@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2018;5(3):38-47

Background
Human beings according to the socio-psychosocial model are in fact considered as an organism composed of three biological, psychological and social interacting systems that are affected by other physical, behavioral, and psychological reactions. ... [1].
Previous Studies
... [2-6]. In general, cardiovascular diseases and cancer can cause changes in the lifestyle of patients, which leads to a significant decrease in the quality of life and psychological well-being in these patients. ... [7]. ... [8-12]. Quality of life is another variable that affects cardiovascular and cancer patients. ... [13]. According to the Donald, quality of life is a term indicating the health and emotional, social and physical development of individuals and their ability to perform routine tasks. ... [14, 15]. It has been found that there is a low level quality of life in coronary heart disease patients and it even decreases by an increase in severity of illness [16]. In addition, Molloy et al. [17] showed that the quality of life in patients with heart failure is not favorable and they face several problems in physical and functional domain of quality of life.
Aim(s)
This study was conducted with the aim of comparing the quality of life and psychological well-being of the patients with cardiovascular diseases and cancer as well as healthy people.
Research type
This research is a descriptive study with a causal-comparative design.
Research society, place and time
The study population included all patients with cardiovascular diseases and cancer at the Avicenna Clinic in Tabriz in 2016, who were diagnosed by physicians and cardiologists and cancer specialists based on the physical and laboratory examinations
Sampling method and number
Purposive sampling method was done. Based on the Cochran formula, the total sample size obtained 150 subjects, including 100 patients and 50 patients’ companions (healthy people). The inclusion criteria were cardiovascular disease or cancer patients diagnosed by physicians, lack of mental retardation and other mental disorders, epilepsy and addiction, and having at least a diploma. Exclusion criteria were physical and psychiatric disorders in addition to cardiovascular disease and cancer, attending psychological training classes through the intervention and unwillingness to participate in the research.
Used devices&materials
The quality of life questionnaire [18, 19] and Ryff psychological well-being questionnaire [10, 20] were used to collect data. For ethical consideration, the subjects were asked to participate in the meeting, at where they were informed about the study process and were entered to the study voluntarily. They were assured about the confidentiality of data, as well. Data was analyzed using descriptive statistics, such as measures of central tendency (mean and standard deviation) and inferential statistics, such as multivariate analysis of variance (MANOVA) (MANOVA).
Findings by Text
In all components of quality of life, the score of healthy people was higher than those with cardiovascular disease and cancer. In general health components, the scores of physical activity and vitality were higher in people with heart disease than those with cancer, whereas patients with cancer scored higher in physical functioning, mental health, bodily pain, mental functioning limitation, and social functioning than those with cardiovascular disease (Table 1). Healthy subjects scored higher than those with cardiovascular disease in the self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, personal growth and psychological well-being dimensions, and the scores of subjects with cardiovascular disease were more than those with cancer (Table 2). There was a significant difference between the patients with cancer and cardiovascular disease and healthy subjects in quality of life (F=95.07; p<0.001). However, the paired sample t-test was used to assess the significance and the higher score among the groups (Table 3). Healthy subjects achieved higher scores in the dimensions, including quality of life and general health, physical functioning, physical functioning limitation, mental health, mental functioning limitation, vitality and social functioning (p<0.05), whereas no significant difference was observed in patients with cardiovascular diseases and cancer (p>0.05). Cardiovascular diseases and cancer patients scored higher in bodily pain compared with healthy subjects (p<0.05), and no significant difference was found between cardiovascular and cancer patients (p>0.05; Table 4).There was a difference between patients with cancer and cardiovascular disease and healthy subjects in psychological well-being (F=175.17; p<0.001). However, the paired sample t-test was used to assess the significance and the higher score among the groups (Table 5).Healthy subjects scored higher in self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, individual growth and psychological well-being in comparison with cardiovascular disease and cancer patients (p<0.001), and cardiovascular disease patients obtained higher score than patients with cancer, which was statistically significant (Table 6)
Main comparison to the similar studies
In the Bengtsson et al. [21] study, quality of life of patients who had a heart attack for the first time was measured 12 to 24 months later and the patients less than 59 years and over 59 years were compared together. There was a difference in the dimensions of social functioning and mental functioning limitation between two groups. Studying the effects of heart attack on the family and especially the patient's spouse showed that the families of patients with heart attack are experienced a high level of tension and psychological stress [22]. ... [23-25]. Abdollahian et al. [26] concluded that men with coronary artery disease, compared with healthy men, used more emotion-focused coping strategies and somatization, whereas problem-focused coping strategies and social support were less used. ... [27-31]. A group of Italian researchers studied cancer patients aged 18 to 65 years and found that the most important mental health factor affecting their psychological well-being was anxiety and in those over 50 years undesirable levels of education, unemployment, and psychological well-being can be observed. Many patients with cancer are depressed with the decreased level of concentration and attention. In other words, prevention of emotional disorders such as depression in cancer patients is necessary, because depression can reduce the psychological well-being of patients, and the interventions to reduce depression can lead to an improvement in their psychological well-being [32].
Suggestions
It is suggested that both medical interventions and psychological interventions to be considered and stress management counseling and management of anxiety should be regarded to improve their quality of life and psychological well-being.
Limitations
The bias can be a big problem with self-report measures, which is one of the limitations of this research.
Conclusions
Patients with cardiovascular disease and cancer have lower levels of quality of life and psychological well-being than healthy subjects.
Acknowledgments
The researchers are thankful to those who collaborated on this research.
Conflict of interest
None declared.
Ethical Permissions
Ethics code: 23620701942012.
Funding Sources
This study is extracted from a master's thesis in Clinical Psychology at the East Azarbaijan Science and Research Branch, Islamic Azad University, Tabriz in 2016.

TABLES and CHARTS

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