade III Level A hospital in China.
Methods
The study was cross-sectional in design, using convenience sampling from a single hospital site in Jiangsu Province, China.
278 stroke patient-caregiver pairs were recruited from a Grade III Level A hospital in Lianyungang City, Jiangsu Province.
Instruments used included a general information questionnaire, the Social Support Rating Scale, the Distress Disclosure Index, and the Benefit Finding Scale.
The cross-sectional design limits causal inference between variables.
Convenience sampling was employed, which may limit generalizability of findings.
What This Means
This research suggests that when stroke patients or their caregivers receive more social support, they are more likely to openly share their thoughts and feelings (self-disclosure), and this openness in turn helps them find positive meaning or personal growth in their experience — a process called 'benefit finding.' The study examined 278 stroke patient-caregiver pairs in China and found that this chain of effects — from social support, through self-disclosure, to benefit finding — held true for both patients and caregivers independently. Notably, caregivers' social support also appeared to influence patients' own benefit finding, suggesting that supporting caregivers has ripple effects on the patients they care for.
The study used a statistical framework called the Actor-Partner Interdependence Mediation Model (APIMeM), which is designed specifically to capture how people in close relationships influence each other's psychological outcomes. By showing that both 'within-person' and 'cross-person' pathways were statistically significant, the research highlights that stroke recovery is not just an individual experience but a shared, relational one. This means that interventions targeting one member of a patient-caregiver pair may benefit the other as well.
This research suggests that healthcare professionals working with stroke patients and caregivers might consider strategies that expand their social support networks and encourage open emotional expression. By helping both patients and caregivers feel more supported and willing to share their inner experiences, it may be possible to foster greater psychological resilience and positive meaning-making during what is often a very difficult period. The findings are limited by the study's cross-sectional design (a single snapshot in time) and its use of a single hospital in China, so further research is needed to confirm these patterns in other populations and settings.
Zhu S, Ban N, Miao X, Guo M, Ma L. (2026). Analysis of the actor-partner interdependence mediation model for self-disclosure between social support and benefit finding among stroke patients and their caregivers.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1890113