Post coronary heart diseases depression: role of illness perception and copping strategies

Objective: Due to unpleasant consequences of depression in patients suffering from cardiac diseases, such as increase in mortality rate during the first year, especially after undergoing a surgery; this study addresses structural relationships between cognitive and behavioral variables including illness perception and coping strategies in predicting depression after undergoing Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI). Besides, one of the cognitive models for assessing psychological adaptation with chronic medical diseases was outlined for the first time. Method: The sample comprised ۲۴۵ coronary patients confronted with the diagnosis for the first time, who had undergone PCI and CABG interventions. They were chosen and interviewed through convenience sampling following one month of initiating treatment process. For this purpose, Beck Depression Inventory for Primary Care (BDI-PC), Coping Inventory for Stressful Situations (CISS-۲۱) and the short format of Disease Perception Questionnaire were administered. Data was analyzed using structural equations modeling (LISREL software). Results: findings indicated that applying emotion-focused coping strategies determined ۴۰% of depression variance in these patients, whereas problem-focused strategies determined ۴.۵% of it and avoidant coping strategy didn’t have a significant role in depression. On the other hand, illness perception as a cognitive variable, could directly determine ۲۶% of depression and ۴.۵% of it through emotion-focused strategies and ۰.۲۵% by means of problem-focused strategies. Also illness perception, could meaningfully determine ۵۰% of emotion-focused coping variance, ۷% of problem-focused variance and ۸% of avoidance variance. Conclusion: Overall results of this study supported Leventhal’s theoretical model of self-regulation and verified the role of cognitive variables (illness perception) and behavioral ones (coping strategy) in emerging depression. Therefore it is recommended that much attention be drawn to the process of developing patient’s illness perception through personal or group trainings and if necessary, offering effective cognitive and behavioral treatments by practitioners.

Keywords:

post coronary heart diseases depression , illness perception , Coping Strategies , CABG , PCI