Perceived Stress, Ways of Coping, and Health Promoting Behavior in Patients with Chronic Cardiovascular Disease

만성심혈관환자의 스트레스 지각, 대처행위, 건강증진행위

  • Published : 2004.08.01


Purpose: The purpose of this study was to identify the relationship among perceived stress, ways of coping, and health promoting behaviors in patients with chronic cardiovascular disease(CCVD). Method: Data was collected by questionnaires from 436 patients with CCVD in a General Hospital in Seoul. The data was analyzed using descriptive statistics, Pearson correlation coefficients, and stepwise multiple regression. Result: The health promoting behavior showed a significant positive correlation with self-efficacy and social support. Also, the health promoting behavior showed a significant negative correlation with perceived stress and symptoms of stress. The stepwise multiple regression analysis revealed that the most powerful predictor of health promoting behaviors was symptoms of stress. Conclusion: A combination of symptoms of stress, social support, self-efficacy, and perceived stress account for 41% of the variance in health promoting behaviors of patients with CCVD. Data from this study suggest that symptoms of stress, social support, ways of coping, and perceived stress are significant influencing factors on health promoting behaviors of patients with CCVD.


  1. Andrew, S, (1998), Psychological factors and cardiovascular disease. Curr Opin Psychiatry, 11(6), 655-660
  2. Korea National Statistical Office (2003), Statistics for morbidity and mortality of the Korean.
  3. Cameron, L., Leventhal, E, A., & Leventhal, H, (1995), Seeking medical care in response to symptoms and life stress, Psychosom Med, 57(1), 37-47
  4. Frank, W. D., Ramsey, S. L., & Shelley, M. C. (2002). Relationship between cardiovascular disease morbidity, risk factors, and stress in a law enforcement cohort. J Occup Environ Med, 44(12), 1182-1189
  5. Han, K. S. (1997). Effect of an integrated stress management program on symptoms of stress of the psychophysiological patients. Doctoral dissertation. Yonsei University, Seoul
  6. Han, K. S., Lee, P. S., & Lee, Y. M. (2000). Influencing factors on symptoms of stress of the middle aged women. J Korean Acad Nurs, 30(6), 1427-1436
  7. Hong, G. P. (2003). Cardiac rehabilitation program. Samsung medical center, Cardiac rehabilitation team.
  8. Kogan, N. H., Gaber, A., & Egan, K. (1988). Hypertension self-regulation : predictors of success in diastolic blood pressure reduction. Res Nurs Health, 11, 105-115
  9. Korea Ministry of Health and Welfare (2000). Health and welfare for new millenium 2010.
  10. Laffrey, S. C., Bailey, B. J., & Carig, K. K (1996). Social support and health promotion outcomes of adults with Psoriasis. Dermatol Nurs, 8(2), 109-143
  11. Laura, G., Nicholas, C., & William, G. (1999). Gender, Social support, and cardiovascular responses to stress. Psychosom Med,. 61(2), 234-242
  12. Lee, P. S., & Han, K S. (1999). Stress appraisal, ways of coping, mood state, and symptoms of stress of the essential hypertension. Korean J Stress Res, 7(2), 31-44
  13. Levenstein, C., Prantera, V., Varvo, M., Scribano, E., & Betro, C. (1993). Development of the perceived stress questionnaire : a new tool for psychosomatic research. J Psychosom Res, 37(1), 19-32
  14. Lee, S. J., Kim, S. I., Lee, P. S., Khim, S. Y., Park, E. S., Park, Y. J., Ryu, H. S., Chang, S. O., & Han, K S. (2002). Construct a structural model for health promoting behavior of chronic illness. J Korean Acad Nurs, 32(1), 62-76
  15. Leventhal, H., Diefenbach, M., & Leventhal, E. A .(1992). Illness cognition : Using common sense to understand treatment adherence and affect cognition interactions. Cognit Ther Res, 16, 143-163
  16. Lipowski, Z. J. (1985). Psychosomatic Medicine and Liason Psychiatry. NewYork : Plenum Medical Book Co.
  17. McWilliam, C. L., Stewart. M., Brown, J. B., Desai, K, & Coderre, P. (1996). Creating health with chronic illness. ANS, 18(3), 1-15
  18. Merz, C., Dwyer, J., Nordstrom, C. K, Walton, K., Salerno, J., & Schneider, R. (2002). Psychosocial stress and cardiovascular disease : pathophysiological links. Behav Med, 27(4), 141-147
  19. Miriam, S., Karina, D., Darlene, M., Alexandra, H., & Lydia, M. (2000). Myocardial infarction : survivors' and spouses' stress, coping, and support. J Adv Nurs, 31(6), 1351-1360
  20. Noro, A., & Aro, S. (1996). Health-related quality of life among the least dependent institutional elderly compared with the non-institutional elderly population. Qual Life Res, 5(3), 355-366
  21. Oh, D. J. (2003). Characteristics of cardiovascular disease. In proceeding book of the symposium for heart disease prevention, The Korean Society of Circulation
  22. Oh, H. S. (1993). Health promoting behaviors and quality of life of Korean Women with arthritis. Unpublished doctoral dissertation. The University of Texas Austin
  23. Pakenham, K I. (1999). Adjustment to multiple sclerosis : application of a stress and coping model. Health Psychol, 18(4), 383-392
  24. Pender, N. J. (1999). Health promotion and nursing. Unpublished manuscript, Nursing Research Institute in Korea University, Seoul, Korea
  25. Primomo, J., Yates, B. C., & Woods, N. F. (1990). Social support for women during chronic illness : the relationship among sources and types to adjustment. Res Nur Health, 13(3), 153-161
  26. Ramsey, S. L. (2003). Cardiovascular disease risk factors and the perception of general health among male law enforcement officers; encouraging behavioral change. AAOHN J, 51(5), 219-226
  27. Reiser, M. F. (1984). Mind, brain, body : toward a convergence of psychoanalysis and neurobiology. NewYork : Basic Books
  28. Sarah, K. S., Avril, A., Curtis, E. R., Donna, A. K., Kimberly, S., Gerdi, W., & Michael, P. A. (2000). Hostility, social support, and carotid artery atherosclerosis in the national heart, lung, and blood institute family heart study. Am J Cardiol, 86(10), 1086-1089
  29. Sawatzky, J. V., & Maimark, B. J. (2002). Physical activity and cardiovascular health in aging women : a health promotion perspective. J Aging Phys Act, 10(4), 396-412
  30. Speca, M., Carlson, L. E., Goodey, E., & Angen, M. (2000). A randomized, wait-list controlled clinical trial : the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med, 62(5), 613-622
  31. William, G., D'vorah M., Shalinee, C., & Thomas, P. G. (1995). Social support as a moderator of cardiovascular reactivity in women : a test of the direct effects and buffering hypotheses. Psychosom Med, 57(1), 16-22