The Relationship Among Self-esteem, Psychological Flexibility And Depression Of Coronary Heart Disease

Objectives To explore psychological flexibility of coronary heart disease patients, and its influence factors among Socio-demographic characteristics and disease characteristics. To investigate the relationship among self-esteem, psychological flexibility and depression of chronic disease and exploring whether psychological flexibility mediated the relationship between self-esteem and and depression.Methods A descriptive study was conducted among coronary heart disease. We selected Coronary heart disease patients conveniently from a tertiary-level hospital in HeFei, Anhui province during May 2014 and May 2015. Totally 177 Coronary heart disease patients were investigated with he demographic questionnaire, Rosenberg self esteem scale, Acceptance and Action Questionnaire-the second version,Self-rating Depression Scale. Statistical Product and Service Solutions were used for the statistics.Results The average score was (25.99±8.31) for psychological flexibility, (26.88±4.86) for self-esteem, (53.10±10.16) for depression. Univariate analysis showed that there existed difference in psychological flexibility for Coronary heart disease patients at difference of age, sex, education level, employment and the level of NYHA (P<0.05). Multiple linear regression indicated that age, sex, education level and the level of NYHA were the influencing factors, totally explain 26.8% of the variation. Correlation analysis showed that psychological flexibility were positively correlated with self-esteem(r=0.761,P<0.01), self-esteem were negatively correlated with depression(r=-0.558,P<0.01), psychological flexibility were negatively correlated with depression(r=-0.662,P<0.01). Mediating effect analysis indicated that both psychological flexibility and self-esteem were the predictive factors of depression, psychological flexibility mediated the relationship between self-esteem and and depression, in which the intermediary effect ratio was 65.8%.Conclusions First, Socio-demographic characteristics and disease characteristics, such as age, sex, education level and the level of NYHA may influence the psychological flexibility which is the core concepts of Acceptance and Commitment Therapy. Researchers should consider these factors when they want to improve the psychological flexibility of coronary heart disease patients with the intervention of Acceptance and Commitment Therapy. Second, both self-esteem and psychological flexibility had direct effect on depression, and psychological flexibility mediated the relationship between self-esteem and and depression. It suggested that in order to improve the depression among coronary heart disease, we can not only improve the self-esteem, but also improve the psychological flexibility.