Mediating effects of cognitive appraisal and coping style between perceived stress and major adverse cardiac events after percutaneous coronary intervention
10.3760/cma.j.cn115682-20200115-00236
- VernacularTitle:认知评价和应对方式在知觉压力与PCI术后主要心脏不良事件间的中介效应
- Author:
Han LYU
1
;
Ping LIN
;
Zhenjuan ZHAO
Author Information
1. 哈尔滨医科大学护理学院，哈尔滨 150001
- Keywords:
Coronary artery disease;
Percutaneous coronary intervention;
Major adverse cardiac events;
Perceived stress;
Cognitive appraisal;
Coping style;
Path analysi
- From:
Chinese Journal of Modern Nursing
2020;26(23):3138-3143
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the potential mediating effects of cognitive appraisal and coping style between perceived stress and major adverse cardiac events (MACE) in patients after percutaneous coronary intervention (PCI) .Methods:Using the convenient sampling method, a total of 383 patients with coronary heart disease who underwent PCI for the first time in the Department of Cardiology in the Second Affiliated Hospital of Harbin Medical University were selected as the research objects from July 2018 to September 2018. They were investigated with Chinese Perceived Stress Scale (CPSS) , Cognitive Appraisal of Health Scale (CAHS) and Medical Coping Modes Questionnaire (MCMQ) . The occurrence of MACE was followed up 1 year after operation. Mplus 7.0 was used for path analysis and to examine the mediating effects of cognitive appraisal and coping style.Results:A total of 364 patients completed the questionnaire survey and 1-year telephone follow-up. The CPSS score of 364 patients after PCI was (29.09±11.07) , and the incidence of MACE was 13.7% in 1 year after PCI. There were 4 significant paths between perceived stress and MACE. The first path was from perceived stress to MACE [ OR=1.023, 95% CI= (1.010-1.347) , P=0.031], and path effect accounted for 29.6% of the total effect. The second path was from perceived stress to threat appraisal to MACE [ OR=1.039, 95% CI= (1.026-1.379) , P=0.010], and acceptance-resignation coping effect accounted for 48.9% of the total effect. The third path was from perceived stress to threat appraisal to yielding response to MACE [ OR=1.010, 95% CI= (1.004-1.096) , P=0.019], and the path effect accounted for 12.1% of the total effect. The fourth path was from perceived stress to challenge appraisal to acceptance-resignation coping to MACE [ OR=1.026, 95% CI= (1.003-1.042) , P<0.050], and the path effect accounted for 4% of the total effect. Conclusions:Perceived stress can act on MACE directly or indirectly through intermediary variables. Challenge appraisal, threat appraisal and acceptance-resignation coping are the intermediary factors of perceived stress and MACE of patients undergoing PCI.
