Modeling psychosocial factors affecting the severity of coronary heart disease: the mediating role of physiological responses and health-related behaviors

Today, cardiovascular diseases (CVDs) remain a leading cause of mortality. They rank first across the globe and are recognized as a multifactorial disorder, one of which is psychosocial factors. The current study aimed to determine the role of the aforementioned factors in coronary heart disease mediated by physiological responses and health-related behaviors. Methods: This descriptive-correlational study was performed on ۲۷۰ men and women who were referred to the Department of Cardiology of Taleghani, Modares, and Farhikhtegan hospitals in Tehran and were selected via the Convenience sampling method. The research instruments were Depression, Anxiety and Stress Scale -۲۱ Items (DASS-۲۱), perceived social support, hostility, type D personality, and adherence to treatment. To assess social variables, the questionnaire of social support, socioeconomic status, quality of life, social comparison, and psychological response was used. Finally, to examine health-related behaviors, questionnaires related to diet, smoking, and physical activity were used. The level of physiological responses of blood lipids was based on blood test results, and the severity of coronary heart disease was measured by coronary angiography. The causal relationship between variables and the research questions was examined using structural equation modeling, particularly through path analysis within the Lisrel software for the measurement model. Results: Based on the findings, it is evident that psychosocial factors have a significant impact on the severity of coronary heart disease. This impact is partly mediated by physiological responses and blood lipids. Therefore, it is important to consider psychosocial factors, unhealthy behaviors, and blood lipids in the treatment of coronary heart disease. The squared multiple correlations in the structural model of psychological factors account for ۲۵.۳۳% of the variance in coronary heart disease. This indicates that psychological factors, physiological responses, and unhealthy behaviors collectively explain ۲۵.۳۳% of the variance. Specifically, psychological factors explain ۴۱.۸% of the variance in physiological responses and ۱۸.۴۹% of the variance in unhealthy behaviors. Additionally, physiological responses account for ۱۰.۸۹% of the variance in coronary heart disease, while unhealthy behaviors explain ۱۴.۱۴% of its variance.

کلیدواژه ها:

Blood lipids ، Coronary Heart disease ، Psychological factors ، Social Factors ، Unhealthy behaviors