Abstract 1731: Social Support, Personal Control, and Psychological Functioning Among Individuals with Heart Failure

Abstract

Heart failure places a large psychosocial burden on patients and their families. Although psychological functioning generally improves for most cardiac patients, impairment persists for a significant minority, posing a serious impediment to well-being. It has been proposed that personal resources, such as social support and coping style, facilitate adaptation to such threatening events as chronic illness, and thus impact psychological outcomes. Purpose: The primary aim of this study was to develop and test two mediating models, drawn on an integrative stress coping framework. The models considered the complex relationships between social support and personal control and two key psychological outcomes, depressive symptoms and anxiety, in individuals coping with heart failure. Social support was hypothesized to have a direct effect on depressive symptoms (Model 1) and anxiety (Model 2), and an indirect effect, mediated by personal control, on these psychological outcomes. Methods: We conducted a secondary analysis of data collected from a cross-sectional survey of patients (N = 242) between 21 and 82 years of age being treated primarily for idiopathic (55.8%) or ischemic (39.7%) cardiomyopathy. Structural equation modeling was used to test the hypotheses. Results: Both models demonstrated good data model fit, with 52% of the variance explained for Model 1 and 38% of the variance explained for Model 2. Statistically significant estimates indicated that social support plays a key role in reducing depressive symptoms and anxiety. Notably, for each model, the mechanism whereby social support reduces psychological distress is entirely through the indirect effect, i.e., through patients’ perceived control. Conclusions: The results provide support for existing theories that emphasize important roles of social support and personal control in improving psychological functioning among the chronically ill. This study raises the possibility that strategies designed to improve social support can be useful in reducing heart failure patients’ depressive symptomatology and anxiety. Such strategies would operate primarily through improving one’s sense of personal control. #