Familism and depression among Singaporeans with coronary heart disease: The mediating role of social support and self-perceived burden

Abstract

Cardiovascular diseases (CVD) are the leading cause of mortality in Singapore, and Coronary Heart Disease (CHD) is the highest contributor to CVD figures. Mood disorders such as depression are prevalent amongst patients with CHD. Past research has focused on the individual risk factors predicting depression, but there is a dearth of research examining how familial attitudes may predict depression. Patients with CHD would be required to make various adjustments in life, and these changes would usually involve the family of the patient. The attitudes that the patient has toward their family members may play a role in their management of CHD. This study was conducted to explore the influence of attitudinal familism on depression in CHD patients, and investigate the potential mediation pathways. Self-perceived burden and social support were the two proposed mediators. Self-report questionnaires on familism, depressive symptoms, social support and self-perceived burden were administered to 86 participants undergoing cardiac rehabilitation at the Singapore Heart Foundation. Hierarchical multiple regression analyses were conducted to test the hypotheses. The findings revealed that familism was not predictive of depressive symptoms, self-perceived burden and social support. In addition, social support and self-perceived burden were found to be significant predictors of depressive symptoms. Further analyses suggested a moderating effect of social support between self-perceived burden and depression. Healthcare professionals should consider assessing patients with CHD for feelings of self-perceived burden and social support to identify patients who may require clinical attention.