Social support and self-efficacy multiply mediate the relationship between medical coping style and resilience in patients with type A aortic dissection.

Abstract

Previous research has shown that medical coping modes are associated with resilience in cardiovascular disease patients. However, postoperatively, the mechanism underlying this association in Stanford type A aortic dissection patients is poorly understood. This study investigated the mediating effects of social support and self-efficacy on the relationship between medical coping modes and resilience in Stanford type A aortic dissection patients postoperatively. We assessed 125 patients after surgery for Stanford type A aortic dissection using the Medical Coping Modes Questionnaire, the General Self-Efficacy Scale, the Social Support Rating Scale, and the Connor-Davidson Resilience Scale. Structural equation modeling with AMOS (v.24) was used to test the hypothesized model with multiple mediators. Both direct and mediational effects (through social support and self-efficacy) of medical coping modes on resilience outcomes were examined. The mean Connor-Davidson Resilience Scale score was 63.78 ± 12.29. Confrontation, social support, and self-efficacy correlated with resilience (r = 0.40, 0.23, 0.72, respectively; all p < 0.01). In multiple mediation models, social support independently (effect = 0.11; 95% confidence interval [CI], 0.04-0.27) and social support and self-efficacy serially (effect = 0.06; 95% CI, 0.02-0.14) mediated the association of confrontation with resilience maintenance, accounting for 57.89 and 10.53% of the total effect, respectively. Social support and self-efficacy were multiple mediators of the relationship between confrontation and resilience. Interventions designed to facilitate confrontation and subsequently increase social support and self-efficacy may be useful to increase resilience in Stanford type A aortic dissection patients.