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Original Article

The Mediating Effects of Resilience between Symptom Experience and Depression in Patients with Chronic Obstructive Pulmonary Disease

Korean Journal of Adult Nursing 2015;27(4):375-383.
Published online: August 31, 2015

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Corresponding author: Lee, Eun-Nam Department of Nursing, Dong-A University, 1 Dongdaesin-dong 3-ga, Seo-gu, Busan 602-714, Korea. Tel: +82-51-240-2864, Fax: +82-51-240-2920, E-mail: enlee@dau.ac.kr
• Received: July 23, 2015   • Accepted: August 4, 2015

Copyright © 2015 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to identify the relationship of resiliency and symptom experience and depression. Subjects (N=152) were patients with chronic obstructive pulmonary disease (COPD).admitted to D University Medical Center in B City.
  • Methods
    Data collection was conducted from July 20 to August 25, 2013. The levels of symptom, resilience, and depression were measured using a seven question symptom experience measuring instrument, a 25-question resilience instrument, and a 15-question Short Geriatric Depression Scale (SGDS). The collected data were analyzed by descriptive analysis, Pearson's correlation coefficients, and path analysis using SPSS/Win 19.0 and AMOS 5.0.
  • Results
    There was a significant negative correlation between symptom and resilience, a significant positive correlation between symptom and depression, and a significant negative correlation between resilience and depression. Symptom showed a direct effect on depression and an indirect effect on depression scores through resilience as a mediating variable.
  • Conclusion
    It is necessary to develop nursing intervention programs to relieve symptom in COPD patients, and to develop appropriate resilience enhancement programs to reduce their depression.
Figure 1.
Path model of symptom, resilience, and depression.
kjan-27-375f1.jpg
Table 1.
General and Disease-related Characteristics of the Subjects (N=151)
Variables Categories n (%) or M±SD
Gender Male 108 (71.5)
Female 43 (28.5)
Age (year)   67.5±9.2
<60 25 (16.6)
60~64 25 (16.6)
65~69 31 (20.5)
70~74 36 (23.8)
≥75 34 (22.5)
Marital status Married 123 (81.4)
Widowed 25 (16.6)
Divorced 3 (2.0)
Educational level None 10 (6.6)
Elementary school 45 (29.8)
Middle school 35 (23.2)
High school 44 (29.1)
≥College 17 (11.3)
Family living together Yes 132 (87.4)
No 19 (12.6)
Income (10,000 won) <100 61 (40.4)
100~<200 32 (21.2)
200~<300 26 (17.2)
≥300 32 (21.2)
Smoking history Never smoker 63 (41.7)
Current smoker 15 (9.9)
Ex-smoker 73 (48.4)
Oxygen therapy Yes 23 (15.2)
No 128 (84.8)
Period from diagnoses (year)   7.36±8.36
<2 33 (21.9)
2~<6 36 (23.8)
6~<10 42 (27.8)
≥10 40 (26.5)
Admission history Yes 104 (68.9)
No 47 (31.1)
Comorbidity Yes 87 (57.6)
No 64 (42.4)
Admission channel Inpatient 52 (34.4)
Outpatient 99 (65.6)
Severity of COPD (FEV1)   52.89±18.64
I (≥80%) 11 (7.3)
II (50~79%) 72 (47.7)
III (30~49%) 46 (30.4)
IV (<30%) 22 (14.6)

COPD=chronic obstructive pulmonary disease, FEV1=forced expiratory volume in 1 second.

Table 2.
The Level of Symptoms, Resilience, and Depression (N=151)
Variables n (%) or M±SD Range
Symptoms 15.56±10.67 0~63
Resilience 86.11±9.93 25~125
Depression 5.70±4.14 0~15
Normal group (<8) 93 (61.6)  
Depressive group (≥8) 58 (38.4)  
Table 3.
Correlations between the Symptoms, Resilience and Depression (N=151)
Variables Symptoms Resilience Depression
r (p) r (p) r (p)
Symptoms 1    
Resilience -.29 (<.001) 1  
Depression .42 (<.001) -.42 (<.001) 1
Table 4.
The Mediating Effect of Resilience on the Relationship between Symptom and Depression (N=151)
Endogenous variables Exogenous variables Path coefficient Direct effect In ndirect effec ct Total effect t p SMC
β (p) β (p) β (p)
Resilience Symptoms -.27 -.29 (.010) - -.29 (.010) -3.65 <.001 .08
Depression Symptoms .13 .32 (.010) .09 (.010) .42 (.010) 4.41 <.001 .27
  Resilience -.14 -.33 (.010) - -.33 (.010) -4.52 <.001  

SMC=squared multiple correlation.

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Figure & Data

References

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    The Mediating Effects of Resilience between Symptom Experience and Depression in Patients with Chronic Obstructive Pulmonary Disease
    Image
    Figure 1. Path model of symptom, resilience, and depression.
    The Mediating Effects of Resilience between Symptom Experience and Depression in Patients with Chronic Obstructive Pulmonary Disease

    General and Disease-related Characteristics of the Subjects (N=151)

    Variables Categories n (%) or M±SD
    Gender Male 108 (71.5)
    Female 43 (28.5)
    Age (year)   67.5±9.2
    <60 25 (16.6)
    60~64 25 (16.6)
    65~69 31 (20.5)
    70~74 36 (23.8)
    ≥75 34 (22.5)
    Marital status Married 123 (81.4)
    Widowed 25 (16.6)
    Divorced 3 (2.0)
    Educational level None 10 (6.6)
    Elementary school 45 (29.8)
    Middle school 35 (23.2)
    High school 44 (29.1)
    ≥College 17 (11.3)
    Family living together Yes 132 (87.4)
    No 19 (12.6)
    Income (10,000 won) <100 61 (40.4)
    100~<200 32 (21.2)
    200~<300 26 (17.2)
    ≥300 32 (21.2)
    Smoking history Never smoker 63 (41.7)
    Current smoker 15 (9.9)
    Ex-smoker 73 (48.4)
    Oxygen therapy Yes 23 (15.2)
    No 128 (84.8)
    Period from diagnoses (year)   7.36±8.36
    <2 33 (21.9)
    2~<6 36 (23.8)
    6~<10 42 (27.8)
    ≥10 40 (26.5)
    Admission history Yes 104 (68.9)
    No 47 (31.1)
    Comorbidity Yes 87 (57.6)
    No 64 (42.4)
    Admission channel Inpatient 52 (34.4)
    Outpatient 99 (65.6)
    Severity of COPD (FEV1)   52.89±18.64
    I (≥80%) 11 (7.3)
    II (50~79%) 72 (47.7)
    III (30~49%) 46 (30.4)
    IV (<30%) 22 (14.6)

    COPD=chronic obstructive pulmonary disease, FEV1=forced expiratory volume in 1 second.

    The Level of Symptoms, Resilience, and Depression (N=151)

    Variables n (%) or M±SD Range
    Symptoms 15.56±10.67 0~63
    Resilience 86.11±9.93 25~125
    Depression 5.70±4.14 0~15
    Normal group (<8) 93 (61.6)  
    Depressive group (≥8) 58 (38.4)  

    Correlations between the Symptoms, Resilience and Depression (N=151)

    Variables Symptoms Resilience Depression
    r (p) r (p) r (p)
    Symptoms 1    
    Resilience -.29 (<.001) 1  
    Depression .42 (<.001) -.42 (<.001) 1

    The Mediating Effect of Resilience on the Relationship between Symptom and Depression (N=151)

    Endogenous variables Exogenous variables Path coefficient Direct effect In ndirect effec ct Total effect t p SMC
    β (p) β (p) β (p)
    Resilience Symptoms -.27 -.29 (.010) - -.29 (.010) -3.65 <.001 .08
    Depression Symptoms .13 .32 (.010) .09 (.010) .42 (.010) 4.41 <.001 .27
      Resilience -.14 -.33 (.010) - -.33 (.010) -4.52 <.001  

    SMC=squared multiple correlation.

    Table 1. General and Disease-related Characteristics of the Subjects (N=151)

    COPD=chronic obstructive pulmonary disease, FEV1=forced expiratory volume in 1 second.

    Table 2. The Level of Symptoms, Resilience, and Depression (N=151)

    Table 3. Correlations between the Symptoms, Resilience and Depression (N=151)

    Table 4. The Mediating Effect of Resilience on the Relationship between Symptom and Depression (N=151)

    SMC=squared multiple correlation.

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