Asian Nurs Res.  2017 Sep;11(3):201-206. 10.1016/j.anr.2017.08.003.

Confrontation as a Mediator between Sense of Coherence and Self-management Behaviors among Elderly Patients with Coronary Heart Disease in North China

• Li Z
• Liu T
• Han J
• Li T
• Zhu Q
• Wang A

• KMID: 2416443
• DOI: http://doi.org/10.1016/j.anr.2017.08.003

Abstract

PURPOSE
Self-management is critical to improve health outcomes of elderly patients with coronary heart disease (CHD). Sense of coherence (SOC) is found to be linked with self-management behaviors. However, their deeper relationship is not clear. The purposes of this study were to investigate the association between SOC and self-management behaviors among elderly CHD patients in China, and whether confrontation mediates this association.
METHODS
A cross-sectional design was used. A total of 275 elderly patients with CHD recruited from the cardiology department in a general hospital in North China were surveyed from October 2015 to April 2016. SOC, confrontation, and self-management behaviors were measured using the Chinese version of the SOC scale, subscale of Medical Coping Modes Questionnair"”Confrontation, and the CHD self-management scale, respectively. Correlation analysis and path analysis were conducted to analyze the data.
RESULTS
The mean (±standard deviation) scores of SOC, confrontation, and self-management behaviors were 62.20 (±9.61), 19.55 (±3.15), and 76.17 (±10.63), respectively. Correlation analysis showed that SOC, confrontation, and self-management behaviors were significantly correlated with each other. Path analysis indicated that SOC exerted a direct effect on self-management behaviors, whereas could affect self-management indirectly via confrontation. Bootstrap test result showed that confrontation played a mediating role (β = .20, p < .001) in the relationship between SOC and self-management behaviors.
CONCLUSION
SOC was related to self-management behaviors, whereas confrontation mediated the effect of SOC on self-management behaviors. In practice, the role of confrontation coping should be valued when developing strategies to strengthen SOC and to improve self-management practice among elderly CHD patients.

Keyword

aged; coping; coronary heart disease; self-care; sense of coherence

MeSH Terms

Aged*
Asian Continental Ancestry Group
Cardiology
China*
Coronary Disease*
Hospitals, General
Humans
Negotiating
Self Care*
Sense of Coherence*