title: Those Who Perceive Their Disease as a Physiological or Psychological Risk Factor Experience More Anxiety at the Beginning of the Cardiac Rehabilitation Program.
abstract: BACKGROUND
  In a cardiac patient, anxiety is the result of the individual's perception of the treatment and is characterized by inability to predict, control, or achieve the desired treatment outcomes.
  
  
  OBJECTIVE
  This study was carried out to investigate the extent of clinical anxiety in patients who underwent a cardiac rehabilitation program with different attitudes toward the disease risk factors.
  
  
  METHODS
  The administrative data of this retrospective study were obtained from the database of the cardiac rehabilitation department of a hospital in Iran. The demographic and clinical information of 603 patients from April 2006 to April 2011 was collected using compiled forms of this database, the Beck anxiety inventory, and the structured clinical interview for axis I disorders. The univariate analysis of variance and the Bonferroni post-hoc analysis were used for data analysis.
  
  
  RESULTS
  After controlling for gender and educational level, we observed statistically significant differences in the modified means between the patients who considered the behavioral risk factors and those who considered the physiological risk factors (P = 0.012, MD = 5.03) and between the patients who regarded the behavioral risk factors and those who regarded the psychological risk factors (P = 0.0005, MD = 5.32) as the underlying cause of their cardiac condition, which means that the level of anxiety in the physiological and psychological groups was higher than that in the behavioral group.
  
  
  CONCLUSIONS
  The anxiety of patients can be controlled through alteration in their attitudes toward the disease risk factors on the grounds that psychological or physiological factors per se do not trigger the occurrence of the disease, whereas behavioral risk factors, as the controlling agent, significantly influence its occurrence.
authors.affiliation: Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.
authors.forename: Mozhgan
authors.initials: M
authors.lastname: Saeidi
authors.affiliation: Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Komasi
authors.affiliation: Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.
authors.forename: Behzad
authors.initials: B
authors.lastname: Heydarpour
authors.affiliation: Department of Psychology, Kermanshah Razi University, Kermanshah, IR Iran.
authors.forename: Khodamorad
authors.initials: K
authors.lastname: Momeni
authors.affiliation: Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Zakiei
keywords: Anxiety; Attitude; Cardiac Rehabilitation; Patients; Risk Factors