Yes, I can (with you)! Dyadic coping and self-management outcomes in cardiovascular disease: The mediating role of health self-efficacy

Cardiac patients show alarming levels of nonadherence to medications. It is important
to consider also patient activation levels. Furthermore, the partner could have a supporting
role in these processes. The aim of this study was to investigate the mediating
role of patient health self-efficacy
(HSE) in the link between dyadic coping (DC) and two
self-management
outcomes (i.e. medication adherence and patient activation) across
the first 6 months of cardiac disease. One hundred couples completed two self-report
questionnaires during the hospitalisation for cardiac disease and 6 months after discharge.
A longitudinal and dyadic research design was adopted. Cross-sectional
analyses
at T0 revealed that patient-provided
and perceived positive DC and common DC
are positively associated with HSE, which in turn is positively associated with medication
adherence. HSE mediated the association between patient positive and common
DC styles, with the only exception of Patient-provided
positive DC, and patient activation.
Conversely, patient-provided
and perceived negative DC are negatively associated
with HSE, which in turns is positively associated with medication adherence and
patient activation. Prospective analyses showed that only patient-perceived
negative
DC at discharge is negatively associated with HSE at T1, which in turns is positively
associated with patient activation over time. These results suggest to consider patient
perceived and provided DC as antecedents of self-management
outcomes via patient
HSE. Furthermore, our results recommend to pay particular attention to negative DC,
whose negative consequences are manifested also over time, planning interventions
targeting partners’ awareness of their own DC style.

Corresponding author: giada.rapelli@unibo.it