title: Patterns and the mediating role of avoidant coping style and illness perception on anxiety and depression in patients with chronic heart failure.
abstract: BACKGROUND
  Emotional distress in patients with chronic heart failure (CHF) predicts mortality, hospital readmission and quality of life. The patient's avoidant coping style and beliefs about the disease have been linked to emotional distress in CHF. However, the pattern and transmitting effects of these variables are indefinite.
  
  
  OBJECTIVE
  This study aimed to examine the links between and the potential mediating role of illness perceptions and avoidant coping style on depression and anxiety in patients with CHF.
  
  
  METHODS
  Self-assessment data from 103 patients with CHF were subjected to path analysis in two hypothesised models. The outcome measures were coping styles, illness perception, anxiety and depression.
  
  
  RESULTS
  Avoidant coping had a direct adverse effect on anxiety and depression. The perception of symptom burden and personal control, significantly mediated the effect between avoidant coping and anxiety and depression.
  
  
  CONCLUSIONS
  Avoidant coping style appears to influence not only emotional distress, but also a malignant symptom perception and low sense of control over the illness.
authors.affiliation: The Swedish Red Cross University College, Stockholm, Sweden.|Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.|Sophiahemmet University, Stockholm, Sweden.
authors.forename: Catarina
authors.identifier: http://orcid.org/0000-0002-1139-9489
authors.initials: C
authors.lastname: Nahlén Bose
authors.affiliation: Academy of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden.
authors.forename: Magnus L
authors.initials: ML
authors.lastname: Elfström
authors.affiliation: The Swedish Red Cross University College, Stockholm, Sweden.|Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Björling
authors.affiliation: Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Persson
authors.affiliation: The Swedish Red Cross University College, Stockholm, Sweden.|Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Saboonchi
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D055809:Illness Behavior; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological
keywords: anxiety; avoidant coping; chronic heart failure; depression; illness perception; path analysis