Type D Personality, Self-Efficacy, and Medication Adherence Following an Acute Coronary Syndrome

被引:56
作者
Molloy, Gerard J. [1 ]
Randall, Gemma [2 ]
Wikman, Anna [4 ]
Perkins-Porras, Linda [3 ]
Messerli-Buergy, Nadine [5 ]
Steptoe, Andrew [2 ]
机构
[1] Univ Stirling, Sch Nat Sci, Div Psychol, Stirling FK9 4LA, Scotland
[2] UCL, Dept Epidemiol & Publ Hlth, London, England
[3] Univ London, Dept Community Hlth Sci, London, England
[4] Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
[5] Univ Bern, Dept Clin Psychol & Psychotherapy, Bern, Switzerland
来源
PSYCHOSOMATIC MEDICINE | 2012年 / 74卷 / 01期
关键词
Type D; adherence; compliance; self-management; negative affectivity; social inhibition; HEART-FAILURE; PSYCHOLOGICAL DISTRESS; DEPRESSIVE SYMPTOMS; ILLNESS BELIEFS; SOCIAL SUPPORT; RISK-FACTORS; MORTALITY; RECOVERY; DISEASE; INTERVENTIONS;
D O I
10.1097/PSY.0b013e31823a5b2f
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: To assess the relationship among Type D personality, self-efficacy, and medication adherence in patients with coronary heart disease. Methods: The study design was prospective and observational. Type D personality, self-efficacy for illness management behaviors, and medication adherence were measured 3 weeks after hospitalization for acute coronary syndrome in 165 patients (mean [standard deviation] age = 61.62 [10.61] years, 16% women). Self-reported medication adherence was measured 6 months later in 118 of these patients. Multiple linear regression and mediation analyses were used to address the study research questions. Results: Using the original categorical classification, 30% of patients with acute coronary syndrome were classified as having Type D personality. Categorically defined patients with Type D personality had significantly poorer medication adherence at 6 months (r = -0.29, p < .01). Negative affectivity (NA; r = -0.25, p = .01) and social inhibition (r = -0.19, p = .04), the components of Type D personality, were associated with medication adherence 6 months after discharge in bivariate analyses. There was no evidence for the interaction of NA and social inhibition, that is, Type D personality, in the prediction of medication adherence 6 months after discharge in multivariate analysis. The observed association between NA and medication adherence 6 months after discharge could be partly explained by indirect effects through self-efficacy in mediation analysis (coefficient = -0.012; 95% bias-corrected and accelerated confidence interval = -0.036 to -0.001). Conclusions: The present data suggest the primacy of NA over the Type D personality construct in predicting medication adherence. Lower levels of self-efficacy may be a mediator between higher levels of NA and poor adherence to medication in patients with coronary heart disease.
引用
收藏
页码:100 / 106
页数:7
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