{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:06:50Z","timestamp":1790370410325,"version":"4.1.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Previous research has shown that medical coping modes are associated with resilience in cardiovascular disease patients. However, postoperatively, the mechanism underlying this association in Stanford type A aortic dissection patients is poorly understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study investigated the mediating effects of social support and self-efficacy on the relationship between medical coping modes and resilience in Stanford type A aortic dissection patients postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed 125 patients after surgery for Stanford type A aortic dissection using the Medical Coping Modes Questionnaire, the General Self-Efficacy Scale, the Social Support Rating Scale, and the Connor\u2013Davidson Resilience Scale. Structural equation modeling with AMOS (v.24) was used to test the hypothesized model with multiple mediators. Both direct and mediational effects (through social support and self-efficacy) of medical coping modes on resilience outcomes were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean Connor\u2013Davidson Resilience Scale score was 63.78\u2009\u00b1\u200912.29. Confrontation, social support, and self-efficacy correlated with resilience (<jats:italic>r<\/jats:italic>\u2009=\u20090.40, 0.23, 0.72, respectively; all <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.01). In multiple mediation models, social support independently (effect\u2009=\u20090.11; 95% confidence interval [CI], 0.04\u20130.27) and social support and self-efficacy serially (effect\u2009=\u20090.06; 95% CI, 0.02\u20130.14) mediated the association of confrontation with resilience maintenance, accounting for 57.89 and 10.53% of the total effect, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Social support and self-efficacy were multiple mediators of the relationship between confrontation and resilience. Interventions designed to facilitate confrontation and subsequently increase social support and self-efficacy may be useful to increase resilience in Stanford type A aortic dissection patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2023.1174038","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T13:10:50Z","timestamp":1685538650000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Social support and self-efficacy multiply mediate the relationship between medical coping style and resilience in patients with type A aortic dissection"],"prefix":"10.3389","volume":"14","author":[{"given":"Miaoxuan","family":"Hong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxuan","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"4070","DOI":"10.21037\/jtd-20-912","article-title":"Quantifying the learning curve of emergent total arch replacement in acute type A aortic dissection","volume":"12","author":"Liu","year":"2020","journal-title":"J Thorac Dis"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1093\/icvts\/ivt481","article-title":"Haemolytic anaemia resulting from the surgical repair of acute type a aortic dissection","volume":"18","author":"Sekine","year":"2014","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1002\/clc.22418","article-title":"Survivors of aortic dissection: activity, mental health, and sexual function","volume":"38","author":"Chaddha","year":"2015","journal-title":"Clin Cardiol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1093\/icvts\/ivy036","article-title":"Health-related quality of life of patients after surgery for acute type a aortic dissection","volume":"27","author":"Adam","year":"2018","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1055\/s-0035-1548734","article-title":"Long-term outcome and quality of life in aortic type a dissection survivors","volume":"64","author":"Endlich","year":"2016","journal-title":"Thorac Cardiovasc Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/s11916-010-0095-9","article-title":"Resilience: a new paradigm for adaptation to chronic pain","volume":"14","author":"Sturgeon","year":"2010","journal-title":"Curr Pain Headache Rep"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e015247","DOI":"10.1161\/JAHA.119.015247","article-title":"Cardiovascular risk and resilience among black adults: rationale and design of the MECA study","volume":"9","author":"Islam","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1093\/eurjcn\/zvaa008","article-title":"Resilience and associated psychological, social\/cultural, behavioural, and biological factors in patients with cardiovascular disease: a systematic review","volume":"20","author":"Love","year":"2021","journal-title":"Eur J Cardiovasc Nurs"},{"key":"ref9","volume-title":"Factors and processes contributing to resilience: The resilience framework","author":"Kumfer","year":"1999"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1186\/s12872-021-02026-1","article-title":"Quality of life and health status of hospitalized adults with congenital heart disease in Vietnam: a cross-sectional study","volume":"21","author":"Truong","year":"2021","journal-title":"BMC Cardiovasc Disord"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1055\/s-0034-1369862","article-title":"Resilienz bei chronischer Herzinsuffizienz [Resilience in chronic heart failure]","volume":"139","author":"Lossnitzer","year":"2014","journal-title":"Dtsch Med Wochenschr"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1037\/0022-3514.50.3.571","article-title":"Appraisal, coping, health status, and psychological symptoms","volume":"50","author":"Folkman","year":"1986","journal-title":"J Pers Soc Psychol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/0022-3999(87)90103-6","article-title":"Degree of life-threat and differential use of coping modes","volume":"31","author":"Feifel","year":"1987","journal-title":"J Psychosom Res"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1097\/JCN.0000000000000357","article-title":"Coping styles mediate the relationship between self-esteem, health locus of control, and health-promoting behavior in Chinese patients with coronary heart disease","volume":"32","author":"Zou","year":"2017","journal-title":"J Cardiovasc Nurs"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1728","DOI":"10.1177\/1359105314564812","article-title":"Differential pathways of positive and negative health behavior change in congestive heart failure patients","volume":"21","author":"Chaves","year":"2016","journal-title":"J Health Psychol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/j.jpsychores.2009.10.001","article-title":"Social support concepts and measures","volume":"69","author":"Gottlieb","year":"2010","journal-title":"J Psychosom Res"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1097\/00006842-200103000-00010","article-title":"Characteristics of socially isolated patients with coronary artery disease who are at elevated risk for mortality","volume":"63","author":"Brummett","year":"2001","journal-title":"Psychosom Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1037\/0033-295X.84.2.191","article-title":"Self-efficacy: toward a unifying theory of behavioral change","volume":"84","author":"Bandura","year":"1977","journal-title":"Psychol Rev"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1093\/eurjcn\/zvac016","article-title":"The relationship between mutuality and contributions to self-care in family caregivers of patients with heart failure: multiple mediating effects of resilience and self-efficacy","volume":"21","author":"Chen","year":"2022","journal-title":"Eur J Cardiovasc Nurs"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1002\/pon.5148","article-title":"Interventions to enhance self-efficacy in cancer patients: a meta-analysis of randomized controlled trials","volume":"28","author":"Merluzzi","year":"2019","journal-title":"Psychooncology"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1037\/hea0000387","article-title":"The impact of changing attitudes, norms, and self-efficacy on health-related intentions and behavior: a meta-analysis","volume":"35","author":"Sheeran","year":"2016","journal-title":"Health 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the 10-item Connor-Davidson resilience scale in Chinese earthquake victims","volume":"64","author":"Wang","year":"2010","journal-title":"Psychiatry Clin Neurosci"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"218","DOI":"10.3969\/J.issn.1000-6729.2011.03.012","article-title":"Reliability and validity of social support rating scale in rural suicides","volume":"25","author":"Lu","year":"2011","journal-title":"Chin Ment Health J"},{"key":"ref30","first-page":"174","article-title":"Measuring optimistic self- beliefs: a Chinese adaptation of the general self-efficacy scale","volume":"38","author":"Zhang","year":"1995","journal-title":"Psychologia"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1007\/s11255-012-0309-7","article-title":"The effect of social support and coping style on depression in patients with continuous ambulatory peritoneal dialysis in southern China","volume":"45","author":"Lin","year":"2013","journal-title":"Int Urol Nephrol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1111\/j.1525-1446.2007.00617.x","article-title":"Psychological status, coping, and social support of people living with HIV\/AIDS in Central China","volume":"24","author":"Sun","year":"2007","journal-title":"Public Health Nurs"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"323","DOI":"10.3200\/JOER.99.6.323-338","article-title":"Reporting structural equation modeling and confirmatory factor analysis results: a review","volume":"99","author":"Schreiber","year":"2006","journal-title":"J Educ Res"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1207\/s15327906mbr2502_4","article-title":"Structural model evaluation and modification: an interval estimation approach","volume":"25","author":"Steiger","year":"1990","journal-title":"Multivariate Behav Res"},{"key":"ref35","first-page":"25","article-title":"Structure equation modeling basic assumptions and concepts: a novices guide","volume":"3","author":"Kumar","year":"2015","journal-title":"Asian J Manag Sci"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1007\/s11205-009-9439-4","article-title":"Validation of the wood\u2019s job satisfaction questionnaire among taiwanese nonprofit sport organization workers","volume":"94","author":"Chen","year":"2009","journal-title":"Soc Indic Res"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"4952","DOI":"10.3760\/cma.j.cn115682-20200512-03296","article-title":"Current status and influencing factors of psychological resilience in patients with acute aortic dissection","volume":"26","author":"Ban","year":"2020","journal-title":"Chin J Mod Nurs"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"939512","DOI":"10.3389\/fnbeh.2022.939512","article-title":"Correlation among psychological resilience, social support, and coping style in patients with complicated Hepatolithiasis","volume":"16","author":"Wang","year":"2022","journal-title":"Front Behav Neurosci"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"510","DOI":"10.4040\/jkan.2003.33.4.510","article-title":"The effects of self-efficacy promoting cardiac rehabilitation program on self-efficacy, health behavior, and quality of life","volume":"33","author":"Song","year":"2003","journal-title":"Taehan Kanho Hakhoe Chi"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"9714","DOI":"10.3390\/ijerph120809714","article-title":"Relationship between health literacy, health-related behaviors and health status: a survey of elderly Chinese","volume":"12","author":"Liu","year":"2015","journal-title":"Int J Environ Res Public Health"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"106103","DOI":"10.1016\/j.ypmed.2020.106103","article-title":"Positive emotions and favorable cardiovascular health: a 20-year longitudinal study","volume":"136","author":"Boehm","year":"2020","journal-title":"Prev Med"},{"key":"ref42","volume-title":"Analysis of influencing factors and mediating effects of mental toughness in patients with hematopoietic stem cell transplantation [D]","author":"Wang","year":"2019"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"106","DOI":"10.3969\/j.issn.1672-1756.2022.01.022","article-title":"Mediating role of coping style between social support and burnout in ICU nurses","volume":"22","author":"Liang","year":"2022","journal-title":"Chinese Nurs Manag"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"21","DOI":"10.3761\/j.issn.0254-1769.2016.01.004","article-title":"Effects of self-efficacy, social support and coping style on mental resilience of patients with acute myocardial infarction","volume":"51","author":"Lili","year":"2016","journal-title":"Chin J Nurs"},{"key":"ref45","first-page":"1","article-title":"Chain mediation effect of self-efficacy and social support between optimism and psychological resilience in patients treated with hematopoietic stem cell transplantation","volume":"10","author":"Wang","year":"2020","journal-title":"China Med Pharm"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s13019-020-1081-x","article-title":"Application of a new blood flow regulator in aortic endovascular therapy","volume":"15","author":"Liu","year":"2020","journal-title":"J Cardiothorac Surg"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"e015060","DOI":"10.1161\/JAHA.119.015060","article-title":"From tear to fear: post-traumatic stress disorder in patients with acute type a aortic dissection","volume":"9","author":"Pasadyn","year":"2020","journal-title":"J Am Heart Assoc"}],"container-title":["Frontiers in 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