Confrontive Coping Research Articles

Prevalence and correlates of common mental disorders among dental students in Brazil.

This study aimed to estimate prevalence of common mental disorders (CMD) and associated factors among dental students. In this cross-sectional study, 230 students answered a questionnaire and instruments to assess CMD (Self Reporting Questionnaire-20), hazardous alcohol consumption (Alcohol Use Disorder Identification Test), social support (Social Support Scale), perceptions of academic life (Dundee Ready Education Environment Measure), coping (Ways of Coping Inventory) and resilience (Resilience Scale). Bivariate analysis was conducted using the Chi-Square and Mann-Whitney tests. Logistic regression included all explanatory variableswith p<0.20 in the bivariate analysis, besides sex and academic year. The explanatory variables were analyzed in five successive blocks (backward-stepwise), until all variables presented statistical significance in the final model (p<0.05). The prevalence of CMD was 45.2% (95%CI: 38.7–51.6), with no significant differences between sexes. Students with no extracurricular activities, who had negatively self- assessed their health status and their academic performance, were about four times more likely to present CMD, followed by receiving psychological or psychiatric treatment during university (AOR: 2.65; 95%CI: 1.1–6.1) and those with high scores for confrontive coping (AOR: 1.20; 95%CI: 1.0–1.4). Resilience was a protective factor for CMD among dental students (AOR: 0.93; 95%CI: 0.9–1.0). Aspects related to academic performance, health status and confrontive coping strategies were risk factors to students’ mental health. Individuals with high levels of resilience showed lower prevalence of CMD. Further prospective studies could contribute to understanding the role of resilience among this population.

The structural equation model on self-efficacy during post-op rehabilitation among non-small cell lung cancer patients.

BackgroundsSelf-efficacy plays an important role in pulmonary rehabilitation, but it is still unknown which factors exert their effects on postsurgical rehabilitation self-efficacy among non-small cell lung cancer (NSCLC) patients. This study aims to assess relationships among physical function, social factors, psychological factors, quality of life (QOL) and self-efficacy, and the effects of these variables on self-efficacy among NSCLC patients.MethodsA cross-sectional survey was administered to 238 postsurgical NSCLC patients (response rate 95.2%) at five tertiary hospitals in Fuzhou, China. the participants completed a pack of questionnaires. Structural equation modeling (SEM) was conducted to test the hypothetical model.ResultsThe SEM results supported the hypothesized structural model (χ2/df = 1.511, p>0.05). The final model showed that confrontation coping, subjective well-being (SWB), social support, psychological growth (PTG) and anxiety and depression can be directly related to self-efficacy (coefficient = 0.335, coefficient = 0.288, coefficient = 0.150, coefficient = 0.024, and coefficient = -0.004, respectively, p<0.01). Confrontation coping also had indirect effect via SWB (coefficient = 0.085, p<0.01), which had indirect connection via PTG (coefficient = 0.005, p<0.01). Social support and anxiety and depression had indirect pathways as well. As expected, self-efficacy directly affected the quality of life.ConclusionsThis study suggests that higher confrontation coping style, SWB, social support, and PTG and lower anxiety and depression levels could effectively enhance their self-efficacy and consequently, improve QOL. These findings may help develop an intervention aimed at enhancing self-efficacy for this patient population.

Strategies of Behavior in Conflicts, Coping strategies, and Defense Mechanisms Among Adolescent Boys and Girls

Introduction. The present paper overviews domestic and foreign studies on conflicts, psychological defense mechanisms, and coping strategies. The novelty of the research lies in studying the relationships among the strategies of behavior in conflicts, coping strategies, and psychological defense mechanisms among adolescent boys and girls.&#x0D; Materials and Methods. These were the Life Style Index questionnaire (R. Plutchik); the Ways of Coping Questionnaire (WCQ) (R. Lazarus); The Thomas–Kilmann Conflict Mode Instrument (TKI). The study involved 23 boys and 16 girls, tenth and eleventh grade secondary school students in Lyubokhna, Bryansk region.&#x0D; Results. The study revealed a statistically significant difference in coping strategies and psychological defense mechanisms in difficult or stressful situations among adolescent boys and girls. The strategy of cooperation in conflict situations had a direct relationship with accepting responsibility and seeking social support in the group of adolescent boys. The strategy of cooperation in conflict situations had an inverse relationship with confrontational coping and self-controlling in the group of adolescent girls.&#x0D; Discussion. Adolescent boys and girls differ in how their strategies of behavior in conflicts are associated with coping strategies and defense mechanisms. The findings are useful for providing psychological assistance to adolescent boys and girls.

Current situation investigation and influencing factors analysis of life quality among asthma inpatients

Objective To explore the quality of life (QOL) of asthma inpatients and analyze its influencing factors. Methods From July 2016 to August 2017, 163 asthma inpatients of Department of Respiratory in China-Japan Union Hospital of Jilin University were selected by convenience sampling. All of the patients were investigated with the Asthma Quality of Life Questionnaire (AQLQ) , Medical Coping Modes Questionnaire (MCMQ) , Herth Hope Index (HHI) . Simple correlation and multivariate regression analysis was used to analyze patients' influencing factors of QOL. Results The total mean score of QOL of asthma inpatients was (3.41±0.46) . A total of 60.1% of patients mainly took confrontation coping mode. There was no patient with the low hope level, 33.1% of patients with the intermediate hope level and 66.9% with the high hope level. There was statistical difference in total score of QOL of patients with different ages, occupations, education, times of being admitted to hospital due to asthma, courses of disease, disease condition, types of drug using, hope level, coping modes (t=4.593, 3.315, 6.698, 4.826, 5.637, 2.686, 6.637, 19.752, 26.330; P<0.05) . Multivariate regression analysis showed that avoidance and confrontation coping mode, drug combination by various ways, whether with basic disease or not, marital status as well as overall hope level were main influencing factors of QOL of asthma inpatients. Conclusions The total QOL of asthma inpatients is below intermediate level. Most patients take confrontation medical coping mode. The overall hope level is high. The main influencing factors of QOL of asthma inpatients include types of drug combination, whether with basic disease or not, marital status, avoidance and confrontation coping mode as well as overall hope level. Key words: Asthma; Quality of life; Influencing factors

Correlations among hope level, coping style and life quality in myasthenia gravis patients

Objective To explore the relationships among hope level, coping style and quality of life (QOL) in myasthenia gravis (MG) patients. Methods From September 2016 to September 2017, 139 MG patients of Shaoxing People's Hospital were selected by convenience sampling. The hope level, coping style and QOL of patients were investigated with the Herth Hope Index (HHI) , Medical Coping Modes Questionnaire (MCMQ) and Quality of Life Questionnaire-Core 30 (QLQ-C30) . Pearson correlation and multiple linear regression were used to analyze the correlations among them and influencing factors of QOL respectively. Results The total score of HHI, score of confrontation dimension, avoidance dimension, yield dimension of MCMQ and score of total QOL of MG patients was (35.85±3.14) , (18.78±3.67) , (15.82±2.37) , (9.94±2.79) and (52.33±11.83) respectively. Correlation analysis showed the total score of HHI of MG patients was positively associated with the total score of total QOL (r=0.675, P<0.05) ; the confrontation coping style was positively associated with the total QOL (r=0.613, P<0.05) ; the yield coping style had a negative correlation with the total QOL (r=-0.582, P<0.05) . Multiple linear regression analysis revealed the influencing factors of QOL of MG patients included the burden of medical expense, classification of Myasthenia Gravis Foundation of America (MGFA) , total score of HHI and yield. Conclusions The QOL of MG patients is in a low level. The main influencing factors of QOL of patients involve the burden of medical expense, classification of MGFA, hope level and yield coping style. Key words: Myasthenia gravis; Quality of life; Level of hope; Coping style

The relative impact of workplace incivility and bullying as a social stressor at work : The effects of workplace incivility and bullying on employees’ coping and behavior

The purpose of this study is to measure the workplace incivility and bullying of deluxe hotel employees, and to examine whether different workplace incivility and bullying are ascribed to personal characteristics or unique culture of the workplace. The purpose of this study is to measure the workplace incivility and bullying of deluxe hotel employees and to examine whether different aspects of those behaviors can be ascribed to personal characteristics or to the unique culture of the workplace. A total of 224 usable questionnaires were collected. Structural equation analysis for the hypothesis test produced the outcome of χSUP2/SUP=637.316 (df=318), χSUP2/SUP/df=2.004, GFI=.836, NFI=.894, CFI=.942, and RMSEA=.067. Workplace incivility perceived by the employees in deluxe hotels significantly affected their avoidance coping behavior, but its impact on the employees’ confrontation coping behavior was insignificant. While workplace bullying significantly affected the employees’ confrontation coping behavior, it did not show a significant impact on the employees’ avoidance coping behavior. Among the factors that affected employees’ counterproductive work behavior, workplace incivility showed a significant impact and workplace bullying did not show a significant impact. Also, American employees more actively protected themselves in situations involving incivility or bullying by the method of confrontation coping as compared to Korean employees. This study puts stress on the necessity to expand the knowledge about workplace incivility and bullying, which are prevalent in deluxe hotels. It also provides a chance to stimulate further studies as it encourages comprehensive debates on incivility and bullying that occur in the working environment in deluxe hotels.

Spirituality, religiousness and coping in patients with schizophrenia: A cross sectional study in a tertiary care hospital

Religion is a form of coping that helps individuals to deal with a wide variety of difficult life situations. But most of the research in this field has been in acute patients of schizophrenia. Also, most of the research on religion and schizophrenia has focused on religion and spirituality as coping mechanisms, and research evaluating the relationship between spirituality/religiousness and repertoire of other coping skills is sparse. Our objective was to evaluate the association between spirituality, religiousness and coping skills in patients with schizophrenia in remission. Hence, a total of 48 consecutive patients with schizophrenia were assessed on Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale (PSP), WHO Quality of Life-Spirituality, Religiousness and Personal Belief scale (WHOQOL-SRPB) and Ways of Coping Checklist - Revised (WCC). Findings were described as patients who used more religiosity and spirituality as measured with WHO-SRPB domain score were better in their managing their stress as they used all the adaptive strategies like planful problem solving, positive reappraisal, distancing, self-controlling, seeking social support rather than maladaptive skills like confrontive coping and escape avoidance. A sound spiritual, religious, or personal belief system positively affects active and adaptive coping skills in patients with schizophrenia during remission, thus helping the individual to cope with illness related stressors.

Individual differences in corticolimbic structural profiles linked to insecure attachment and coping styles in motor functional neurological disorders

BackgroundInsecure attachment and maladaptive coping are important predisposing vulnerabilities for Functional Neurological Disorders (FND)/Conversion Disorder, yet no prior structural neuroimaging studies have investigated biomarkers associated with these risk factors in FND populations. This magnetic resonance imaging study examined cortical thickness and subcortical volumes associated with self-reported attachment and coping styles in patients with FND. We hypothesized that insecure attachment and maladaptive coping would relate to limbic-paralimbic structural alterations. MethodsFreeSurfer cortical thickness and subcortical volumetric analyses were performed in 26 patients with motor FND (21 women; 5 men) and 27 healthy controls (22 women; 5 men). For between-group comparisons, patients with FND were stratified by Relationship Scales Questionnaire, Ways of Coping Scale-Revised, and Connor-Davidson Resilience Scale scores. Within-group analyses were also performed in patients with FND. All analyses were performed in the complete cohort and separately in women only to evaluate for gender-specific effects. Cortical thickness analyses were whole-brain corrected at the cluster-wise level; subcortical analyses were Bonferroni corrected. ResultsIn women with FND, dismissing attachment correlated with reduced left parahippocampal cortical thickness. Confrontive coping was associated with reduced right hippocampal volume, while accepting responsibility positively correlated with right precentral gyrus cortical thickness. These findings held adjusting for anti-depressant use. All FND-related findings were within the normal range when compared to healthy women. ConclusionThese observations connect individual-differences in limbic-paralimbic and premotor structures to attachment and coping styles in FND. The relationship between parahippocampal thickness and dismissing attachment may indicate aberrant social-emotional and contextual appraisal in women with FND.

The effects of confrontation and avoidance coping in response to workplace incivility.

Workplace incivility has significant adverse consequences for targets. However, we know remarkably little about how targets of incivility cope and even less about which coping strategies are effective. Drawing on the coping process of the transactional model of stress, we examine confrontation as a form of problem-focused coping and avoidance as a form of emotion-focused coping in response to incivility. We examine the effects of these coping strategies on reoccurrence of incivility, incivility enacted by targets, psychological forgiveness, and emotional exhaustion. Focusing on the target's perspective of a series of uncivil interactions between a target and perpetrator, we conducted a 3-wave study of employees from various occupations. Employing the critical incident technique, participants reported on an incident of workplace incivility, and then answered a series of questions over 3 waves of data collection regarding their interactions with this perpetrator. Our findings suggest that confrontation and avoidance are ineffective in preventing reoccurrence of incivility. Avoidance can additionally lead to increased emotional exhaustion, target-enacted incivility, and lower psychological forgiveness. However, confrontation coping has promise with regards to eliciting positive outcomes such as psychological forgiveness that are beneficial to interpersonal workplace relationships. (PsycINFO Database Record

Stress and coping of police officers in the South African Police Service

Working in the police service can be physically and emotionally demanding. Officers use various coping methods to deal with the stressors. The main aim of this study was to investigate which coping responses are used most by police officers in the South African Police Service and to investigate how the prevalence of these coping responses changes over time. A longitudinal approach was used where data were collected at three different points in time. The final sample ( n = 120) was used for this study. The results indicate that police officers predominantly use planful problem-solving, positive reappraisal, and confrontive coping to deal with their daily stress. Planful problem-solving and positive reappraisal are seen as adaptive ways of dealing with stress, while the outcomes of confrontive coping are context dependent. The coping responses of seeking social support, escape avoidance, and accepting responsibility were used less frequently. The results indicate that coping styles change over time as police officers accepted significantly less responsibility, made less use of confrontive coping, and relied more on planful problem-solving, positive reappraisal, and escape avoidance. The findings of this study have important implications for the diagnosis and treatment of stress of active police officers. It is recommended that interventions such as emotional competence training be used to reinforce and refresh positive coping strategies to enhance the emotional well-being of police officers.

The relationship between coping styles and benefit finding of Chinese cancer patients: The mediating role of distress.

To identify the relationship of medical coping styles and benefit finding in Chinese early-stage cancer patients by preliminary pilot study. Three hundred and fifty one cancer patients were recruited from the Affiliated Jiangyin Hospital of Southeast University medical college and the Nantong Tumor Hospital in this study. Measurements were Chinese Benefit Finding Scale, Medical Coping Modes Questionnaire- Chinese version and Distress Thermometer. Regression analysis and pathway analysis were employed to identify the correlation of medical coping styles and benefit finding, and the mediating role of distress. Hierarchical regression analyses showed that confrontation coping style explained 24% of the variance in benefit finding, controlling for demographics and medical variables. While confrontation and resignation coping styles explained 10% and 6% of variance in distress separately. Pathway analyses implied that distress was found to mediate the effect of confrontation coping style on benefit finding in our study. Our study suggested an indirect association between medical coping styles and benefit finding, and a negative correlation of distress to medical coping styles and benefit finding. These results indicated that medical coping styles could influence benefit finding through distress.

A self-efficacy enhancing intervention for pulmonary rehabilitation based on motivational interviewing for postoperative lung cancers patients: modeling and randomized exploratory trial

The objective of this study was to evaluate the feasibility and preliminary efficacy of a self-efficacy enhancing intervention designed for pulmonary rehabilitation based on motivational interviewing (MI) for postsurgical non-small cell lung cancer (NSCLC) patients. This study was a 2-arm pilot randomized controlled trial and was conducted in two cardiothoracic surgery departments, a tertiary hospital in Fuzhou, China. 28 postsurgical NSCLC patients were randomized to a 3 month (6 session) self-efficacy enhancing intervention based on MI or usual care (UC). Data were measured at baseline and after intervention. The MI based self-efficacy enhancing intervention group was superior to the UC group for reducing anxiety and depression, improving self-efficacy, quality of life, confrontational coping, social support and functional capacity. However, no statistically significant difference was observed in subjective well-being, posttraumatic growth, body mass index and pulmonary function between the two groups. This pilot study demonstrated the feasibility of MI based self-efficacy enhancing intervention for postsurgical NSCLC patients. A larger randomized trial would demonstrate a more rigorous test of efficacy.

Factors associated with adoption of coping strategies among Chinese patients with heart failure in ethnic minority regions.

To examine the coping strategies in patients with heart failure (HF) in the ethnic minority regions of China and to explore the factors affecting the adoption of coping strategies. Effective coping with illness is an important element that influences the adaptation and increases the patient quality of life. Although different factors have been proposed to be determinants of coping strategy, findings are inconclusive, especially when it comes to the cultural background. A cross-sectional study was performed. A total of 360 HF patients in four districts of Xinjiang were enrolled. All participants completed the Medical Coping Modes Questionnaire, the Minnesota Living with HF Questionnaire and self-management Questionnaire. Heart failure patients had lower scores in confrontation and higher scores in avoidance and acceptance resignation than patients in the Chinese norm. The multiple regression analysis revealed several factors that indicate confrontation coping including symptom management, employment status and psychological and social management, whereas religion (R2), disease duration, employment status and payment system (P2) were identified as indicators of avoidance coping. In addition, ethnicity (E1), disease duration and employment status were indicators of acceptance resignation coping. Our findings from this study suggest that HF patients in the ethnic minority regions may use less confrontation coping and more avoidance and acceptance resignation coping than patients in the Chinese norm. Moreover, the cultural background, duration of disease, quality of life and self-management play important roles in the selection of HF coping strategy. The disparities of racial/ethnic exist in coping strategy. Healthcare providers are required to better understand the role of religion in the coping process and how it contributes to the selection of coping strategies.

The relationship between the family structure and characteristics of the stress reaction in adolescent addicts

To study the relationship between the family structure and characteristics of the response to stress in adolescent addicts. The study included 65 patients who used psychoactive substances and 42 healthy controls. A set of psychological methods was used. In the group of adolescent addicts, a low result was revealed on the scale 'family cohesion'. A high level of development of such mechanisms of psychological defense as denial, suppression, repression, compensation, substitution, intellectualization and reactive education was diagnosed in both groups. Significant differences were revealed only in repression. Such stress coping strategies as self-control, escape-avoidance and problem-solving were more often used in the main group while confrontational coping, distancing, seeking social support, accepting responsibility and positive reassessment were used in the control group. Lower indices of resilience in adolescent addicts compared to the control group.

Coping and Protective Behavior of Residents of Radioactive Contaminated Territories Depending on Age and Gender

The article examines the results of an empirical study of the coping and protective behavior of the residents of radioactive contaminated territories, depending on age and gender. The specifics of coping and protection are revealed depending on age and gender. It is shown that young men and women more often use non-constructive ways of coping behavior to cope with difficult life situations, in comparison with adult men and women. Men are worse than women at relieving stress and maintaining self-esteem in difficult life situations through the use of coping strategies. It was established that the residents of radioactive territories do not want to take responsibility for their lives, but passively expect assistance without any independent actions aimed at resolving their problems. It was revealed that substitution as a mechanism of psychological defense is more pronounced in adolescent and mature men than in girls and women, respectively. The relationship between defensive and coping behavior in adolescence and adulthood was described. It was established that in adolescence, confrontational coping, manifested through aggressive efforts aimed at actively asserting one’s opinion and desires in relations with others and trying to have one’s own way, through chaotic activities that do not change the situation, is closely related to the mechanisms of psychological defense. Substitution does not allow the use of constructive ways of coping both in adolescence and in adulthood. The results of the study can be used to provide psychological assistance to residents of radioactive contaminated areas.

Stress levels and coping behavior in patients with chronic insomnia

To assess stress level and coping strategies in chronic insomnia as its potential psychological factors. The study group included 29 patients (19 women), aged 18-55 years old (mean age 33.1±2.1 years), with chronic insomnia diagnosed in accordance with the International Classification of Sleep Disorders III. The control group was formed by 32 subjects (11 men), aged 18-55 years old (mean age 31.5±2.0 years), without sleep disorders. Insomnia Severity Index and polysomnography were used to evaluate sleep quality. Stress level and coping strategies were assessed via an interview (stressfull life events during last year, their duration, their controllability, unexpectedness, and outcome), and by 'Level of subjective control' and 'Ways of coping questionnaires'. Both groups were comparable by the mean number of significant events during last year (4.97±0.34 vs 4.72±0.23, p=0.54). Patients with insomnia more often reported the loss of a relative (p=0.04), while controls more frequently reported positive events, such as pregnancy (p=0.007) or wedding (p=0.02) among close ones. Insomniacs more often described the stressful events as uncontrolled (p<0.001) and prolonged (p<0.001). They demonstrated lower indices of all the scales of the 'Level of subjective control', questionnaire except the scale of interpersonal attitudes. They rarely implemented confrontive coping (p=0.001), seeking social support (p<0.001), accepting responsibility (p<0.001) and positive reappraisal (p<0.001). The interpretation of stressful events and personal response in insomnia patients might be considered as psychological risk factors for insomnia development.

A Study of Relationship between Hopelessness and Coping Strategies in Cancer Patients

Although cancer patients often experience hopelessness and other psychological problems, research on hopelessness and coping strategies is rare. The objectives of this study were to identify the levels of hopelessness experienced and the coping strategies used by breast, colorectal and stomach cancer patients.200 cancer patients (92 disfigured and 108 non-disfigured were included in the sample. Patients completed the sample survey packets comprising of Beck’s Hopelessness Scale (Beck, 1974) and Ways of Coping Questionnaire (Lazarus &amp; Folkman, 1988). Majority of the cancer patients were in moderate level of hopelessness. Seeking social support coping strategy was used most often by the cancer patients and Confrontive coping strategy was used the least. Significant negative correlation existed between hopelessness and use of coping strategies viz. distancing, self-controlling, accepting responsibility, Planful problem solving and positive reappraisal. t-test revealed more hopelessness in disfigured group of cancer patients. t-test also revealed that self-controlling and positive reappraisal coping strategies were used less by disfigured group of cancer patients.

Gender Differences of Stressful Life Events, Coping Style, Symptom Severity, and Health-Related Quality of Life in Patients With Panic Disorder.

Although affective disorders have been known to have sex differences in the associated clinical characteristics and quality of life (QOL), sex differences among patients with panic disorder (PD) have remained relatively unexplored in Korea. We examined the sex differences in different types of stressful life events (SLEs), coping styles, symptom severity, and health-related QOL (HRQOL) in patients with PD. Data from 291 female and 254 male participants diagnosed with PD were analyzed using a structured clinical interview following the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria. Females with PD reported more SLEs including separation issues, physical illness or disability, and pregnancy-related problems than males. They also reported lower levels of confrontation and help-seeking coping strategies and higher levels of agoraphobia in symptom severity than males. The HRQOL of females with PD was significantly lower than male in physical functioning of HRQOL. This study suggests that the patient's sex is relevant to the assessment and treatment of PD.

Confrontation as a Mediator between Sense of Coherence and Self-management Behaviors among Elderly Patients with Coronary Heart Disease in North China

Self-management is critical to improve health outcomes of elderly patients with coronary heart disease (CHD). Sense of coherence (SOC) is found to be linked with self-management behaviors. However, their deeper relationship is not clear. The purposes of this study were to investigate the association between SOC and self-management behaviors among elderly CHD patients in China, and whether confrontation mediates this association. A cross-sectional design was used. A total of 275 elderly patients with CHD recruited from the cardiology department in a general hospital in North China were surveyed from October 2015 to April 2016. SOC, confrontation, and self-management behaviors were measured using the Chinese version of the SOC scale, subscale of Medical Coping Modes Questionnaire-Confrontation, and the CHD self-management scale, respectively. Correlation analysis and path analysis were conducted to analyze the data. The mean (±standard deviation) scores of SOC, confrontation, and self-management behaviors were 62.20 (±9.61), 19.55 (±3.15), and 76.17 (±10.63), respectively. Correlation analysis showed that SOC, confrontation, and self-management behaviors were significantly correlated with each other. Path analysis indicated that SOC exerted a direct effect on self-management behaviors, whereas could affect self-management indirectly via confrontation. Bootstrap test result showed that confrontation played a mediating role (β=.20, p<.001) in the relationship between SOC and self-management behaviors. SOC was related to self-management behaviors, whereas confrontation mediated the effect of SOC on self-management behaviors. In practice, the role of confrontation coping should be valued when developing strategies to strengthen SOC and to improve self-management practice among elderly CHD patients.

Coping Styles Mediate the Relationship Between Self-esteem, Health Locus of Control, and Health-Promoting Behavior in Chinese Patients With Coronary Heart Disease.

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. 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. 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. 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. 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.