Coping Styles Mediate the Relationship Between Self-esteem, Health Locus of Control, and Health-Promoting Behavior in Chinese Patients With Coronary Heart Disease.
BACKGROUND
Health-promoting behavior plays an important role in reducing the burden of coronary heart disease. Self-esteem and health locus of control may contribute to health-promoting behavior, and coping styles may mediate these associations.


OBJECTIVE
The aims of our study were to examine whether self-esteem and health locus of control are associated with health-promoting behavior and examine the possible mediating effect of coping styles in patients with coronary heart disease.


METHODS
Health-promoting behavior, self-esteem, health locus of control, and coping styles were assessed in 272 hospitalized patients (60 ± 12 years, 61% male) with coronary heart disease. Hierarchical regression analysis was conducted to analyze the relationships between health-promoting behavior and other variables. Mediation effect was examined according to the methods of Baron and Kenny.


RESULTS
The mean score for health-promoting behavior was 2.57 ± 0.51; 38.2% of patients (n = 104) scored lower than 2.5. Self-esteem (β = .139, P < .05), confrontation coping style (β = .491, P < .001), disease duration (≥6 months, β = .147, P < .05), and monthly income (≥1000 RMB [approximately US$154], β = .111, P < .05) were positively associated with health-promoting behavior, accounting for 47.5% of its variance (F = 19.828). Confrontation partly mediated the association between self-esteem and health-promoting behavior and completely mediated the relationship between internal health locus of control and health-promoting behavior.


CONCLUSIONS
Confrontation plays a mediating role in the association among self-esteem, internal health locus of control, and health-promoting behavior. Strategies should be undertaken to encourage the use of confrontation coping style, which will facilitate health-promoting behavior.
Huijing Zou, BM, RN Master's Student, School of Nursing, Shandong University, Jinan, Shandong Province, P.R. China. Qian Tian, MM, RN Teaching Assistant, Heze Medical College, Heze, Shandong Province, P.R. China. Yuxia Chen, BM, RN Master's Student, School of Nursing, Shandong University, Jinan, Shandong Province, P.R. China. Cheng Cheng, BSN, RN Master's Student, School of Nursing, Shandong University, Jinan, Shandong Province, P.R. China. Xiuzhen Fan, PhD, RN Professor and Director of Academic Committee, School of Nursing, Shandong University, Jinan, Shandong Province, P.R. China.
Huijing
H
Zou
Qian
Q
Tian
Yuxia
Y
Chen
Cheng
C
Cheng
Xiuzhen
X
Fan
D000223:Adaptation, Psychological; D000328:Adult; D002681:China; D003327:Coronary Disease / Q000150:complications / Q000523:psychology*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012649:Self Concept; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D011795:Surveys and Questionnaires