The relationship between stress appraisal, coping behavior, and subjective well-being in Chinese elderly with a diagnosis of congestive heart failure

Abstract

The purpose of this study was to examine the relationships between stress appraisal, coping behavior, and subjective well-being. The theoretical framework for the investigation was based on a process theory of stress and coping developed by Lazarus and Folkman (1984). A descriptive correlational research design was used to examine the relationships among the variables. Convenience sampling was used to select the subjects from three hospitals in Northern Taiwan. A convenience sample of 133 Chinese elderly aged 60 and over had a diagnosis of Congestive Heart Failure. Subjects were interviewed with structured questionnaires. Stress appraisal was measured by the Appraisal Scale. Coping was measured by the revised Ways of Coping Checklist. Subjective well-being was measured by the Philadelphia Geriatric Center Morale Scale. Descriptive statistics were reported for several demographic variables. Several multiple regressions were performed to determine the significance of the independent variables. Those Chinese elderly patients who perceived Congestive Heart Failure as a challenge, used more problem-focused coping and less emotional-focused coping. When Congestive Heart Failure is viewed as a threat or harm, they used more emotional-focused coping. There were no significant relationships between benefit appraisal and coping behaviors. The seven significant predictors of subjective well-being were identified as higher income, less threat and harm appraisals, less avoidance coping behavior, and higher health perception. Demographics (age, gender, education and income), severity of illness, and comorbidity variables together explained a significant amount of the variance (11%) in subjective well-being, but only income was an individually significant predictor. Stress appraisal, coping behaviors, physical functioning, and health perception contributed an additional statistically significant amount variance (46%) of subjective well-being after controlling for demographic variables, severity of illness, and comorbidity. Additional findings indicated that men had significantly higher physical functioning and subjective well-being than women. In addition, men used more problem-focused coping. Findings provide more information for health care providers to recognize the variables that influence subjective well-being, identify patients at greater risk for lower subjective well-being, and assist patients to achieve the highest subjective well-being possible within the constraints of their heart disease.