POSTTRAUMATIC STRESS DISORDER SYMPTOMS, TYPE D PERSONALITY, PSYCHOLOGICAL INFLEXIBILITY, SELF-EFFICACY AND THEIR RELATIONSHIPS AMONG PATIENTS WITH ACUTE CORONARY SYNDROME IN SINGAPORE: A DESCRIPTIVE CORRELATIONAL STUDY

Abstract

Background: Acute coronary syndrome (ACS) can be psychologically traumatic to patients and are increasingly recognised as possible triggers of posttraumatic stress disorder (PTSD). Cardiac-induced PTSD (CDI-PTSD) is debilitating and associated with risk of increased cardiac events. However, the PTSD status of ACS patients in Singapore and its risk factors remain unexplored. Aims: The aims of this study are to investigate PTSD and identify its significant predictors among patients with ACS in Singapore. Methods: A cross-sectional descriptive correlational study design was adopted. 94 participants were recruited from cardiology wards of a public tertiary hospital. The instruments used include a sociodemographic information sheet, clinical information sheet, posttraumatic stress disorder checklist (PCL-5), Type D personality scale (DS14), Self-efficacy for managing Chronic Diseases 6-item Scale (SEMCD), and Acceptance and Action Questionnaire 2nd Edition (AAQ-II). Descriptive and inferential statistics were used for data analysis. Results: ACS patients in Singapore had a relatively low CDI-PTSD prevalence. PTSD symptoms were associated with sociodemographic factors including gender, age, employment status, and clinical variables such as Cardiovascular Disease-related hospitalization frequency, Congestive heart failure (CHF) and coronary stenting. PTSD symptoms were also associated with type D personality and its subdomains (negative affect and social inhibition), self-efficacy, and psychological inflexibility. Multiple linear regression analysis indicated that predictors of CDI-PTSD symptoms include psychological inflexibility, coronary stenting, self-efficacy, negative affect, religion and income, accounting for 15.6% to 46.7% of variance (R2=.156-.467). Conclusion: Type D personality, Self-efficacy, Psychological inflexibility, several sociodemographic and clinical factors were associated with PTSD symptoms. Predictors of CDI-PTSD symptoms were psychological inflexibility, coronary stenting, self-efficacy, negative affect, religion and income. Implications: Results are helpful for identifying patients at increased CDI-PTSD risk and may be key to establishing precautionary measures for high-risk patients. The study’s findings may be further explored in future studies using a qualitative or longitudinal approach.