HPRHealth Psychology ResearchTBA2420-8124Health Psychology Research10.52965/001c.133564GeneralIllness perceptions as predictive factors for anxiety and depressive symptoms among patients with coronary heart diseasehttps://healthpr.org/journal/HPR/13/1/10.52965/001c.133564AlSutariManal,KhraisatOmar20251312025-04-05BackgroundIndividuals diagnosed with Coronary Heart Disease (CHD) form specific perceptions about their condition. These illness perceptions (IP) influence several clinical and mental aspects of patients’ health outcomes. ObjectiveTo describe IP in Jordanian patients with CHD and to examine the role of IP domains in predicting anxiety and depressive symptoms in Jordanian patients with CHD. MethodsIn a cross-sectional study, a convenience sample of 193 patients with CHD, who visited the cardiac clinic for routine followup, completed the brief illness perception questionnaire and the Hospital Anxiety and Depression Scale. ResultsParticipants perceived CHD as a chronic condition with moderate negative consequences and they were highly concerned about their illness. Illness perceptions domains were significantly associated with anxiety and depressive symptoms. Personal control, treatment control, and disease identity were significant predictors of depressive symptoms, while personal control and emotional representation were significant predictors of anxiety symptoms. ConclusionFindings indicate that negative illness perceptions are strongly associated with anxiety and depressive symptoms. Study findings suggest that interventions targeting personal control, treatment control, identity, and emotional representation could improve CHD patients’ mental well-beingCoronary disease, perception, anxiety, depression

British Heart Foundation. Global Heart and Circulatory Diseases Factsheet. Global Heart & Circulatory Diseases Factsheet. Accessed August 24, 2024. https://www.bhf.org.uk/-/media/files/for-professionals/research/heart-statistics/bhf-cvd-statistics-global-actsheet.pdf?reve61c05db17e9439a8c2e4720f6ca0a19&hash=6350DE1B2A19D939431D876311077C7B Al-Ajlouni YA, Al Ta’ani O, Shamaileh G, Nagi Y, Tanashat M, Al-Bitar F, et al. The Burden of cardiovascular diseases in Jordan: a longitudinal analysis from the global burden of disease study, 1990-2019. BMC Public Health. 2024;24(1):879. doi:10.1186/s12889-024-18316-0 Leventhal H, Phillips LA, Burns E. The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management. J Behav Med. 2016;39(6):935-946. doi:10.1007/s10865-016-9782-2  Lotfi-Tokaldany M, Sadeghian S, Mosavi SA, Omidi N, Rahnemoun Z, Kazzazi EH, et al. Association between cognitive representation of illness and the outcome of patients with premature coronary artery disease. J Psychosom Res. 2022;162:111019. doi:10.1016/j.jpsychores.2022.111019 Lerdal A, Hofoss D, Gay CL, Fagermoen MS. Perception of illness among patients with heart failure is related to their general health independently of their mood and functional capacity. J Patient Rep Outcomes. 2019;3(1):55. doi:10.1186/s41687-019-0142-1  Mobini S, Allahbakhshian A, Shabanloei R, Sarbakhsh P. Illness Perception, Self-Efficacy, and Medication Adherence in Patients with Coronary Artery Disease: A Path Analysis of Conceptual Model. SAGE Open Nurs. 2023;12(9):2377. doi:10.1177/23779608231171772  Nur KRM. Illness perception and cardiovascular health behavior among persons with ischemic heart disease in Indonesia. Int J Nurs Sci. 2018;5(2):174-180. doi:10.1016/j.ijnss.2018.04.007 Akosile W, Tiyatiye B, Colquhoun D, Young R. Management of depression in patients with coronary artery disease: A systematic review. Asian J Psychiatr. 2023;83:103534. doi:10.1016/j.ajp.2023.103534  Karami N, Kazeminia M, Karami A, Salimi Y, Ziapour A, Janjani P. Global prevalence of depression, anxiety, and stress in cardiac patients: A systematic review and meta-analysis. J Affect Disord. 2022;324:175-189. doi:10.1016/j.jad..12.055  Zou H, Chair SY, Zhang C, Bao A. Depressive and anxiety symptoms and illness perception among patients with acute coronary syndrome. J Adv Nurs. 2023;79(7):2632-2642. doi:10.1111/jan.15612  Pokrajac-Bulian A, Ambrosi-Randić N. Illness perception in overweight and obese patients with cardiovascular diseases. Eat Disord. 2020;25(1):69-78. doi:10.1007/s40519-018-0506-1  Chen C, Fang W, An Y, Wang L, Fan X. The multiple mediating effects of illness perceptions and coping strategies on the relationship between physical symptoms and depressive symptoms in patients with heart failure. Eur J Cardiovasc Nurs. 2020;19(2):125-133. doi:10.1177/1474515119864759  Ashour A, Al-Smadi A, Shajrawi A, Al-Rawashdeh S, Alshraifeen A, Abed M. Changes in illness perception among patients’ undergoing percutaneous coronary intervention. Heart Lung. 2020;49(6):836-841. doi:10.1016/j.hrtlng.2020.08.026  Faul F, Erdfelder E, Buchner A, Lang A. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149-1160. doi:10.3758/BRM.41.4.1149  Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60(6):631-637. doi:10.1016/j.jpsychores.2005.10.020  Saarti S, Jabbour H, El Osta N, Hajj A, Khabbaz LR. Cross-cultural adaptation and psychometric properties of an Arabic language version of the Brief Illness Perception Questionnaire in Lebanon. Libyan J Med. 2016;11:31976. doi:10.3402/ljm.v11.31976  Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-370. doi:10.1111/j.1600-0447.1983.tb09716  Snaith R. The Hospital Anxiety and Depression Scale. Health Qual Life Outcomes. 2003;1(29):1-4. doi:10.1186/1477-7525-1-299 Al-Gamal E. Testing of the Hospital Anxiety and Depression Scale in Patients with Chronic Obstructive Pulmonary Disease. Int J Nurs Knowl. 2017;28(2):94-99. doi:10.1111/2047-3095.12106  Thagizadeh A, Ghahramanian A, Zamanzadeh V, Aslanabadi N, Onyeka TC, Ramazanzadeh N. Illness perception and cardiovascular risk factors in patients with myocardial infarction undergoing percutaneous coronary intervention in Iran. BMC Cardiovasc Disord. 2022;22(1):245. doi:10.1186/s12872-022-02684-9  Henao Pérez M, López Medina DC, Lemos Hoyos M, Ríos Zapata P. Depression and the risk of adverse outcomes at 5 years in patients with coronary heart disease. Heliyon. 2020;6(11):e05425. doi:10.1016/j.heliyon.2020.e05425  Carmin C, Ownby R, Fontanella C, Steelesmith D, Binkley P. Impact of Mental Health Treatment on Outcomes in Patients with Heart Failure and Ischemic Heart Disease. J Am Heart Assoc. 2024;13:e031117. doi:10.1161/JAHA.123.031117  Jennings CS, Astin F, Prescott E, Hansen T, Gale CP, De Bacquer D. Illness perceptions and health literacy are strongly associated with health-related quality of life, anxiety, and depression in patients with coronary heart disease: results from the EUROASPIRE V cross-sectional survey. Eur J Cardiovasc Nurs. 2023;22(7):719-729. doi:10.1093/eurjcn/zvac105  Jaltuszewska S, Chojnacka-Szawlowska G, Majkowicz M, Zdonczyk S, Homenda W, Hebel K. Illness Perception and the Severity of Depression and Anxiety Symptoms in Patients with Multimorbidity: Observational Cohort Studies. J Clin Med. 2023;13(1):69. doi:10.3390/jcm13010069  Kazmi S, Murtaza F, Hashmi F, Iftikhar M, Iqbal M, Nasir A. Predictive and Protective Role of Grit, Internal Locus of Control and Social Support in Mental Health of Cardiac Patients. Pak J Health Sci. 2023;4(04):34-42. doi:10.54393/pjhs.v4i04.653  Luque B, Farhane-Medina NZ, Villalba M, Castillo-Mayén R, Cuadrado E, Tabernero C. Positivity and Health Locus of Control: Key Variables to Intervene on Well-Being of Cardiovascular Disease Patients. J Pers Med. 2023;13(5):873. doi:10.3390/jpm13050873  Priorello LJ, Arbona C. Illness intrusiveness, health locus of control, and anxiety symptoms among veterans with congestive heart failure. Health Psychol Open. 2024;11:1-9. doi:10.1177/20551029241250311  Papanikolaou V, Gadallah M, Leon GR, Massou E, Prodromitis G, Skembris A, et al. Relationship of locus of control, psychological distress, and trauma exposure in groups impacted by intense political conflict in Egypt. Prehosp Disaster Med. 2013;28(5):423-427. doi:10.1017/S1049023X13008601  Kukić M, Pokrajac-Bulian A. Heart-Focused Anxiety as a Mediator Between Illness Perception and Negative Affect in Cardiac Patients. Mediterr J Clin Psychol. 2022;10(1). doi:10.13129/2282-1619/mjcp-3374  de Heer EW, Palacios JE, Adèr HJ, van Marwijk HWJ, Tylee A, van der Feltz-Cornelis CM. Chest pain, depression and anxiety in coronary heart disease: Consequence or cause? A prospective clinical study in primary care. J Psychosom Res. 2020;129:109891. doi:10.1016/j.jpsychores.2019.109891 Hayek SS, Ko YA, Awad M, Del Mar Soto A, Ahmed H, Patel K, et al. Depression and chest pain in patients with coronary artery disease. Int J Cardiol. 2017;230:420-426. doi:10.1016/j.ijcard.2016.12.091  Al-Sutari M, Ahmad M. Predictors of adherence to self-care behaviors among patients with coronary heart disease. Nursing Practice Today. 2022;9(2):145-157. doi:10.18502/npt.v9i2.8897  Hayek SS, Ko YA, Awad M, Del Mar Soto A, Ahmed H, Patel K, et al. Depression and chest pain in patients with coronary artery disease. Int J Cardiol. 2017;230:420-426. doi:10.1016/j.ijcard.2016.12.091  Garcia M, Moazzami K, Almuwaqqat Z, Young A, Okoh A, Shah AJ, et al. Psychological Distress and the Risk of Adverse Cardiovascular Outcomes in Patients with Coronary Heart Disease. JACC Adv. 2024;3(2):100794. doi:10.1016/j.jacad.v.2023.100794  Zhen J, Wang J, Wang YL, Jiao J, Li J, Du XJ, et al. Fear of recurrence in elderly patients with coronary heart disease: the current situation and influencing factors according to a questionnaire analysis. BMC Cardiovasc Disord. 2022;22(1):419. doi:10.1186/s12872-022-02853-w  Al-Sutari M, Abdalrahim M. Symptom Burden and Quality of Life Among Patients with Heart Failure. SAGE Open Nursing. Published online 2024:1-11. doi:10.1177/23779608241242023