The Effect of Dimensions of Illness Perceptions on the Variation of Quality of Life in Patients With Coronary Artery Disease


According to previous studies in patients with Coronary artery disease (CAD), it is important to consider both medical conditions and psychological factors such as illness perceptions to explain differences in Health-Related Quality of Life (HRQoL). Patient’s illness perception is formed based on Patient’s beliefs and perceived information about their conditions, presumably influencing the individual’s mental health and how the patients deal with the medical conditions. The objective of this study was to analyze the relationship between illness perception and quality of life in patients with CAD. In this cross-sectional study, 99 CAD patients filled out questionnaires, including the brief illness perception questionnaire, the Health-related quality of life scale (SF36). The data were analyzed using multiple linear regression.When corrected for confounders, identity (β=−0.47) was  associated with Physical Component (PCS). Identity  and age explained 53% of the variation in PCS (R2=0.53). Personal control (β=0.20), identity (β=−0.23) and Emotional response (β=−0.25)  were associated with Mental Component (MCS). They explained 47% of the variation in the Mental Component (R2=0.47) domain. This study showed that there is a relationship between illness perception and quality of life in patients with CAD. Better HRQoL was found in patients who have a better understanding of the disease, experience better personal control, and have less of a physical and mental response. Results from this study provide starting points for the development of interventions focusing on illness perceptions to support CAD patients in their disease management and to improve HRQoL.

Napoli C, Glass CK, Witztum JL, Deutsch R, D'Armiento FP, Palinski W. Influence of maternal hypercholesterolemia during pregnancy on progression of early atherosclerotic lesions in childhood: Fate of Early Lesions in Children (FELIC) study. Lancet 1999;354:1234-41.

RogerVL, GoAS, Lloyd-JonesDM, BenjaminEJ, BerryJD, BordenWB. Heart disease and stroke statistics. 2012 update: a report from the American Heart Association. Circulation 2012;125:e2-220.

Lemelin ET. Lifecourse socioeconomic position & cardiovascular health. ProQuest; 2008. (Accessed January 2018, 12, at 304575433?pqigsite=gscholar).

Verma SK, Kumar B, Bahl VK. Aorta-ostial atherosclerotic coronary artery disease—Risk factor profiles, demographic and angiographic features. Int J Cardiol Heart Vasc 2016;12:26-31.

Lukarinen H. Life course of people with coronary artery disease. J Clin Nurs 1999;8:701-11.

Turner RC, Millns H, Neil HA, Stratton IM, Manley SE, Matthews DR, et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ 1998;316:823-8.

Spilker B, editor. Quality of life and pharmacoeconomics in clinical trials. Philadelphia: Lippincott-Raven, 1996.

Staniūtė M, Vaškelytė J, Rumbinaitė E, Kaminskaitė B, Samsanavičienė S, Plungienė S, et al. Impact of left ventricular function on health-related quality of life in coronary artery disease patients. J Medi Clin 2015;1:233-9.

McGee HM, Oldridge N, Hellemans IM. Quality of life evaluation in cardiovascular disease: a role for the European Society of Cardiology. Eur J Cardiovasc Prev Rehabil 2005;12:191-2.

SukheeAhn, RN, Rhayun Song, RN, Si Wan Choi. Effects of Selfcare Health Behaviors on Quality of Life Mediated by Cardiovascular Risk Factors Among Individuals with Coronary Artery Disease: J Asian Nurs Res 2016;10:158-63.

Ridder D, Geenen R, Kuijer R, Middendorp H. Psychological adjustment to chronic disease. Lancet 2008;372:246-55.

Moss-Morris R. Adjusting to chronic illness: time for a unified theory. J Health Psychol 2013;18:681-6.

Leventhal HL, Brissette I, Leventhal EA.Common-Sense Model of self-regulation of health and illness.In: The Self-Regulation of Health and Illness Behavior. Cameron LD, Leventhal H, eds. London: Routledge, 2003:42-65.

Hagger MS, Orbell S. A meta-analytic review of the commonsense model of illness representations. J Psychol Health 2003;18:141-84.

Petrie KJ, Weinman J. Why illness perceptions matter. Clin Med 2006;6:536-9.

Le Grande MR, Elliott PC, Worcester MU, Murphy BM, Goble AJ, Kugathasan V, et al. Identifying illness perception schemata and their association with depression and quality of life in cardiac patients. Psychol Health Med 2012;17:709-22.

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;50:945-53.

Husson O, Mols F, van de Poll Franse LV. The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol 2011;22:761-72.

Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res 2006;60:631-7.

Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D. The revised Illness Perception Questionnaire (IPQ-R). J Psychol Health 2002;17:1-16.

American Psychiatric Association (APA), editor. Diagnostic and Statistical Manual of Mental Disorder. 4thed. New York: American Psychiatric Association, 1994.

Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res 2006;60:631-7.

Bagherian R, Bahrami Ehsan H, Saneei H. Relationship Between History of myocardial Infarction and Cognitive Representation ofMyocardial Infarction. J Res Psychological Health 2008;2:29-39.

AsghariMoghaddam M, Faghihi S. Validity and reliability of health survey questionnaire (SF-36) in two Iranian sample. J Daneshvare Raftar 2004;10:1-10.

FoxwelR, Morley Ch and Frizele D. Illness perceptions, mood and quality of life: A systematic review of coronary heart disease patients Conclusion, J Psychosomatic Res 2013;75:211-22.

Heijmans MJ. Coping and adaptive outcome in chronic fatigue syndrome: importance of illness cognitions. J Psychosom Res 1998;45:3-51.

Heijmans MJ. The role of patients’ illness representations in coping and functioning with Addison’s disease. Br J Health Psychol 1999;4:137-49.

Hallegraeff J, van DS, Krijnen W, de Greef MHG. Measurement of acute nonspecific low back pain perception in primary care physical therapy: reliability and validity of the brief illness perception questionnaire. BMC Musculoskelet Disord 2013;14:53.

Heijmans M, Foets M, Rijken M, Schreurs K, Ridder D, Bensing J. Stress in chronic disease: do the perceptions of patients and their general practitioners match? Br J Health Psychol 2001;6:229-42.

deRidder DTD, Theunissen NCM, van Dulmen SM. Does training general practitioners to elicit patients’ illness representations and action plans influence their communication as a whole? Patient Educ Couns 2007;66:327-36.

Pietrabissa G Sorgente A, Castelnuovo G. Integrating Motivational Interviewing with Brief Strategic Therapy for Heart Patients. J ProcediaSocial Behav Sci 2015;165:136-43.

Jansen DL, Heijmans M, Rijken M, Kaptein AA. The development of and first experiences with a behavioral self-regulation intervention for end-stage renal disease patients and their partners. J Health Psychol 2011;16:274-83.

Stafford L, Berk M, Jackson HJ. Are illness perceptions about coronary artery disease predictive of depression and quality of life outcomes? J Psychosomatic Res 2009;66:211-20.

IssueVol 56, No 3 (2018) QRcode
Coronary artery disease CAD Psychological factors Illness perception Health-related quality of life

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How to Cite
Madani MS, Salesi M, Mohammadi J. The Effect of Dimensions of Illness Perceptions on the Variation of Quality of Life in Patients With Coronary Artery Disease. Acta Med Iran. 2018;56(3):189-195.