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Dissertation
Depressive symptoms and problem solving as predictors of adherence to the cardiac medical regimen
Doctor of Philosophy (Ph.D.), Medical College of Pennsylvania and Hahnemann University
Aug 1999
DOI:
https://doi.org/10.17918/00008424
Abstract
Adherence to the cardiac medical regimen involves diet, smoking reduction, exercise, taking medications, stress modification, and appointment keeping. Prior investigations, which focused on appointment keeping at Phase 11 programs, found that 50% of patients have poor adherence (Clark, 1997; Comoss, 1988; Farmer & Gotto, 1992; Oldridge, 1988). These studies have advanced the understanding of medical and demographic factors related to adherence but have largely ignored psychological variables. The present study addresses this gap in the literature by hypothesizing that depressive symptoms, problem-solving, and their interaction will predict adherence to the six components of the cardiac medical regimen above and beyond demographic (i.e., age, gender, smoking status, occupation, and knowledge) and medical (i.e., diagnosis and disease severity) variables. Participants completed the self-report questionnaires Profile of Mood States (McNair, Lorr, & Droppleman, 1992), Social Problem-Solving Inventory - Revised Short Form (D'Zurilla, Nezu, Nezu, & Maydeu-Olivares, in press), and Health Behavior Scale (Miller, Johnson, Garrett, Wikoff, & McMahon, 1982). Multiple regression analyses were conducted on 57 cardiac rehabilitation participants (56% men; mean age 62, SD = 10 years; 60% Caucasian, 35% African-American, 3% Hispanic, and 2% Asian) enrolled in a Phase II program. Participants were diagnosed with either myocardial infarction (n = 15) or angina (n = 11) and/or had coronary artery bypass grafting (n = 25), percutaneous transluminal coronary angioplasty (n = 19), or stents (n = 14). It was found that 41% of the variability in smoking reduction adherence can be accounted for by depressive symptoms and the demographic and medical variables, F(9, 47) = 3.69, p = .001. About 47% of the variability in smoking reduction adherence can be attributed to problem solving, depressive symptoms, and the demographic and medical variables, F(10, 46) = 4.08, p < .001. About 77% of the variability in smoking reduction adherence can be accounted for by problem solving, depressive symptoms, their interaction, and the demographic and medical variables, F(11, 45) = 13.52, p < .001. Results suggest that tailored behavioral medicine treatment may be needed to increase adherence to the smoking reduction regimen for cardiac patients with more depressive symptoms and fewer problem-solving abilities.
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Details
- Title
- Depressive symptoms and problem solving as predictors of adherence to the cardiac medical regimen
- Creators
- Stephanie Lynn Deaner
- Contributors
- Arthur M. Nezu (Advisor) - Drexel University, Medical College of Pennsylvania and Hahnemann University (1993-1996, 1998-2002)
- Awarding Institution
- Medical College of Pennsylvania and Hahnemann University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Medical College of Pennsylvania and Hahnemann University; Philadelphia, Pennsylvania
- Number of pages
- xi, 153 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Medical College of Pennsylvania and Hahnemann University (1993-1996, 1998-2002); Clinical and Health Psychology [Historical]; School of Health Professions (1998-2000)
- Other Identifier
- 991021888869604721