نقش انعطاف‌پذیری روان‌شناختی بر کیفیت زندگی بیماران مبتلا به بیماری‌های عروق کرونر قلب با میانجی‌گری ادراک بیماری: ارائه‌ی یک مدل معادلات ساختاری

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی کارشناس ارشد روانشناسی سلامت، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 استاد، گروه روانشناسی سلامت، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 دانشیار، گروه روانشناسی سلامت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 استاد، گروه آمار زیستی و اپیدمیولوژی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

5 استاد، مرکز تحقیقات قلب مداخله‌ای، پژوهشکده‌ی قلب و عروق، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: عوامل روان‌شناختی، نقش مهمی در سازگاری و کیفیت زندگی بیماران قلبی دارند. این مطالعه به منظور بررسی نقش واسطه‌ای ادراک بیماری در رابطه‌ی بین انعطاف‌پذیری روان‌شناختی و کیفیت زندگی بیماران مبتلا به بیماری عروق کرونر قلب انجام شد.
روش‌ها: در یک مطالعه‌ی مقطعی، از بین کلیه‌ی بیماران مبتلا به بیماری عروق کرونر قلب مراجعه‌کننده به بیمارستان تخصصی شهید چمران اصفهان در سال 1399، تعداد 220 بیمار با در نظر گرفتن معیارهای ورود و خروج به صورت پی‌درپی انتخاب گردیدند. به منظور جمع‌آوری داده‌ها، پرسش‌نامه‌ی عوامل دموگرافیک، پرسش‌نامه‌ی کوتاه شده‌ی ادراک بیماری برودبنت (B-IP)، پرسش‌نامه‌ی کیفیت زندگی واروشربون (SF-36)، پرسش‌نامه‌ی پذیرش و عمل باند (AAQ-II) پرسش‌نامه‌ی آمیختگی گیلاندرز (CFQ) و پرسش‌نامه‌ی زندگی ارزش‌محور ترمپتر (VLQ)، مورد استفاده قرار گرفت. سپس داده با روش مدل معادلات ساختاری مورد تجزیه و تحلیل قرار گرفت.
یافته‌ها: نتایج پژوهش نشان داد، بین انعطاف‌پذیری روان‌شناختی و کیفیت زندگی ارتباط مستقیم و معنی‌داری وجود دارد (505/0- = r)، همچنین بین ادراک بیماری با کیفیت زندگی، رابطه‌ی معکوس معنی‌داری وجود دارد (285/0- = r). همچنین یافته‌های این پژوهش نشان داد، رابطه‌ی کیفیت زندگی و انعطاف‌پذیری روان‌شناختی از طریق ادراک بیماری به طور معنی‌داری وساطت می‌شود (603/0- = r). ادراک بیماری، رابطه‌ی پذیرش و عمل، ارزش‌ها، آمیختگی، مدت ابتلا به بیماری را به طور معنی‌داری واسطه می‌کند (028/0)، (56/0)، (094/0-) و (050/0).
نتیجه‌گیری: به نظر می‌رسد ادارک بیماری به عنوان متغیر واسطه‌ای بین انعطاف‌پذیری روان‌شناختی و کیفیت زندگی، می‌تواند نقش قابل توجهی داشته باشد. لذا توجه به این عوامل در مداخلات درمانی و توانبخشی مورد تأکید می‌باشد.

کلیدواژه‌ها

عنوان مقاله [English]

The Role of Psychological Flexibility on Quality of Life in Patients with Coronary Artery Disease (CAD) Mediated by Illness Perception: Structural Equation Model

نویسندگان [English]

  • Tavakol Khanizadeh 1
  • Reza Bagherian-Sararoudi 2
  • Amrollah Ebrahimi 3
  • Awat Feizi 4
  • Hamid Sanei 5
1 MSc Student of Health Psychology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Professor, Department of Health Psychology, Isfahan University of Medical Sciences, Isfahan, Iran
3 Associate Professor, Department of Health Psychology, Isfahan University of Medical Sciences, Isfahan, Iran
4 Professor, Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
5 Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medicine Sciences, Isfahan, Iran
چکیده [English]

Background: Psychological variables play a major role in adaptation and quality of life among heart patients. This study was conducted to investigate the mediating role of illness perception in the relationship between psychological flexibility and quality of life in patients with coronary artery disease.
Methods: In the present cross-sectional study, 220 patients with coronary artery disease referred to Isfahan's Shahid Chamran Specialist Hospital were selected based on inclusion and exclusion criteria. For data collection, demographic information questionnaire, Brief Illness Perception Questionnaire (B-IP), quality of life questionnaire (SF-36), Bond acceptance and action questionnaire (AAQ-II), Gillanders Cognitive defusion Questionnaire (CFQ), and the Cluster Value-Driven Life Questionnaire (VLQ) were used. The gathered data was analysed using structural equation modeling method.
Findings: The results of study revealed a direct relationship between PF and QOL (r = -0.505), also significant negative relationship was found between IP and QOL (r = 0.285). In addition, the intensity of general relationship between QOL and PF through mediating role of IP was estimated at (r < 0.603). IP significantly mediates the relationship between acceptance and practice, values, fusion, on illness duration (0.028, 0.56,
-0.094, and 0.50).
Conclusion: It seems that, Illness perception as a mediacing variable between psychological flexibility and quality of life plays a significant role. Thus, considering this for treatment and rehabilitation purposes has been emphasized.

کلیدواژه‌ها [English]

  • Coronary artery disease
  • Quality of life
  • Illness perception
  • Psychological flexibility

مراجع

  1. Ghorbaninia FS, Monirpour N, Modaress MP. Mediating role of illness perception and coping strategies among individuals with inflammatory bowel disease. J Appl Behav Sci 2019; 6(3): 31-42.
  2. 2 Eram S, Hasani J, Moradi A. Process model of emotion regulation in patients with coronary heart diseases, implanted cardioverter defibrillator recipients and normal subjects. J Adv Med Biomed Res 2016; 24(104): 39-48. [In Persian].
  3. Dunderdale K, Thompson DR, Miles JN, Beer SF, Furze G. Quality-of-life measurement in chronic heart failure: do we take account of the patient perspective? Eur J Heart Fail 2005; 7(4): 572-82.
  4. Catunda C, Seidl EMF, Lemétayer F. Illness perception and quality of life of HIV-positive persons: mediation effects of tenacious and flexible goal pursuit. Psychol Health Med 2017; 22(2): 129-37.
  5. Bahrami Quality of life in cancer and chronic
    disease. Isfahan, Iran: Isfahan University of Medical Sciences and Health Services; 2013.
  6. Knowles SR, Wilson JL, Connell WR, Kamm MA. Preliminary examination of the relations between disease activity, illness perceptions, coping strategies, and psychological morbidity in Crohn's disease guided by the common sense model of illness. Inflamm Bowel Dis 2011; 17(12): 2551-7.
  7. Afshar H, Bagherian Sararoudi R, Foroozandeh N, Khorramian N, Daghaghzadeh H, Maracy MR, et al. The relationship between illness perception and symptom severity in patients with irritable bowel syndrome. J Isfahan Med Sch 2011; 29(137): 526-36. [In Persian].
  8. Bagherian-Sararoudi Ahmadzadeh GH, Abadchi R. Study of the relationship between coping strategies, personality variables and perception of disease in patients with myocardial infarction.
    NPWJM 2018; 6(18): 53-60. [In Persian].
  9. Goodman H, Firouzi A, Banya W, Lau-Walker M, Cowie MR. Illness perception, self-care behaviour and quality of life of heart failure patients: a longitudinal questionnaire survey. Int J Nurs Stud 2013; 50(7): 945-53.
  10. Eydi M, Najafi Ghezeljeh T, Haghani SH. The prediction of self-care behaviors and quality of life based on disease perception in patients with heart failure. Iran J Nurs 2020; 33(124): 13-26. [In Persian].
  11. Rajpura J, Nayak R. Medication adherence in a sample of elderly suffering from hypertension: evaluating the influence of illness perceptions, treatment beliefs, and illness burden. J Manag Care Pharm 2014; 20(1): 58-65.
  12. Graham CD, Gouick J, Ferreira N, Gillanders D. The influence of psychological flexibility on life satisfaction and mood in muscle disorders. Rehabil Psychol 2016; 61(2): 210-7.
  13. Hayes SC, Pistorello J, Levin ME. Acceptance and commitment therapy as a unified model of behavior change. Couns Psychol 2012; 40(7): 976-1002.
  14. Jahangiri F, Karimi J, Afshar Comparison of dimensions of psychological flexibility in patients with irritable bowel syndrome and normal counterparts. Armaghane-danesh 2017; 22(1): 75-86. [In Persian].
  15. Shahabi A, Ehteshamzadeh P, Asgari P, Makvandi B. Comparison of the effectiveness of acceptance and commitment therapy and guided imagery on the resilience of cardiac disease patients referring to the heart rehabilitation department. Horizon Med Sci 2020; 26(3): 276-97.
  16. Densham S, Williams D, Johnson A, Turner-Cobb JM. Enhanced psychological flexibility and improved quality of life in chronic fatigue syndrome/myalgic encephalomyelitis. J Psychosom Res 2016; 88: 42-7.
  17. McAteer G, Gillanders D. Investigating the role of psychological flexibility, masculine self-esteem and stoicism as predictors of psychological distress and quality of life in men living with prostate cancer. Eur J Cancer Care (Engl) 2019; 28(4): e13097.
  18. Meyer EC, Frankfurt SB, Kimbrel NA, DeBeer BB, Gulliver SB, Morrisette SB. The influence of mindfulness, self-compassion, psychological flexibility, and posttraumatic stress disorder on disability and quality of life over time in war veterans. J Clin Psychol 2018; 74(7): 1272-80.
  19. Kalantari H, Bagherian Sararoodi R, Afshar H, Khoramian N, Forouzandeh N, Daghagh Zadeh H, et al. Relationship between illness perceptions and quality of life in patients with irritable bowel syndrome. J Mazandaran Univ Med Sci 2012; 22(90): 33-41. [In Persian].
  20. Bagherian-Sararoudi R, Maracy M, Sanei H, Shiri M. Relationship between type D personality subscales, coping strategies, illness perception, and fatigue in myocardial infarction patients using structural equation modeling, in Isfahan, Iran 2016-17. Iran J Psychiatry Behav Sci 2019; 13(4): e86965.
  21. Taft TH, Keefer L, Artz C, Bratten J, Jones MP. Perceptions of illness stigma in patients with inflammatory bowel disease and irritable bowel syndrome. Qual Life Res 2011; 20(9): 1391-9.
  22. Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behav Ther 2011; 42(4): 676-88.
  23. Imani M, Pourshahbazi M. Prediction of borderline personality disorder based on psychological flexibility components: Acceptance and action, values and cognitive defusion. J Res Psychol Health 2017; 10(4): 1-9.
  24. Gillanders DT, Bolderston H, Bond FW, Dempster M, Flaxman PE, Campbell L, et al. The development and initial validation of the cognitive fusion questionnaire. Behav Ther 2014; 45(1): 83-101.
  25. Trompetter HR, Ten Klooster PM, Schreurs KM, Fledderus M, Westerhof GJ, Bohlmeijer ET. Measuring values and committed action with the Engaged Living Scale (ELS): psychometric evaluation in a nonclinical sample and a chronic pain sample. Psychol Assess 2013; 25(4): 1235-46.
  26. Taghadosi M, Ghanbari Afra L, Gilasi HR, Ghanbari Afra M, Taheri Kharame Z. The relationship between sexual satisfaction and quality of life in patients with acute coronary syndrome. Medsurg Nurs 2015; 4(1): 16-22. [In Persian].
  27. Group W. Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Qual Life Res1993; 2(2): 153-9.
  28. Park JM, Choi MG, Oh JH, Cho YK, Lee IS, Kim SW, et al. Cross-cultural validation of irritable bowel syndrome quality of life in Korea. Dig Dis Sci 2006; 51(8): 1478-84.
  29. Montazari A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Qual Life Res 2006; 14(3): 875-82.
  30. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res 2006; 60(6): 631-7.
  31. Bagherian Sararoudi R, Bahrami EH, Sanei H. Relationship between history of myocardial infraction and cognitive representation of myocardial infraction. Res Psychol Health 2008; 2(2): 29-39. [In Persian].
  32. Habibi A. Structural equation modeling book. Jahad Daneshgahi Publications. 6th 2017. [In Persian].
  33. Zahraei S, Amini S. Saebi S. Relationship between disease perception, stigma experience and cognitive fusion with quality of life in women with multiple sclerosis. J Psychol Stud 2018; 14(2): 25-40.
    [In Persian].
  34. Leonidou C, Panayiotou G, Bati A, Karekla M. Coping with psychosomatic symptoms: The buffering role of psychological flexibility and impact on quality of life. J Health Psychol 2019; 24(2): 175-87.
  35. Ghahnaviyeh LA, Bagherian B, Feizi A, Afshari A, Mostafavi Darani FM. The effectiveness of acceptance and commitment therapy on quality of life in a patient with myocardial infarction: a randomized control trial. Iran J Psychiatry 2020; 15(1): 1-9.
  36. Mofid V, Fatehizadeh M, Dorosti F. Effectiveness of acceptance and commitment based treatment on depression and quality of life of delinquent women prisoners in Isfahan. Strategic Research on Social Problems in Iran 2017; 6(3): 17-30. [In Persian].
  37. Eydi M, Najafi Ghezeljeh T, Haghani S. The prediction of self-care behaviors and quality of life based on disease perception in patients with heart failure. Iran J Nurs 2020; 33(124): 13-26. [In Persian].
  38. Akbari AS, Cheraghi MA, Kazemnejad A, Nomali M, Zakerimoghadam M. Effect of illness perception correction-based educational program on quality of life and self-care in patients with heart failure: a randomized controlled trial. J Caring Sci 2019; 8(2): 89-93.
  39. O’Donovan CE, Painter L, Lowe B, Robinson H, Broadbent E. The impact of illness perceptions and disease severity on quality of life in congenital heart disease. Cardiol Young 2016; 26(1): 100-9.
  40. Bagherian-Sararoudi R, Motmaen M, Maracy MR, Pishghadam E, Kheirabadi GR. Efficacy of illness perception focused intervention on quality of life, anxiety, and depression in patients with myocardial infarction. J Res Med Sci 2016; 26(21): 125.
  41. Anvari MH, Ebrahimi A, Neshatdoost HT, Afshar H, Abedi A. The effectiveness of group-based acceptance and commitment therapy on pain-related anxiety, acceptance of pain and pain intensity in patients with chronic pain. J Isfahan Med Sch 2014; 32(295): 1156-65. [In Persian].
  42. Moradi A, Hassani J, Barajali M, Abdollah Zadeh B. Modeling structural relations of executive functions and psychological flexibility and beliefs of disease in adaptation to disease and psychological health in cardiovascular patients. MJMS 2019; 62(December): 147-59. [In Persian].
مجله دانشکده پزشکی اصفهان
دوره 40، شماره 662
هفته 2 اردیبهشت ماه
فروردین و اردیبهشت 1401
صفحه 115-123

فایل ها

سابقه مقاله

  • تاریخ دریافت: 26 اردیبهشت 1401
  • تاریخ پذیرش: 26 اردیبهشت 1401

هم رسانی

ارجاع به این مقاله

آمار