Document Type : Original Article(s)

Authors

1 Associate Professor, Behavioral Sciences Research Center AND Department of Health Psychology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Professor, Department of Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

3 Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medicine Sciences, Isfahan, Iran

4 PhD Candidate, Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

BACKGROUND: In physical diseases including cardiovascular diseases (CVDs), illness perception (IP) plays an important role in illness outcomes. Fatigue is a major bothersome symptom after myocardial infarction (MI). This manuscript presents the research design, methodology, and primary findings of a study on factors in relation with fatigue and IP in patients with MI, and changes in fatigue after intervention on IP.METHODS: 241 patients with MI who experienced a first-time acute MI (AMI) participated in this study in 2016-2017. During hospitalization, the demographic and clinical information of participants were collected. After four months, the information regarding fatigue, IP, coping with stress, type D personality, perceived social support (PSS), and locus of control of the participants was collected at their houses. About one year later, based on the results of phase one of the study, a psychoeducation course was conducted for 35 of the patients as intervention group while 36 patients were supervised as control group. Two months later, the role of IP in fatigue changes of the participants was assessed.RESULTS: 155 (65%) of the patients had positive family history of coronary heart disease (CHD). 103 (43%) were cigarette smokers, 100 (43.5%) had high blood cholesterol, and 72 (30%) had sedentary life style before MI.CONCLUSION: The overview of the factors related to fatigue and IP of the patients with MI could help the care teams to provide better care in the recovery period of the illness. 

Keywords

  1. World Health Organization. Cardiovascular diseases (CVDs) [Online]. [cited 2017]; Available from: URL: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
  2. Shams M, Samavat T, Hojatzadeh A, Afkhami A, Mahdavi A, Bashti S. The ways of prevention and control of cardiovascular diseases. Tehran, Iran: Javan Publications; 2013. [In Persian].
  3. Leventhal H, Nerenz DR, Steele DJ. Illness representation and coping with health threats. In: Baum A, Taylor SE, Singer JE, Editors. Handbook of Psychology and Health: Social Psychological Aspects of Health. Mahwah, NJ: Lawrence Erlbaum; 1984. p. 219-52.
  4. Lett HS, Blumenthal JA, Babyak MA, Sherwood A, Strauman T, Robins C, et al. Depression as a risk factor for coronary artery disease: Evidence, mechanisms, and treatment. Psychosom Med 2004; 66(3): 305-15.
  5. Hagger MS, Orbell S. A meta-analytic review of the common-sense model of illness representations. Psychology & Health 2003; 18(2): 141-84.
  6. van Esch SC, Nijkamp MD, Cornel MC, Snoek FJ. Illness representations of type 2 diabetes patients are associated with perceptions of diabetes threat in relatives. J Health Psychol 2014; 19(3): 358-68.
  7. Woith WM, Rappleyea ML. Emotional representation of tuberculosis with stigma, treatment delay, and medication adherence in Russia. J Health Psychol 2016; 21(5): 770-80.
  8. Wearden AJ. Illness perception interventions for heart attack patients and their spouses: Invited commentary. J Psychosom Res 2009; 67(1): 25-7.
  9. Diefenbach MA, Leventhal H. The common-sense model of illness representation: Theoretical and practical considerations. J Soc Distress Homeless 1996; 5(1): 11-38.
  10. Dodd M, Janson S, Facione N, Faucett J, Froelicher ES, Humphreys J, et al. Advancing the science of symptom management. J Adv Nurs 2001; 33(5): 668-76.
  11. Alsen P, Brink E, Persson LO. Living with incomprehensible fatigue after recent myocardial infarction. J Adv Nurs 2008; 64(5): 459-68.
  12. Andersson EK, Borglin G, Willman A. The experience of younger adults following myocardial infarction. Qual Health Res 2013; 23(6): 762-72.
  13. Alsen P, Brink E, Brandstrom Y, Karlson BW, Persson LO. Fatigue after myocardial infarction: relationships with indices of emotional distress, and sociodemographic and clinical variables. Int J Nurs Pract 2010; 16(4): 326-34.
  14. Alsen P, Brink E, Persson LO, Brandstrom Y, Karlson BW. Illness perceptions after myocardial infarction: relations to fatigue, emotional distress, and health-related quality of life. J Cardiovasc Nurs 2010; 25(2): E1-E10.
  15. Alsen P, Brink E. Fatigue after myocardial infarction-a two-year follow-up study. J Clin Nurs 2013; 22(11-12): 1647-52.
  16. Olson K. A new way of thinking about fatigue: A reconceptualization. Oncol Nurs Forum 2007; 34(1): 93-9.
  17. Leventhal H, Brissette I, Leventhal EA. The common-sense model of self-regulation of health and illness. In: Cameron LD, Leventhal H, Editors. The self-regulation of health and illness behaviour. Abingdon, UK: Routledge; 2003. p. 42-65.
  18. Broadbent E, Ellis CJ, Thomas J, Gamble G, Petrie KJ. Further development of an illness perception intervention for myocardial infarction patients: A randomized controlled trial. J Psychosom Res 2009; 67(1): 17-23.
  19. Petrie KJ, Cameron LD, Ellis CJ, Buick D, Weinman J. Changing illness perceptions after myocardial infarction: An early intervention randomized controlled trial. Psychosom Med 2002; 64(4): 580-6.
  20. Broadbent E, Ellis CJ, Thomas J, Gamble G, Petrie KJ. Can an illness perception intervention reduce illness anxiety in spouses of myocardial infarction patients? A randomized controlled trial. J Psychosom Res 2009; 67(1): 11-5.
  21. Yaraghchi A, Rezaei O, Mandegar MH, Bagherian R. The Relationship Between Illness Perception and Quality of life in Iranian Patients with Coronary Artery Bypass Graft. Procedia Soc Behav Sci 2012; 46: 3329-34.
  22. Bagherian SR, Bahrami EH, Sanei H. Relationship between history of myocardial infraction and cognitive representation of myocardial infraction. Research in Psychological Health 2008; 2(2): 29-39.
  23. 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 MedIran 2018; 56(3): 189-95.
  24. Stafford L, Berk M, Jackson HJ. Are illness perceptions about coronary artery disease predictive of depression and quality of life outcomes? J Psychosom Res 2009; 66(3): 211-20.
  25. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res 2006; 60(6): 631-7.
  26. Denollet J. DS14: standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosom Med 2005; 67(1): 89-97.
  27. Pedersen SS, Denollet J. Validity of the Type D personality construct in Danish post-MI patients and healthy controls. J Psychosom Res 2004; 57(3): 265-72.
  28. Bagherian R, Bahrami EH. Psychometric properties of the Persian version of type D personality scale (DS14). Iran J Psychiatry Behav Sci 2011; 5(2): 12-7. [In Persian].
  29. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess 1988; 52(1): 30-41.
  30. Canty-Mitchell J, Zimet GD. Psychometric properties of the Multidimensional Scale of Perceived Social Support in urban adolescents. Am J Community Psychol 2000; 28(3): 391-400.
  31. Bagherian-Sararoudi R, Hajian A, Ehsan HB, Sarafraz MR, Zimet GD. Psychometric properties of the persian version of the multidimensional scale of perceived social support in Iran. Int J Prev Med 2013; 4(11): 1277-81.
  32. Hartz A, Bentler S, Watson D. Measuring fatigue severity in primary care patients. J Psychosom Res 2003; 54(6): 515-21.
  33. Hadi N, Khademalhosseini Z, Khademalhosseini M. Comparison of prevalence of fatigue in adult diabetic mellitus patients with healthy population in Shiraz 2010. Shiraz E-Med J 2012; 13(3): 94-101.
  34. Farahani M, Cooper M, Jin P. Is locus of control unidimensional or multidimensional? Data from Persian translations of Rotter's I-E scale and Levenson's I, P, and C scales. Psychol Res 1996; 2: 38-62.
  35. Levenson H. Multidimensional locus of control in psychiatric patients. J Consult Clin Psychol 1973; 41(3): 397-404.
  36. Moshki M, Ghofranipour F, Hajizadeh E, Azadfallah P. Validity and reliability of the multidimensional health locus of control scale for college students. BMC Public Health 2007; 7: 295.
  37. Endler NS, Parker JD. Multidimensional assessment of coping: a critical evaluation. J Pers Soc Psychol 1990; 58(5): 844-54.
  38. Endler NS, Parker JD. State and trait anxiety, depression and coping styles. Aust J Psychol 1990; 42(2): 207-20.
  39. Endler NS, Parker JD. The multidimensional assessment of coping: Concepts, issues, and measurement. In: Van Heck GL, Bonaiuto P, Deary IJ, Nowack W, Editors. Personality psychology in Europe. Tilburg, Netherlands: Tilburg University Press; 1993. p. 309-19.
  40. Endler NS, Parker JD. Assessment of multidimensional coping: Task, emotion, and avoidance strategies. Psychological Assessment 1994; 6(1): 50-60.
  41. Ghoreyshi Rad F. Validation of Endler & Parker coping scale of stressful situations. J Res Behav Sci 2010; 1: 1-7.