Mediating Effect of Physical Activity in the Relationship between Depressive Symptoms and Health-related Quality of Life in Patients with Coronary Artery Disease: The 2016 Nationwide Community Health Survey in Korea

Mi Hwa Won

doi:10.7475/kjan.2019.31.6.691

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Won: Mediating Effect of Physical Activity in the Relationship between Depressive Symptoms and Health-related Quality of Life in Patients with Coronary Artery Disease: The 2016 Nationwide Community Health Survey in Korea

Original Article

Korean Journal of Adult Nursing 2019; 31(6): 691-700.

Published online: 20 December 2019

DOI: https://doi.org/10.7475/kjan.2019.31.6.691

Mediating Effect of Physical Activity in the Relationship between Depressive Symptoms and Health-related Quality of Life in Patients with Coronary Artery Disease: The 2016 Nationwide Community Health Survey in Korea

Mi Hwa Won

Assistant Professor, Department of Nursing, Wonkwang University, Ilsan, Korea.

Corresponding author: Won, Mi Hwa. Department of Nursing, Wonkwang University, 460 Iksan-daero, Iksan 54538, Korea. Tel: +82-63-850-6045, Fax: +82-63-850-6666, mihwon7729@wku.ac.kr

Received 25 October 2019 Revised 27 November 2019 Accepted 5 December 2019

Korean Society of Adult Nursing

(open-access):

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 examine the mediating role of physical activity in the relationship between depressive symptoms and health-related quality of life in patients with coronary artery disease.

Methods

A descriptive cross-sectional study design was conducted using the data from the 2016 Korea Community Health Survey. The participants comprised 6,072 patients with coronary artery disease aged 19 years or older. Depressive symptoms, physical activity, and health-related quality of life were assessed. The collected data were analyzed by a complex sample test using SPSS/WIN 24.0 program. Bootstrapping methodology was utilized to examine the mediating role of physical activity in the relationship between depressive symptoms and health-related quality of life with SPSS PROCESS macro Model 4.

Results

The results of the hierarchical linear regression analysis showed that depressive symptoms (t=−22.37, p<.001) and physical activity (t=12.12, p<.001) were significant predictor of health-related quality of life. A mediation analysis further revealed that physical activity mediates the relationship between depressive symptoms and health-related quality of life.

Conclusion

This study suggests that the negative impact of depressive symptoms on health-related quality of life can be improved through physical activity. Healthcare providers should consider these finding during early assessment of depressive symptoms in patients with coronary artery disease. Moreover, developing intervention strategies to enhance the level of physical activity could improve health-related quality of life of patients.

Keywords: Coronary artery disease, Depression, Exercise, Quality of life

Figures and Tables

Figure 1

Mediating effect of physical activity on the relationship between the depressive symptoms and health-related quality.

Table 1

Weighted Prevalence of Patients Characteristics (N=6,072)

n=unweighted sample size; N=weighted sample size; SD=standard deviation.

Table 2

Differences in Health-related Quality of Life according to Weighted Prevalence of Patients Characteristics (N=6,072)

n=unweighted sample size; SD=standard deviation.

Table 3

Descriptive Statistics on Physical Activity and Healthrelated Quality of Life (N=6,072)

n=unweighted sample size; HEPA=health enhancing physical activity; MET=metabolic equivalents task; SD=standard deviation.

Table 4

Mediating Effect of Physical Activity on the Relationship between the Depressive Symptoms and Health-related Quality (N=6,072)

Adj. R²=Adjusted R²; CI=confidence interval; DS=depressive symptoms; HRQoL=health-realted Quality; PA=physical activity; SE=standard error.

ACKNOWLEDGEMENT

This paper was supported by Wonkwang University in 2019.

Notes

^{CONFLICTS OF INTEREST} The author declared no conflict of interest.

^AUTHORSHIP

Study conception and design acquisition, data collection, analysis and interpretation of the data, drafting and critical revision of the manuscript - WMH.

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ORCID iDs: Mi Hwa Won
https://orcid.org/0000-0002-3452-7295
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