Social Support and Self-Efficacy as Mediating Factors Affecting the Association Between Depression and Medication Adherence in Older Patients with Coronary Heart Disease: A Multiple Mediator Model with a Cross-Sectional Study

Yi Zhou,1 Qiwen Huo,1 Shaoying Du,1 Xiaoyang Shi,1 Qisong Shi,2 Shanshan Cui,3 Cuina Feng,4 Xiaojing Du,1 Yan Wang1 1School of Nursing, Hebei University, Baoding, Hebei, People’s Republic of China; 2Department of Cardiovascular Medicine, The Second Hospital of Baoding, Baoding, Hebei, People’s Republic of China; 3Department of General Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, People’s Republic of China; 4Department of Cardiovascular Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, People’s Republic of ChinaCorrespondence: Yan WangSchool of Nursing, Hebei University, 342 Yuhuadong Road, Baoding, Hebei, 071000, People’s Republic of China, Tel/Fax +86 3125075605, Email chjanwy@163.comPurpose: Medication non-adherence is a major public health issue. Recent evidence suggests that depression, inadequate social support, and lower levels of self-efficacy are associated with poor medication adherence. However, the mechanism underlying the association among depression, social support, self-efficacy and medication adherence is unclear. This study aims to examine the mediating role of social support and self-efficacy between depression and medication adherence in older patients with coronary heart disease.Patients and Methods: Data were collected from 238 hospitalized older patients with coronary heart disease. Depression, social support, self-efficacy, and medication adherence were assessed using structured questionnaires. A serial multiple mediation model was tested using the PROCESS macro for SPSS.Results: A total of 238 older patients with CHD with a mean age of 70.5 years were involved in this cross-sectional study. Depression was negatively correlated with medication adherence in older patients with coronary heart disease. Social support and self-efficacy were positively associated with medication adherence, and fully mediated the relationship between depression and medication adherence. Three mediation paths were inclu