Original Article

Association between Illness Perception and Emotional Status in Iranian Patients after Heart Transplantation

Abstract

Background: Heart transplantation is a major procedure which imposes high emotional stress on patients. Illness perception (IP) is a psychological issue which affects psychological adjustment after transplantation. This study aimed to investigate the association between IP and emotional status in Iranian post-heart transplantation patients.
Methods: The present cross-sectional study, conducted between 2018 and 2019 in Imam Khomeini Hospital, Tehran, Iran, recruited 121 post-heart transplantation patients. IP was measured using the Brief Illness Perception Questionnaire (B-IPQ), and emotional status was measured using the Hospital Anxiety and Depression Scale. The association between IP and depression/anxiety was assessed.
Results: Men comprised 80.2% of the study population. The mean age of the participants was 43.9±12.95 years. Definite caseness for depression and anxiety was reported in 11.6% and 18.2% of the participants, respectively. The median score of IP was 55. The association between anxiety and IP in total IP and the 3 dimensions of IP was statically significant (P=0.015, P=0.018, P=0.002, and P=0.023 for the cognition, emotion, and understanding dimensions and the total IPQ, respectively). Additionally, the association between depression and IP was significant (P=0.001, P=0.029, and P=0.002 for the cognition and emotion dimensions and the total IPQ, correspondingly, except for the understanding dimension). Furthermore, lower levels of anxiety in the patients showed a greater impact on IP than did depression.
Conclusion: There was a significant association between IP and depression and anxiety in our study population. Therefore, the diagnosis and management of anxiety and depression in heart transplantation patients may improve IP. The cross-sectional design of the present study precluded an investigation of the causality between IP and emotional status.

1. Matsuda H, Ichikawa H, Ueno T, Sawa Y. Heart transplantation for adults with congenital heart disease: current status and future prospects. Gen Thorac Cardiovasc Surg 2017;65:309-320.
2. Kirklin JK, Pambukian SV, McGiffin DC, Benza RL. Current outcomes following heart transplantation. Semin Thorac Cardiovasc Surg 2004;16:395-403.
3. Mandegar MH, Bagheri J, Chitsaz S, Jebelli M, Javidi D, Sarzaeem MR, Eghtesadi-Araghi P, Razavi J, Darehzereshki A, Assar O. Heart transplantation in Iran; a comprehensive single-center review of 15-year performance. Arch Iran Med 2009;12:111-115.
4. Salehi M, Bakhshandeh AR, Latifi S, Rahmanian M. Heart transplant survival rate in Iran: a single-center registry report. Asian Cardiovasc Thorac Ann 2014;22:534-538.
5. Conway A, Schadewaldt V, Clark R, Ski C, Thompson DR, Kynoch K, Doering L. The effectiveness of non-pharmacological interventions in improving psychological outcomes for heart transplant recipients: a systematic review. Eur J Cardiovasc Nurs 2014;13:108-115.
6. Lesko LM, Hawkinz DR. Psychological aspects of transplantation medicine. In: Akhtar S, ed. New Psychiatric Syndromes: DSM-III and Beyond. New York: Jason Aronson; 1983. p. 265-309.
7. Brocks Y, Zittermann A, Grisse D, Schmid-Ott G, Stock-Gießendanner S, Schulz U, Brakhage J, Benkler A, Gummert J, Tigges-Limmer K. Adherence of heart transplant recipients to prescribed medication and recommended lifestyle habits. Prog Transplant 2017;27:160-166.
8. Peyrovi H, Raiesdana N, Mehrdad N. Living with a heart transplant: a phenomenological study. Prog Transplant 2014;24:234-241.
9. Deshields TL, McDonough EM, Mannen RK, Miller LW. Psychological and cognitive status before and after heart transplantation. Gen Hosp Psychiatry 1996;18(6 Suppl):62S-69S.
10. Doering LV, Chen B, Deng M, Mancini D, Kobashigawa J, Hickey K. Perceived control and health-related quality of life in heart transplant recipients. Eur J Cardiovasc Nurs 2018;17:513-520.
11. Leventhal H, Contrada RJ, Leventhal E. A. The impact of perceived hypertension status on anxiety and the white coat effect. Ann Behav Med 2007;34:10-13.
12. Kucukarslan SN. A review of published studies of patients' illness perceptions and medication adherence: lessons learned and future directions. Res Social Adm Pharm 2012;8:371-382.
13. Basu S, Poole J. The brief illness perception questionnaire. Occup Med (Lond) 2016;66:419-420.
14. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-370.
15. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002;52:69-77.
16. Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health Qual Life Outcomes 2003;1:14.
17. Janelle C, O'Connor K, Dupuis G. Evaluating illness representations in heart transplant patients. J Health Psychol 2016;21:1850-1859.
18. Lotfi-Tokaldany M, Karimi A, Shahmansouri N, Sadeghian S, Abbasi SH, Jalali A, Ayatollahzade Isfahani F, Saadat S. Illness perceptions in patients with premature coronary artery disease: a sex-based analysis 8 years after the diagnosis. J Clin Psychol Med Settings 2019;26:158-165.
19. Morgan K, Villiers-Tuthill A, Barker M, McGee H. The contribution of illness perception to psychological distress in heart failure patients. BMC Psychol 2014;2:50.
20. Kugler J, Tenderich G, Stahlhut P, Posival H, Körner MM, Körfer R, Krüskemper GM. Emotional adjustment and perceived locus of control in heart transplant patients. J Psychosom Res 1994;38:403-408.
21. Noorbala AA, Faghihzadeh S, Kamali K, Bagheri Yazdi SA, Hajebi A, Mousavi MT, Akhondzadeh S, Faghihzadeh E, Nouri B. Mental health survey of the Iranian adult population in 2015. Arch Iran Med 2017;20:128-134.
Files
IssueVol 15 No 1 (2020): J Teh Univ Heart Ctr QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jthc.v15i1.3333
Keywords
Perception Depression Anxiety Heart transplantation
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Shahmansouri N, Salehi M, Bakhshandeh AR, Sattarzadeh Badkoubeh R, Lotfi- Tokaldani M, Noorbala AA, Mashayekhi A. Association between Illness Perception and Emotional Status in Iranian Patients after Heart Transplantation. J Tehran Heart Cent. 2020;15(1):12-17.