The Relationships among Health Locus of Control and Resilience, Social Support and Health Promoting Behavior in Patients with Newly Diagnosed Coronary Artery Diseases

Nayeon Shin; Younhee Kang

doi:10.7469/kjan.2015.27.3.294

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Shin and Kang: The Relationships among Health Locus of Control and Resilience, Social Support and Health Promoting Behavior in Patients with Newly Diagnosed Coronary Artery Diseases

Original Article

Korean J Adult Nurs 2015;27(3):294-303.

Published online: NaN June 2015

DOI: https://doi.org/10.7469/kjan.2015.27.3.294

The Relationships among Health Locus of Control and Resilience, Social Support and Health Promoting Behavior in Patients with Newly Diagnosed Coronary Artery Diseases

Nayeon Shin¹, Younhee Kang²

^¹Graduate School, Ewha Womans University, Seoul

^²Division of Nursing Science, Ewha Womans University, Seoul, Korea

Corresponding author: Kang, Younhee Division of Nursing Science, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-4483, Fax: +82-2-3277-2850, E-mail: yxk12@ewha.ac.kr

Received 22 March 20152 June 2015 Accepted 15 June 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to determine the relationships among health locus of control, resilience, social support, and health promoting behavior in patients with coronary artery diseases.

Methods

This study utilized a descriptive correlational design using a survey method. The subjects were 165 coronary artery disease patients at the cardiology out-patient clinic of the C university hospital. Data were collected through Health Locus of Control Scale, Resilience Scale, ENRICHD Social Support Instrument, Health Promoting Lifestyle Profile scale. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and hierarchial regression.

Results

There were significant positive bivariate correlations of health promoting behavior with internal health locus of control, doctors health locus of control, resilience and social support respectively, and correlation between resilience and social support. Among predictors, internal health locus of control (β=.28), social support (β=.28) and resilience (β=.25) had statistically significant influences on health promoting behavior.

Conclusion

These results proposed that internal health locus of control, social support and resilience have important influences on health promoting behavior. Nursing interventions to enhance internal health locus of control, resilience and social support might be essential for patients with coronary artery disease in order to promote their health behaviors.

Keywords: Coronary artery disease, Internal-external control, Psychological resilience, Social support, Health promotion

REFERENCES

1.Statistics Korea. 2013 Annual report on the cause of death statistics [Internet]. Seoul: Statistics Korea;2014. [cited 2014 September 15]. Available from:. http://kostat.go.kr/portal/korea/kor_nw/2/6/1/index.board?bmode=read&bSeq=&aSeq=330181&pageNo=1&rowNum=10&navCount=10&currPg=&sTarget=title&sTxt=.

2.Hallveig B., Louise J., Colleen N., Michelle G. Health-related quality of life in women with coronary artery disease. European Journal of Cardiovascular Nursing. 2009. 8(1):18–25. http://dx.doi.org/10.1016/j.ejcnurse.2008.05.002.

3.Silarova B., Nagyova I., Rosenberger J., Studencan M., Ondu-sova D., Reijneveld SA, et al. Sense of coherence as a predictor of health-related behaviours among patients with coronary heart disease. European Journal of Cardiovascular Nursing. 2014. 13(4):345–56. http://dx.doi.org/10.1177/1474515113497136.

4.Bergvik S., So̸rlie T., Wynn R. Coronary patients who returned to work had stronger internal locus of control beliefs than those who did not return to work. British Journal of Health Psychology. 2011. 17(3):596–608. http://dx.doi.org/10.1111/j.2044-8287.2011.02058.x.

5.Hwang SY., Kweon YR., Kim AL. Perceptions of barriers to cardiovascular risk factors and decision to seek treatment among middle-aged men with acute myocardial infarction. The Korean Journal of Adult Nursing. 2010. 22(5):537–51.

6.Staniute M., Brozaitiene J., Bunevicius R. Effects of social support and stressful life events on health-related quality of life in coronary artery disease patients. The Journal of Cardiovascular Nursing. 2013. 28(1):83–9. http://dx.doi.org/10.1097/jcn.0b013e318233e69d.

7.Grotz M., Hapke U., Lampert T., Baumeister H. Health locus of control and health behaviour: results from a nationally representative survey. Psychology, Health & Medicine. 2011. 16(2):129–40. http://dx.doi.org/10.1080/13548506.2010.521570.

8.Chung MH., Chao TY., Chou KR., Lee HL. Health-promoting lifestyle factors of cancer survivors in Taiwan. Cancer Nursing. 2009. 32(3):E8–E14. http://dx.doi.org/10.1097/ncc.0b013e318199002b.

9.Oh JE., Park HS., Kim DH. The relationships among hostility, perceived social support and health behavior compliance of patients with coronary artery disease. The Korean Journal of Fundamentals of Nursing. 2010. 17(1):99–108.

10.Wang W., Lau Y., Chow A., Thompson DR., He HG. Health-related quality of life and social support among Chinese patients with coronary heart disease in mainland China. European Journal of Cardiovascular Nursing. 2014. 13(1):48–54. http://dx.doi.org/10.1177/1474515113476995.

11.Son HS., Thomas SA., Friedmann E. The association between psychological distress and coping patterns in post-MI patients and their partners. Journal of Clinical Nursing. 2012. 21(15/16):2392–4. http://dx.doi.org/10.1111/j.1365-2702.2012.04165.x.

12.Edward KL. Empowering cardiac patients using resilience as a practice strategy. British Journal of Cardiac Nursing. 2014. 9(3):110. http://dx.doi.org/10.12968/bjca.2014.9.3.110.

13.Shin SJ., Jung DY., Hwang EH. Concept analysis of resilience in patients with cardiovascular diseases. Journal of Korean Academy of Nursing. 2009. 39(6):788–95. http://dx.doi.org/10.4040/jkan.2009.39.6.788.

14.Stewart DE., Yuen T. A systematic review of resilience in the physically ill. Psychosomatics. 2011. 52:199–209. http://dx.doi.org/10.1016/j.psym.2011.01.036.

15.Shin SJ. Development of a cardiovascular disease resilience scale. The Korean Journal of Adult Nursing. 2010. 22(2):161–70.

16.The Korean Society of Cardiology. Intervention in patients with coronary artery disease [Internet]. Seoul: The Korean Society of Cardiology;2013. [cited 2015 January 31]. Available from:. http://www.circulation.or.kr/general/content/?depth1=4.

17.Mancia G., Fagard R., Narkiewicz K., Redon J., Zanchetti A., Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension. European Heart Journal. 2014. 34(28):2159–219. http://dx.doi.org/10.1093/eurheartj/eht151.

18.Faul F., Erdfelder E., Buchner A., Lang AG. Statistical power analyses using Gpower 3.1: tests for correlation and regression analyses. Behavior Research Methods. 2009. 41(4):1149–60. http://dx.doi.org/10.3758/BRM.41.4.1149.

19.Wallston KA., Stein MJ., Smith CA. Form C of MHLC scales: a condition-specific measure of locus of control. Journal of Personality Assessment. 1994. 63(3):160–70. http://dx.doi.org/10.1207/s15327752jpa6303_10.

20.Wagnild GM., Young HM. Development and psychometric evaluation of the resilience scale. Journal of Nursing Measurement. 1993. 1(2):165–78.

21.The ENRICHD Investigators. Enhancing recovery in coronary heart disease patients (ENRICHD): study design and methods. American Heart Journal. 2000. 139(1):1–9. http://dx.doi.org/10.1016/s0002-8703(00)90301-6.

22.Walker SN., Sechrist KR., Pender NJ. The health-promoting lifestyle profile: development and psychometric characteristics. Nursing Research. 1987. 36(2):76–81. http://dx.doi.org/10.1097/00006199-198703000-00002.

23.Thanavaro JL., Thanavaro S., Delicath T. Health promotion behaviors in women with chest pain. Heart & Lung: The Journal of Acute and Critical Care. 2010. 39(5):394–403. http://dx.doi.org/10.1016/j.hrtlng.2009.10.016.

24.Egan JT., Leonardson G., Best LG., Welty T., Calhoun D., Beals J. Multidimensional health locus of control in American Indians: the strong heart study. Ethnicity & Disease. 2009. 19(3):338–43.

25.Jiang W., Samad Z., Boyle S., Becker RC., Williams R., Kuhn C, et al. Prevalence and clinical characteristics of mental stress-induced myocardial ischemia in patients with coronary heart disease. Journal of the American College of Cardiology. 2013. 61(7):714–22. http://dx.doi.org/10.1016/j.jacc.2012.11.037.

26.Boo SJ., Froelicher ES. Cardiovascular risk factors and 10-year risk for coronary heart disease in Korean women. Asian Nursing Research. 2012. 6(1):1–8. http://dx.doi.org/10.1016/j.anr.2012.02.001.

27.Slovinec D'A., Monika E., Pelletier LG., Reid RD., Huta V. The roles of self-efficacy and motivation in the prediction of short and long term adherence to exercise among patients with coronary heart disease. Health Psychology. 2014. 33(11):1344–53. http://dx.doi.org/10.1037/hea0000094.

28.Song RY., Park MK., Cheong JO., Park JH., Seong IW. Effects of Tai Chi exercises on cardiovascular risks, recurrence risk, and quality of life in patients with coronary artery disease. The Journal of Korean Academic Society of Adult Nursing. 2013. 25(5):515–26. http://dx.doi.org/10.7475/kjan.2013.25.5.515.

29.Opuchilik K., Wrzesinska M., Kocur J. The assessment of the level of coping style and health locus of control in patients with coronary heart disease and hypertension. Psychiatria Polska. 2009. 43(2):235–45.

30.Ruiz JM., Hamann HA., Coyne JC., Compare A. In sickness and in health: interpersonal risk and resilience in cardiovascular disease. Clinical Psychology and Heart Disease. 2006. 13:233–72. http://dx.doi.org/10.1007/978-88-470-0378-1_14.

Table 1.

The General Characteristics and Risk Factors related Coronary Artery Disease (N=165)

Characteristics	Categories	n (%)	M±SD	Range
Gender	Male	101 (62.5)
Gender	Female	64 (37.5)
Age (year)	40~49	36 (21.0)	60.52±6.39	42~83
	50~59	38 (22.0)
	60~69	79 (49.4)
	≥70	12 (7.6)
Education (year)	Elementary school (≤6)	55 (34.1)	10.32±2.50	0~19
	Middle school (7~9)	38 (22.4)
	High school (10~12)	40 (24.7)
	Undergraduate school (≥13)	32 (18.8)
Spouse	Yes	120 (76.5)
Spouse	No	45 (23.5)
Occupation	Yes	42 (24.7)
Occupation	No	123 (75.3)
Living arrangement of family	Spouse & child	71 (45.9)
	Spouse	50 (29.4)
	Child	32 (18.8)
	Solitude	12 (5.9)
Diagnosis	Stable angina	44 (25.3)
	Unstable angina	75 (48.1)
	Myocardial infarction	38 (21.5)
	Variant angina	8 (5.1)
Periods since diagnosed (month)			2.91±0.45
PCI	Yes	145 (89.9)
PCI	No	20 (10.1)
BMI (kg/m²)			24.57±3.11
Hyperlipidemia (mg/dL) (total cholesterol)	Hyperlipidemia (＞210)	111 (69.6)	198.25±31.24
Hyperlipidemia (mg/dL) (total cholesterol)	Normal (≤210)	54 (30.4)	198.25±31.24
Family History	Yes	78 (41.8)
Family History	No	87 (58.2)
Exercise	No	61 (40.0)
	Occasionally	46 (24.3)
	Frequently (≥3 times/week)	58 (35.7)
Ejection fraction (%)			68.37±15.25
Comorbidity (DM, HTN, CVA)	0	48 (31.6)
	1	42 (24.0)
	2	47 (31.6)
	3	28 (12.6)
Smoking status	Smoker	62 (34.6)
	Ex-smoker	36 (21.8)
	Non-smoker	67 (43.6)

CVA=cardiovascular accident; DM=diabetes mellitus; HTN=hypertension; PCI=percutaneous coronary intervention.

Table 2.

Degree of Health Locus of Control, Resilience, Social Support and Health Promoting Behavior (N=165)

Variables	M±SD	Min	Max	Range
Health locus of control-internal	24.18±3.99	11	30	6~30
Health locus of control-chance	18.07±4.51	6	30	6~30
Health locus of control-power others	12.01±2.77	3	15	3~15
Health locus of control-doctors	12.27±2.70	6	15	3~15
Resilience	119.08±19.88	32	163	25~175
Social support	23.19±4.86	9	30	6~30
Health promoting behavior	129.88±17.84	83	193	52~208

Table 3.

Levels of Health Promoting Behavior according to the Characteristics of the Participants (N=165)

Characteristics	Categories	n (%)	M±SD	t or F	p	Duncan
Gender	Male	101 (61.2)	132.94±23.47	1.04	.299
Gender	Female	64 (39.8)	127.31±20.05	1.04	.299
Age (year)	40~49	36 (21.8)	131.33±28.18	0.67	.060
	50~59	38 (23.0)	131.89±16.69
	60~69	79 (47.9)	133.61±19.60
	≥70	12 (7.3)	134.84±11.50
Education (year)	Elementary school (≤6)	55 (34.1)	128.30±24.51	1.30	.279
	Middle school (7~9)	38 (22.4)	129.67±22.49
	High school (10~12)	40 (24.7)	127.86±19.52
	Undergraduate school (≥13)	32 (18.8)	140.81±22.09
Spouse	Yes	120 (76.5)	132.84±21.52	1.43	.012
Spouse	No	45 (23.5)	124.71±25.05	1.43	.012
Occupation	Yes	42 (24.7)	133.67±18.28	0.49	.620
Occupation	No	123 (75.3)	133.67±18.28	0.49	.620
Living arrangement of family	Spouse & child^d	71 (45.9)	134.13±22.66	1.96	.014	d＞a
	Spouse^c	50 (29.4)	132.76±20.61
	Child^b	32 (18.8)	124.36±25.10
	Solitude^a	12 (5.9)	109.75±12.39
Diagnosis	Stable angina	44 (26.7)	131.75±26.93	0.09	.965
	Unstable angina	75 (45.5)	131.49±22.60
	Myocardial infarction	38 (23.0)	130.65±19.42
	Varient angina	8 (4.8)	125.50±11.00
PCI	Yes	145 (87.9)	130.26±22.33	0.93	.350
PCI	No	20 (12.1)	138.13±23.43	0.93	.350
Hyperlipidemia (total cholesterol)	Hyperlipidemia (＞210)	111 (69.6)	129.40±21.46	1.30	.040
Hyperlipidemia (total cholesterol)	Normal (≤210)	54 (30.4)	134.11±25.56	1.30	.040
Family history	Yes	78 (41.8)	131.91±20.10	-0.28	.778
Family history	No	87 (58.2)	130.44±24.18	-0.28	.778
Exercise	No	61 (40.0)	126.67±23.57	1.00	.047
	Occasionally	46 (24.3)	132.40±17.81
	Frequently (≥3 times/wk)	58 (35.6)	134.82±24.00

PCI=percutaneous coronary intervention.

Table 4.

Relationships between Health Locus of Control, Resilience, Social support and Health Promoting Behavior (N=165)

Variables	Health locus of control				Resilience	Social support
	Internal	Chance	Power-others	Doctors	Resilience	Social support
	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
Resilience	.35 (.002)	-.06 (.602)	-.15 (.170)	.17 (.125)
Social support	.27 (.015)	-.25 (.027)	-.35 (.001)	.20 (.070)	.34 (＜.001)
Health promoting behavior	.38 (.001)	.14 (.208)	-.07 (.523)	.21 (.017)	.32 (.002)	.36 (＜.001)

Table 5.

Results of Multiple Regression Analysis of Factors Affecting to the Health Promoting Behavior (N=165)

Variables	Step I			Step II
Variables	β	t	p	β	t	p
Spouse	.00	0.07	.823	.00	0.09	.852
Living arrangement of family	.25	0.17	.560	.01	0.26	.793
Exercise	-.35	-0.18	.102	-.25	-1.68	.093
Hyperlipidemia	-.09	0.81	.352	-.08	0.72	.491
Health locus of control-internal				.28	2.30	.024
Health locus of control-doctors				.00	-0.02	.977
Resilience				.25	2.36	.021
Social support				.28	2.50	.015
	R²=.32, F=3.85, p＜.001			R²=.43, F=5.95, p＜.001

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