Comparison of the Effectiveness of Emotional Self-Regulation Strategies and Pain Coping Strategies on Health Dimensions among Patients with Coronary Heart Disease

Document Type : Original Article

Authors

1 Department of Health Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran

2 Associate Professor, Department of Psychology, Kharazmi University, Tehran, Iran

3 Assistant Professor, Department of Health Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran

Abstract

Background: Healthy heart is essential to human life, and cardiovascular disease is not specific to any age or gender and can affect anyone at any age and gender.
 
Objectives: This study was conducted to compare the effectiveness of emotional self-regulation strategies and pain coping strategies on health dimensions among patients with coronary heart disease.
 
Methods: This semi-experimental study was conducted based on a pretest-posttest control group design and follow-up. The statistical population consisted of all patients with coronary heart disease referring to Heshmatieh Hospital in Sabzevar, Razavi Khorasan Province, Iran, within July-October, 2019. A total of 45 samples were randomly selected and divided into two experimental and one control group. The research instrument was the General Health Questionnaire. The data were analyzed using repeated measure analysis of variance in SPSS 25.
 
Results: The results showed that emotional self-regulation strategies and pain coping strategies had an effect on health dimensions and reduced physical symptoms, anxiety and insomnia, social dysfunction, and depression in patients with coronary heart disease (P<0.001). The findings also revealed that in the physical symptoms dimension, the difference between emotional self-regulation strategies and pain coping strategies was significant, and pain coping strategies were more effective than emotional self-regulation strategies (P<0.001).
 
Conclusion: Training emotional self-regulation and pain coping skills may enhance health outcomes in people with coronary heart disease.

Keywords


Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

1. Appleton A, Buka S, Loucks E. Divergent associations of adaptive and maladaptive emotion regulation strategies with Inflammation. Health Psychol. 2013; 32: 748-56.
https://doi.org/10.1037/a0030068
PMid:23815767 PMCid:PMC3793468
 
2. Berking M, Wupperman P, Reichardt A, Pejic T, Dippel A, Znoj H. Emotion regulation skills as a treatment target in psychotherapy. Behavior Research and Therapy 2008; 46: 1230-237.
https://doi.org/10.1016/j.brat.2008.08.005
PMid:18835479
 
3. Vlachakis C, Dragoumani K, Raftopoulou S, Mantaiou M, Papageorgiou L, Tsaniras SC, Megalooikonomou V, Vlachakis D. Human emotions on the onset of cardiovascular and small vessel related diseases. in vivo. 2018;32(4):859-70.
https://doi.org/10.21873/invivo.11320
PMid:29936471 PMCid:PMC6117769
 
4. Meeus M. Are pain beliefs, cognitions, and behaviors influenced by race, ethnicity, and culture in patients with chronic musculoskeletal pain: a systematic review. Pain Physician. 2018;21:541-8.
https://doi.org/10.36076/ppj.2018.6.541
PMid:30508984
 
5. Gratz KL, Roemer L. The relationship between emotion dysregulation and deliberate self‐harm among female undergraduate students at an urban commuter university. Cognitive behavior therapy. 2008;37(1):14- 25.
https://doi.org/10.1080/16506070701819524
PMid:18365795
 
6. Gross J. Emotion regulation: Taking stock and moving forward. Am Psychol J. 2013; 13: 359-65.
https://doi.org/10.1037/a0032135
PMid:23527510
 
7. John O, Gross J. Healthy and unhealthy emotion regulation: personality processes, individual differences, and life span development. J Personality. 2004; 72: 1302-36.
https://doi.org/10.1111/j.1467-6494.2004.00298.x
PMid:15509284
 
8. Kraaij V, van Emmerik A, Garnefski N, Schroevers MJ, Lo-Fo-Wong D, van Empelen P, Dusseldorp E, Witlox R, Maes S. Effects of a cognitive-behavioral self- help program and a computerized structured writing
 
9. intervention on depressed mood for HIV-infected people: A pilot randomized controlled trial. Patient Education and Counseling. 2010;80(2):200-4.
https://doi.org/10.1016/j.pec.2009.08.014
PMid:19781889
 
10. Kubzansky LD, Thurston R. Emotional vitality and incident coronary heart disease. Arch Gen Psychiatry. 2007; 64: 1393-1401.
https://doi.org/10.1001/archpsyc.64.12.1393
PMid:18056547
 
11. Lavie CJ, Milani RV. Cardiac rehabilitation and exercise training in secondary coronary heart disease prevention. J Progress in Cardiovascular Diseases. 2012;53(6):397-403.
https://doi.org/10.1016/j.pcad.2011.02.008
PMid:21545925
 
12. McDermott MJ, Tull MT, Gratz KL, Daughters SB, Lejuez CW. The role of anxiety sensitivity and difficulties in emotion regulation in posttraumatic stress disorder among crack/cocaine dependent patients in residential substance abuse treatment. Journal of anxiety disorders. 2009;23(5):591-9.
https://doi.org/10.1016/j.janxdis.2009.01.006
PMid:19233609 PMCid:PMC2698460
 
13. Nakamura S, Kato K, Yoshida A, Fukuma N, Okumura Y, Ito H, Mizuno K. Prognostic value of depression, anxiety, and anger in hospitalized cardiovascular disease patients for predicting adverse cardiac outcomes. The American journal of cardiology. 2013;111(10):1432-6.
https://doi.org/10.1016/j.amjcard.2013.01.293
PMid:23433760
 
14. Porter A, Fischer MJ, Brooks D, Bruce M, Charleston J, Cleveland WH, et al. Quality of life and psychosocial factors in African Americans with hypertensive chronic kidney disease. J Translational Research. 2012;159(1):4- 11.
https://doi.org/10.1016/j.trsl.2011.09.004
PMid:22153804 PMCid:PMC3240805
 
15. Smith TW, Deits‐Lebehn C, Williams PG, Baucom BR, Uchino BN. Toward social psychophysiology of vagally mediated heart rate variability: Concepts and methods in self‐regulation, emotion, and interpersonal processes. Social and Personality Psychology Compass. 2020;14(3):e12516.
https://doi.org/10.1111/spc3.12516
 
16. Stoney C. Stress and pain. handbook of Pain and Palliative Care 2018 (pp. 361-376). Springer, Cham.
https://doi.org/10.1007/978-3-319-95369-4_19
 
17. Bose C, Bjorling G, Elfström M, Persson H, Saboonchi F. Implementation of coping effectiveness training in patients with chronic heart failure : participants evaluations indicate psychosocial benefits. Eur J Cardiovasc Nurs. 2015;14(1):10-S10.
 
18. Jackson JL. Influence of traits, coping, affect, and illness knowledge on adherence among patients in cardiac rehabilitation [Internet]. ProQuest Dissertations and Theses. 2010. Available from: http://search.proquest.com/docview/758452994?accounti d=41453
 
19. Ghannam BM, Hamdan-Mansour AM, Arabiat DH, Azzeghaiby SN, Abeiat DD Al, Badawi TH Al. Psychosocial Wellbeing of Patients Diagnosed with Coronary Artery Disease. Psychology. 2014;5(8):801-7. 19.Jain A, Verma S. Prevalence of Stress and Coping Strategies Among College Students. J Adv Med Dent Sci Res |Vol [Internet]. 2016;4(6):6. Available from: www.jamdsr.com
https://doi.org/10.4236/psych.2014.58091
 
20. Nasiłowska-Barud A, Fedorovich V, Zapolski T, Sikorska-Jaroszyńska M, Wysokiński A. Pain-coping strategies in women with ischemic heart disease. Ann Agric Environ Med. 2013;20(4):767-72.
 
21. Zou H, Tian Q, Chen Y, Cheng C, Fan X. Coping styles mediate the relationship between self-esteem, health locus of control, and health-promoting behavior in Chinese patients with coronary heart disease. J Cardiovasc Nurs. 2017;32(4):331-8.
https://doi.org/10.1097/JCN.0000000000000357
PMid:27306855
 
22. Nissen NK, Jónsdóttir M, Spindler H, Zwisler ADO. Resistance to change: Role of relationship and communal coping for coronary heart disease patients and their partners in making lifestyle changes. Scand J Public Health. 2018;46(6):659-66.
https://doi.org/10.1177/1403494818756562
PMid:29400128
 
23. Li Z, Liu T, Han J, Li T, Zhu Q, Wang A. Confrontation as a Mediator between Sense of Coherence and Self-management Behaviors among Elderly Patients with Coronary Heart Disease in North China. Asian Nurs Res (Korean Soc Nurs Sci). 2017;11(3):201-6.
https://doi.org/10.1016/j.anr.2017.08.003
PMid:28991601
 
24. Kähkönen O, Kankkunen P, Miettinen H, Lamidi ML, Saaranen T. Perceived social support following percutaneous coronary intervention is a crucial factor in patients with coronary heart disease. J Clin Nurs. 2017;26(9-10):1264-80.
https://doi.org/10.1111/jocn.13527
PMid:27535229
 
25. Alhurani AS, Dekker R, Ahmad M, Miller J, Yousef KM, Abdulqader B, et al. Stress, cognitive appraisal, coping, and event-free survival in patients with heart failure. Hear Lung. 2018;47(3):205-10.
https://doi.org/10.1016/j.hrtlng.2018.03.008
PMid:29627073 PMCid:PMC5924439
 
26. Nahlén Bose C, Persson H, Björling G, Ljunggren G, Elfström ML, Saboonchi F. Evaluation of a Coping Effectiveness Training intervention in patients with chronic heart failure - A randomized controlled trial. Eur J Cardiovasc Nurs. 2016;15(7):537-48.
https://doi.org/10.1177/1474515115625033
PMid:26733462
 
27. Breuninger C, Sláma DM, Krämer M, Schmitz J, Tuschen-Caffier B. Psychophysiological Reactivity, Interoception and Emotion Regulation in Patients with Agoraphobia During Virtual Reality Anxiety Induction. Cognit Ther Res. 2017;41(2):193-205.
https://doi.org/10.1007/s10608-016-9814-9
 
28. Nazifi M, Mokarami HR, Akbaritabar AK, FarajiKujerdi M, Tabrizi R, Rahi A. Reliability, validity and factor structure of the persian translation of general health questionnire (ghq-28) in hospitals of kerman university of medical sciences. Journal of Fasa University of Medical Sciences. 2014;3(4):336-42.
https://doi.org/10.17795/jhealthscope-15547
 
29. Najafi Ghezeljeh T, Emami A. Strategies for recreating normal life: Iranian coronary heart disease patients' perspectives on coping strategies. J Clin Nurs. 2014;23(15-16):2151-61
https://doi.org/10.1111/jocn.12428
PMid:24330453