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OBJECTIVES: Primary objective was to identify the relationship between stress and positive attitude among adults with Coronary Heart Disease (CHD). Secondary objective was to predict Stress from Positive attitude in illness by controlling demographic characteristics (age, gender, and marital status) among adults with CHD.
METHODS: This was a Cross-sectional survey research conducted during March-May 2017 in Public Hospitals of Faisalabad, Pakistan. Study sample was selected through purposive sampling technique. The sample size consisted of 278 (155 men, 123 women) CHD inpatients and out patients with age range from 18-80 years. Perceived Stress scale Urdu 10 items (PSS-10) and Silver Lining Questionnaire (SLQ) Urdu version 38 were used to measure stress and positive attitude in illness respectively. SPSS 21 was used for statistical analysis.
RESULTS: A significant positive relationship exists between age and stress while a significant negative relationship exists between positivity and stress among adults with CHD. After controlling the demographic characteristics such as age, gender, and marital status, positive attitude in illness is significant predictor of stress among adults with CHD.
CONCLUSION: Adults with CHD have a high level of stress and low level of positive attitude. Stress and positive attitude are interlinked and statistically significant negative relationship among adults with CHD, further age; gender and marital status are significant predictors of stress among CHD adult patients.
KEY-WORDS: Stress (Non-MeSH); Coronary Disease (MeSH); Adult (MeSH); Positive attitude (Non-MeSH)
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1. Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics—2017 update: a report from the American Heart Association. Circulation 2017;135(10):e146-e603. DOI: 10.1161/CIR.0000000000000485.
2. England and Wales, Office for National Statistics 2016. Deaths registered by cause, gender and age. [Cited on: June 25, 2017] Available at: www.nomisweb.co.uk/articles/983.aspx.
3. Scotland, National Records of Scotland 2016. Deaths, by gender, age and cause. [Cited on: June 25, 2017] Available at: www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/vital-events-reference-tables/2015/section-6-deaths-causes.
4. Jafar TH, Qadri Z, Chaturvedi N. Coronary artery disease epidemic in Pakistan: more electrocardiographic evidence of ischaemia in women than in men. Heart 2008;94(4):408-13. DOI: 10.1136/hrt.2007.120774.
5. Kivimäki M, Virtanen M, Elovainio M, Kouvonen A, Väänänen A, Vahtera J. Work stress in the etiology of coronary heart disease—a meta-analysis. Scand J Work Environ Health 2006 Dec;32(6):431-42. DOI: 10.5271/sjweh.1049.
6. Steptoe A, Kivimäki M. Stress and cardiovascular disease. Nat Rev Cardiol 2012 Apr 3;9(6):360-70. DOI: 10.1038/nrcardio.2012.45.
7. Steptoe A, Kivimäki M. Stress and cardiovascular disease: an update on current knowledge. Annu Rev Public Health 2013 Jan;34:337-54. DOI: 10.1146/annurev-publhealth-031912-114452.
8. Macleod J, Smith GD, Heslop P, Metcalfe C, Carroll D, Hart C. Psychological stress and cardiovascular disease: empirical demonstration of bias in a prospective observational study of Scottish men. BMJ 2002;324(7348):1247-51. DOI: 10.1136/bmj.324.7348.1247.
9. Avey JB, Wernsing TS, Mhatre KH. A longitudinal analysis of positive psychological constructs and emotions on stress, anxiety, and well-being. J Leadersh Organ Stud 2011;18(2):216-28. DOI: 10.1177/1548051810397368.
10. Virtanen M, Elovainio M, Josefsson K, Batty GD, Singh-Manoux A, Kivimäki M. Coronary heart disease and risk factors as predictors of trajectories of psychological distress from midlife to old age. Heart 2017 May;103(9):659-65. DOI: 10.1136/heartjnl-2016-310207.
11. Sodergren SC, Hyland ME. What are the positive consequences of illness? Psychology Health 2000;15(1):85-97. DOI: 10.1080/08870440008400290.
12. Sodergren SC, Hyland ME, Crawford A, Partridge MR. Positivity in illness: Self‐delusion or existential growth? Br J Health Psychol 2004 May;9(Pt 2):163-74. DOI: 10.1348/135910704773891023.
13. Lærum E, Johnsen N, Smith P, Larsen S. Myocardial infarction may induce positive changes in life-style and in the quality of life. Scand J Prim Health Care 1988 May;6(2):67-71. DOI: 10.3109/02813438809009293.
14. Sodergren SC, Hyland ME, Singh SJ, Sewell L. The effect of rehabilitation on positive interpretations of illness. Psychol Health 2002;17(6):753-60 DOI: 10.1080/0887044021000009674.
15. Davidson KW, Mostofsky E, Whang W. Don't worry, be happy: positive affect and reduced 10-year incident coronary heart disease: the Canadian Nova Scotia Health Survey. European Heart Journal. 2010;31(9):1065-70. DOI: 10.1093/eurheartj/ehp603.
16. Kurd BJ, Dar MI, Shoaib M, Malik L, Aijaz Z, Asif I. Relationship between stress and coronary heart disease. Asian Cardiovasc Thorac Ann 2014 Feb;22(2):142-7. DOI: 10.1177/0218492312469803.
17. Tindle H, Davis E, Kuller L. Attitudes and cardiovascular disease. Maturitas. 2010;67(2):108-13. DOI: 10.1016/j.maturitas.2010.04.020.
18. Mariam, A., Sarwar, A., Maqsood, R., Bashir, A., &Aamir, K. (2011). Translation and adaptation of “Perceived Stress Scale (PSS10)” in Urdu Language. www.psy.cmu.edu/~scohen/scales.html#! , accessed on 30/07/2017
19. Hewitt PL, Flett GL, Mosher SW. The Perceived Stress Scale: Factor structure and relation to depression symptoms in a psychiatric sample. Journal of Psychopathology and Behavioral Assessment. 1992;14(3):247-57.
20. Sodergren SC, Hyland ME. Qualitative phase in the development of the Silver Lining Questionnaire. Quality of Life Research, 6, (7-8), 365. DOI: 10.13072/midss.78.
21. Krantz DS, McCeney MK. Effects of psychological and social factors on organic disease: a critical assessment of research on coronary heart disease. Annu Rev Psychol 2002;53(1):341-69. DOI: 10.1146/annurev.psych.53.100901.135208.
22. Hooper MW, Dietz NA, Wilson JC. Sociocultural Risk Factors for Elevated Perceived Stress among African American Smokers. J Health Dispar Res Pract 2017;9(4):13.
23. Folkman S. Stress: appraisal and coping. In Encyclopedia of behavioral medicine 2013 (pp. 1913-1915). Springer, New York, NY.
24. Cooper CL, Marshall J. Occupational sources of stress: A review of the literature relating to coronary heart disease and mental ill health. J Occup Psychol 1976;49(1):11-28. DOI: 10.1111/j.2044-8325.1976.tb00325.x.
25. Bride OM, Dunwoody L, Lowe-Strong A, Kennedy SM. Examining adversarial growth in illness: The factor structure of the silver lining questionnaire (SLQ-38). Psychol Health 2008;23(6):661-78. DOI: 10.1080/14768320701356540.
26. Wang EY, Dixson J, Schiller NB, Whooley MA. Causes and Predictors of Death in Patients With Coronary Heart Disease (from the Heart and Soul Study). Am J Cardiol 2017 Jan 1;119(1):27-34. DOI: 10.1016/j.amjcard.2016.09.006.
27. Khayyam-Nekouei Z, Neshatdoost H, Yousefy A, Sadeghi M, Manshaee G. Psychological factors and coronary heart disease. ARYA Atheroscler 2013;9(1):102-11.
28. Williams ED, Stamatakis E, Chandola T, Hamer M. Physical activity behaviour and coronary heart disease mortality among South Asian people in the UK: an observational longitudinal study. Heart 2011 Apr;97(8):655-9. DOI: 10.1136/hrt.2010.201012.