Analysis Of The Level Of Resilience And Its Protective Factors Among Patients With Acute Myocardial Infarction

ObjectivesTo investigate the level of resilience in patients with acute myocardial infarction (AMI);to analyze the correlation between resilience and the personal, family and social factors in the dynamical systems theory model of resilience; to explore the protective factors of resilience in order to provide implications to improve the resilience of AMI patients from the perspective of positive psychology.MethodsConvenience sampling method was adopted and a total of 202 AMI patients from two tertiary lstclass general hospitals of Shandong Province were selected. The data collection tools included general information and clinical information questionnaire, Connor-Davidson Resilience Scale (CD-RISC 10),General Self-Efficacy Scale (GSES), Internality, Powerful Others and Chance Scale (IPC), the Positive and Negative Affect Scale (PANAS), Family Apgar Index (FAI) and Perceived Social Support Scale (PSSS) to collect information related to the level of resilience and personal characteristics (including self-efficacy, emotional state and locus of mental control), family care index and social support. SPSS 18.0 software was used for data input and statistical analysis, including descriptive statistics, one-way analysis of variance(ANOVA), independent sample t-test, Pearson correlation analysis and hierarchical multiple linear regression analysis.Results1. Demographic data and clinical informationThe average age of the participants was 61.90 (SD=11.17), among which patients over 60 years old accounted for 55.4% and 64.9% were male. About 74.8% of the patients were still on work. Patients with coronary heart disease (CHD) accounted for 55% and patients with CHD family history accounted for 23.3%.40.1% of the patients had emotional predisposing factor and 32.7%of the patients experienced fatigue before heart attack.23.8% of the patients had AMI complication, including post-infarction syndrome, arrhythmia, ventricular aneurysm and cardiac shock. Patients with level 1 NYHA account for 53.5%.2. Resilience score and its difference in demographic data and clinical information The mean (SD) score of resilience was 25.38(6.30). Among them, the score less than 20 accounted for 29.2%,20 to 30 scores accounted for 53% and over 30 scores accounted for 17.8%. ANOVA showed that there were significant difference in resilience among patients with different gender, occupation, education level, place of residence, family income and cardiac function grading (P<0.05).Among them, male gender, retirement, higher education level, urban resident and higher family income were protective factors. The better the cardiac function, the higher score in resilience. Meanwhile, patients with CHD history scored higher than patients with no CHD history (P=0.051)3. Correlation between the psychological and social factors and the resiliencePearson correlation analysis indicated that resilience positively related with self-efficacy, positive emotions, internal control, perceived social support and family care index (r=0.427-0.747, P<0.05) and negatively related with negative emotions, opportunity, and the powerful others (r=-.011～-0.258, P<0.05).4. Regression analysis of the protective factors of resilienceUnivariate regression analysis showed that self-efficacy, internal control, positive emotions, perceived social support and family care index positively predicted resilience respectively. (β=0.427-0.747,P<0.001) while opportunity, the powerful others negatively predicted resilience(β=-0.011-0.258,.P<0.001). Negative emotions had no impact on the resilience.Hierarchical regression analysis showed that self-efficacy and locus of mental control positively predicted the resilience in the second step (β= 0.547, P< 0.001;β= 0.168, P = 0.005) and they accounted for 40.4% of variance in resilience. In the third step, self-efficacy, internal control and the family care positively predicted the resilience (fi= 0.498, P< 0.001; 0= 0.165, P= 0.005;β= 0.162, P=0.002) and family care index accounted for 1.8% of the variance in resilience. In the fourth step, self-efficacy, internal control and family care index positively predicted the resilience (β= 0.473, P< 0.001; β= 0.140, P=0.024; β= 0.145, P= 0.007) while social support did not predict the resilience(β=0.093, P=0.165).Conclusion1.The level of resilience in AMI patients was in the middle level.2.Self-efficacy, internal control, positive emotions, perceived social support and family care index positively correlate with the resilience of AMI patients while opportunity and powerful others negatively correlate with the resilience.3.Self-efficacy, internal control and family care index positively predict the resilience and they are the protective factors of the resilience of AMI patients.