Structural Model of psychological risk and protective factors affecting on quality of life in patients with coronary heart disease: A psychocardiology model.
BACKGROUND
Conducted researches show that psychological factors may have a very important role in the etiology, continuity and consequences of coronary heart diseases. This study has drawn the psychological risk and protective factors and their effects in patients with coronary heart diseases (CHD) in a structural model. It aims to determine the structural relations between psychological risk and protective factors with quality of life in patients with coronary heart disease.


METHODS
The present cross-sectional and correlational studies were conducted using structural equation modeling. The study sample included 398 patients of coronary heart disease in the university referral Hospital, as well as other city health care centers in Isfahan city. They were selected based on random sampling method. Then, in case, they were executed the following questionnaires: Coping with stressful situations (CISS- 21), life orientation (LOT-10), general self-efficacy (GSE-10), depression, anxiety and stress (DASS-21), perceived stress (PSS-14), multidimensional social support (MSPSS-12), alexithymia (TAS-20), spiritual intelligence (SQ-23) and quality of life (WHOQOL-26).


RESULTS
The results showed that protective and risk factors could affect the quality of life in patients with CHD with factor loadings of 0.35 and -0.60, respectively. Moreover, based on the values of the framework of the model such as relative chi-square (CMIN/DF = 3.25), the Comparative Fit Index (CFI = 0.93), the Parsimony Comparative Fit Index (PCFI = 0.68), the Root Mean Square Error of Approximation (RMSEA = 0.07) and details of the model (significance of the relationships) it has been confirmed that the psychocardiological structural model of the study is the good fitting model.


CONCLUSIONS
This study was among the first to research the different psychological risk and protective factors of coronary heart diseases in the form of a structural model. The results of this study have emphasized the necessity of noticing the psychological factors in primary prevention by preventive programs and in secondary prevention by rehabilitation centers to improve the quality of life of the people with heart diseases.
Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran.
Zohreh Khayyam
ZK
Nekouei
Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Alireza
A
Yousefy
Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran.
Hamid Taher Neshat
HT
Doost
Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran.
Gholamreza
G
Manshaee
Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran.
Masoumeh
M
Sadeghei
Coronary heart disease; Psycho-Cardiology; Psychological risk factors; protective; structural model