The Mediating Effect of the Resilience on the Relationship between Type D Personality and Compliance in Patients with Coronary Artery Disease

Mi Yo Cheon; Jiyeon Kang

doi:10.7469/kjan.2016.28.1.61

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Cheon and Kang: The Mediating Effect of the Resilience on the Relationship between Type D Personality and Compliance in Patients with Coronary Artery Disease

Original Article

Korean J Adult Nurs 2016;28(1):61-70.

Published online: February 2016

DOI: https://doi.org/10.7469/kjan.2016.28.1.61

The Mediating Effect of the Resilience on the Relationship between Type D Personality and Compliance in Patients with Coronary Artery Disease

Mi Yo Cheon¹, Jiyeon Kang^2,

^¹Dong-A University Medical Center, CCU, Busan

^²Department of Nursing, Dong-A University, Busan, Korea

Corresponding author: Kang, Jiyeon Department of Nursing, Dong-A University, 1 Dongdaesin-dong 3-ga, Seo-gu, Busan 602-714, Korea. Tel: +82-51-240-2871, Fax: +82-51-240-2920, E-mail: jykang@dau.ac.kr

Received 16 October 20158 January 2016 Accepted 22 January 2016

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

This study aimed to identify the mediating effect of the resilience on the relationship between type D personality and compliance of Coronary Artery Disease (CAD) patients.

Methods

The subjects were 236 CAD patients who visited the cardiology outpatient clinics of D University Medical Center in B City in Korea. The type D personality, resilience, and compliance of subjects were measured using structured questionnaires from July to August, 2014. The mediating effect was analyzed by a multiple hierarchical regression.

Results

The subjects with type D personality accounted for 30.9% of all study subjects. The resilience and compliance of type D subjects were significantly lower than those of non type D subjects. There was a significant correlation between resilience and compliance. The direct effect of type D personality on compliance was not significant (β=-.07, p=.243), while the indirect effect of type D personality on compliance via resilience was significant (β=.23, p<.001).

Conclusion

On the basis of above results, it can be concluded that the resilience had completely mediating effect on the relation between type D personality and compliance of CAD patients. Further studies need to be done to develop the intervention enhancing resilience of CAD patients with Type D personality.

Keywords: Coronary artery disease, Patient compliance, Type D personality, Psychological resilience

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Figure 1.

Model for mediating effect of resilience between the type D personality and compliance.

Table 1.

Differences of Compliance according to the Subjects' Characteristics (N=236)

Characteristics	Categories	n (%)	M±SD	t or F	p	Post-hoc test
Gender	Female	106 (44.9)	95.37±11.09	2.30	.022
Gender	Male	130 (55.1)	91.63±13.84
Age (year)	30~49^a	23 (9.7)	82.13±16.16	12.73^†	＜.001	a＜b^‡
	50~59^a	58 (24.6)	89.47±11.92
	60~69^b	87 (36.9)	95.37±12.54
	≥70^b	68 (28.8)	97.74±9.16
Education	Elementary school	46 (19.5)	95.13±9.32	1.29	.279
	Middle school	52 (22.0)	95.17±12.57
	High school	78 (33.1)	92.58±12.83
	≥College	60 (25.4)	91.25±14.94
Living with family	Yes	210 (89.0)	93.64±12.73	1.14	.256
Living with family	No	26 (11.0)	90.62±13.23
Religion	Yes	166 (70.3)	94.51±12.29	2.23	.027
Religion	No	70 (29.7)	90.47±13.57
Occupation	Yes	105 (44.5)	90.51±13.95	3.06	.002
Occupation	No	131 (55.5)	95.55±11.34
Monthly income (10,000 won)	＜100	117 (49.6)	94.59±11.22	2.39	.069
	100~199	29 (12.3)	95.83±10.53
	200~299	32 (13.6)	92.97±14.00
	≥300	58 (24.6)	89.66±15.39
Alcohol	Yes	85 (36.0)	88.18±13.40	4.84	＜.001
Alcohol	No	151 (64.0)	96.20±11.51
Smoking	Yes	56 (23.7)	84.29±14.47	6.57	＜.001
Smoking	No	180 (76.3)	96.12±10.82
Years of follow-up	＜3^a	59 (25.0)	88.69±13.91	6.04	＜.001	a＜c^‡
	3~＜6^b	58 (24.6)	91.33±12.51
	6~＜11^c	75 (31.8)	97.01±11.99
	≥11^c	44 (18.6)	95.80±10.65
Comorbidity	Yes	225 (95.3)	93.89±12.32	3.24	.001
	Hypertension	89 (39.6)
	Dyslipidemia	50 (22.2)
	Others	86 (38.2)
	No	11 (4.7)	81.36±16.66
Familial history of heart disease	Yes	75 (31.8)	93.61±13.13	0.25	.804
Familial history of heart disease	No	161 (68.2)	93.17±12.67
Admission experience	Yes	188 (79.7)	94.26±12.53	2.27	.024
Admission experience	No	48 (20.3)	89.60±13.25
Number of admission	1	112 (59.6)	93.38±12.59	1.16	.248
Number of admission	≥2	76 (40.4)	95.54±12.41
Surgery /intervention	Yes	143 (60.6)	94.69±12.35	2.08	.038
Surgery /intervention	No	93 (39.4)	91.15±13.30
Diagnosis	Unstable angina^a	117 (49.6)	96.15±11.65	4.02	.004
	Stable angina^a	69 (29.2)	92.32±12.81
	NSTEMI^a	25 (10.6)	87.72±15.12
	STEMI^a	15 (6.4)	86.73±13.63
	Variant angina^a	10 (4.2)	90.80±10.27

NSTEMI=Non ST segment elevation myocardial infarction; STEMI=ST segment elevation myocardial infarction;

^† Welch's ANOVA due to unmet homogeneity assumption;

^‡ Scheffé test.

Table 2.

Type D Personality, Resilience, and Compliance of Study Subjects (N=236)

Variables	Categories	n (%)	Range	M±SD	Negative affectivity	Social inhibition
Variables	Categories	n (%)	Range	M±SD	M±SD	M±SD
Personality	Type D	73 (30.9)			15.77±3.81	14.88±3.81
	Non-type D	163 (69.1)			5.79±5.25	3.94±4.02
	Total	236 (100.0)			8.87±6.70	7.32±6.42
Resilience			25~175	130.14±23.24
Compliance	Medication		5~25	21.77±2.84
	Daily activities		5~25	19.50±3.89
	Exercise & stress management		5~25	17.59±3.82
	Diet		5~25	17.44±3.62
	Risk factor management		5~25	17.01±4.05
	Total		25~125	93.31±12.79

Table 3.

Differences of Resilience and Compliance according to the Type D Personality (N=236)

Variables	Type D (n=73)	Non-type D (n=163)	t	p
Variables	M±SD	M±SD	t	p
Resilience	122.18±25.02	133.71±21.54	3.61	＜.001
Compliance	90.74±12.54	94.46±12.77	2.08	.039

Table 4.

Mediating Effect of Resilience on the Relationship between the D Type Personality and Compliance (N=236)

Step		Path		B	SE	_β	Adjusted R²	p
Step 1	D type personality	→	Compliance	-3.50	1.72	-.13	.18	.043
Step 2	D type personality	→	Resilience	-11.38	3.21	-.23	.08	.001
Step 3	Resilience	→	Compliance	0.14	0.03	.25	.22	＜.001
Step 4	D type personality	→	Compliance	-2.02	1.72	-.07	.22	.243
	Resilience			0.13	0.04	.23		＜.001

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