The Relationship Among Dyadic Coping,anxiety And Depression Of Young And Middle-aged Patients With Coronary Heart Disease And Their Spouses

Objective:To investigate the status of dyadic coping,anxiety and depression in young and middle-aged patients with coronary heart disease and their spouses.To analysis the relationship among dyadic coping,anxiety and depression by using actor-partner interdependence model constructed by the method of structural equation.Thus giving evidence for formulating targeted interventions to improve the coping style of patients and their spouses against coronary heart disease and reduce the level of anxiety and depression in both parties.Methods:245 young and middle-aged patients with coronary heart disease and their partners from Cardiology Department of the Third Affiliated Hospital of Soochow University were investigated by convenience sampling from November 2018 to October 2019.Patients and their spouses completed the general data questionnaire,Dyadic Coping Inventory and Hospital Anxiety and Depression Scale.SPSS 24.0 and Amos 24.0 statistical analysis of data were used.Effective data were analyzed using the method of descriptive statistics,Chi-square test,t test,non-parametric test,correlation analysis,structural equation modeling analysis.Results:1.The detection rates of anxiety and depression between young and middle-aged patients with coronary heart disease and their spousesAmong 245 patients:78 patients(31.83%)had anxiety,61 patients(24.89%)had depression,47 patients(19.18%)had both anxiety and depression.Among 245 spouses:73 spouses(29.79%)had anxiety,72 spouses(29.38%)had depression,40 spouses(16.33%)had both anxiety and depression.There was no significant difference in the incidence of anxiety,depression and anxiety combined depression between patients and their spouses(χ=0.239～1.249,P>0.05).2.The scores of dyadic coping styles between young and middle-aged patients with coronary heart disease and their spousesThe scores of five dimensions of dyadic coping of patients were:stress communication(3.27±0.59),support dyadic coping(3.44±0.59),delegated dyadic coping(3.47±0.76),common dyadic coping(3.52±0.65)and negative dyadic coping(1.98±0.68).The scores of spouses’ were:stress communication(3.34±0.55),support dyadic coping(3.50±0.58),delegated dyadic coping(3.54±0.73),common dyadic coping(3.54±0.63)and negative dyadic coping(1.99±0.76).Patients and spouses’ total dyadic coping and dimensions of positive dyadic coping were at a medium level,paired t-test showed that there was no significant difference in the four dimensions of positive dyadic coping between patients and their spouses(t=-1.917～-0.417,P>0.05).Patients and their spouses’ negative dyadic coping were at a low level,paired t-test showed that there was no significant difference in the negative dyadic coping between patients and their spouses(t=-0.220,P>0.05).3.Analysis of influential factors of anxiety and depression in young and middle-aged patients with coronary heart disease and their spousesBinary Logistic regression results show that family month income less than 3000 yuan was the risk factor of anxiety of patients,working status was the protective factor of anxiety of patients.Family month income less than 5000 yuan was the risk factor of depression of patients,working status was the protective factor of depression of patients.Family month income less than 3000 yuan,non-st-segment elevation myocardial infarction and unstable angina were the risk factors of anxiety of spouses,family month income less than 3000 yuan was the risk factor of depression of spouses.4.Correlation analysis of dyadic coping,anxiety and depression in young and middle-aged patients with coronary heart disease and their spousesThe anxiety and depression of young and middle-aged patients with coronary heart disease were positively correlated with the spouses’ anxiety and depression(r=0.223～0.478,P<0.01).Patients’ positive dyadic coping was positively correlated with that of their spouses’(r=0.372～0.467,P<0.01),patients’ negative dyadic coping was positively correlated with that of their spouses’(r=0.275,P<0.01).5.The results of actor-partner interdependence model of dyadic coping and anxiety and depression in young and middle-aged patients with coronary heart disease and their spousesActor effects:positive dyadic coping of patients and their spouses can negatively predict their own anxiety and depression(βpatients=-0.325,βspouses=-0.375,P<0.05),negative dyadic coping of patients and their spouses can positively predict their own anxiety and depression(βpatients=0.170,βspouses=0.125,P<0.01).Partner effects:positive dyadic coping of patients and their spouses can negatively predict the level of anxiety and depression of the other party(βpatients=-0.336,βspouses=-0.518,P<0.01),negative dyadic coping of patients and their spouses can positively predict the anxiety and depression of the other person(βpatients=0.161,βspouses=0.174,P<0.01).Conclusion:1.The detection rates of anxiety and depression are high in young and middle-aged patients with coronary heart disease and their spouses.Binary Logistic regression results show that family month income and occupational status are influential factors of anxiety and depression in young and middle-aged patients with coronary heart disease.Family month income and diagnosis are the influencing factors of anxiety in spouses,family month income is the influencing factor of depression in spouses.2.The scores of positive dyadic coping of young and middle-aged patients with coronary heart disease and their spouses are at a medium level,and the negative dyadic coping are at a low level.3.The scores of anxiety,depression and dyadic coping are significant correlated between young and middle-aged patients with coronary heart disease and their spouses.4.The level of anxiety and depression of young and middle-aged patients with coronary heart disease and their spouses are affected by their own and their partners’ dyadic coping styles.The higher the level of positive dyadic coping,the lower the level of anxiety and depression of themselves and their spouses.The higher the level of negative dyadic coping,the higher the level of anxiety and depression of themselves and their spouses.