Background: Depression is a significant predictor of the quality of life among patients with coronary heart disease. Therefore, it is essential to explore the factors associated with depression. Illness cognition is considered one of the factors affecting depression. However, the relationship between illness cognition and the incidence of depression among Indonesian patients have not been widely investigated.
Objective: This study aimed to investigate the correlation between illness cognition, consisting of the acceptance, perceived benefits, and helplessness variables, and depression in patients with coronary heart disease.
Methods: This study employed a correlational research design with a total of 106 patients undergoing treatment at a hospital in West Java, Indonesia, selected using convenience sampling. Data were collected using a demographic questionnaire, Beck-Depression Inventory-II (BDI-II), and ICQ (Illness-Cognition Questionnaire). Data were analyzed using mean (SD), median, frequency distribution, and Spearman-rank.
Results: 72% of respondents had no depression. Nevertheless, mild, moderate, and major depression suffered by 15%, 9%, and 4% of respondents, respectively. In terms of illness cognition, patients scored higher within the perceived benefits dimension (mean 20.13, SD 3.05), followed by acceptance (mean 18.22, SD 3.33) and helplessness (mean 13.20, SD 4.77), respectively. Furthermore, helplessness was significantly associated with depression (p <.01) with a positive correlation coefficient (r). Also, all items on the helplessness dimension had a significant correlation (p <.01) with depression accompanied by a positive r-value.
Conclusion: Helplessness had a significant relationship with depression. So, cardiovascular nurses can anticipate depression in patients by making nursing interventions that can decrease the patients’ feelings of helplessness. Thus, factors that reduce helplessness need to be explored and taken into accounts in the treatment of patients with coronary heart disease.
Adisasmito, W., Amir, V., Atin, A., Megraini, A., & Kusuma, D. (2020). Geographic and socioeconomic disparity in cardiovascular risk factors in Indonesia: Analysis of the Basic Health Research 2018. BMC Public Health, 20(1), 1-13. https://doi.org/10.1186/s12889-020-09099-1
Amin, A. A., Jones, A. M., Nugent, K., Rumsfeld, J. S., & Spertus, J. A. (2006). The prevalence of unrecognized depression in patients with acute coronary syndrome. American Heart Journal, 152(5), 928-934. https://doi.org/10.1016/j.ahj.2006.05.006
Amni, R. (2020). Hubungan antara kesejahteraan spiritual dan tingkat depresi pasien sindrom koroner akut di unit perawatan intensif [The relationship between spiritual well-being and depression levels of patients with acute coronary syndrome in the cardiac intensive care unit]. (Theses), Padjadjaran University, Bandung, West Java, Indonesia. Retrieved from http://repository.unpad.ac.id/frontdoor/index/index/docId/36422
Beck, A. T., Steer, R. A., & Brown, G. (1996). Beck Depression Inventory–II [Database record]. APA PsycTests. https://doi.org/10.1037/t00742-000
Bujang, M. A., & Baharum, N. (2016). Sample size guideline for correlation analysis. World Journal of Social Science Research, 3(1), 37-46. https://doi.org/10.22158/wjssr.v3n1p37
Cameron, L. D., & Leventhal, H. (2003). The self-regulation of health and illness behaviour (1st ed.). UK: Routledge/Taylor & Francis.
Capobianco, L., Faija, C., Husain, Z., & Wells, A. (2020). Metacognitive beliefs and their relationship with anxiety and depression in physical illnesses: A systematic review. Plos One, 15(9), e0238457. https://doi.org/10.1371/journal.pone.0238457
Carney, R. M., & Freedland, K. E. (2017). Depression and coronary heart disease. Nature Reviews Cardiology, 14(3), 145-155. https://doi.org/10.1038/nrcardio.2016.181
Chaerunnisa, S. M., Nur’aeni, A., & Hernawaty, T. (2017). The corelation between social support and depression in coronary heart disease patients. Journal of Nursing Care & Biomolecular, 2(2), 92-98. https://doi.org/10.32700/jnc.v2i2.66
Chow, C., Atkins, E., Islam, S., Lung, T., & Conroy, K. (2017). Reducing the burden of cardiovascular disease in Indonesia. Newtown, Australia: The George Institute for Global Health.
Delima, P. P., Sriati, A., & Nur’aeni, A. (2018). Illness cognition pada pasien dengan penyakit jantung koroner [Illness cognition in patients with coronary heart disease]. Journal of Nursing Care & Biomolecular, 1(1), 42-49. https://doi.org/10.24198/jnc.v1i1.15763
Evers, A. W. M., Kraaimaat, F. W., van Lankveld, W., Jongen, P. J. H., Jacobs, J. W. G., & Bijlsma, J. W. J. (2001). Beyond unfavorable thinking: the illness cognition questionnaire for chronic diseases. Journal of Consulting and Clinical Psychology, 69(6), 1026-1036. https://doi.org/10.1037/0022-006X.69.6.1026
Ginting, H., Näring, G., Van Der Veld, W. M., Srisayekti, W., & Becker, E. S. (2013). Validating the Beck Depression Inventory-II in Indonesia's general population and coronary heart disease patients. International Journal of Clinical and Health Psychology, 13(3), 235-242. https://doi.org/10.1016/S1697-2600(13)70028-0
Hare, D. L., Toukhsati, S. R., Johansson, P., & Jaarsma, T. (2014). Depression and cardiovascular disease: A clinical review. European Heart Journal, 35(21), 1365-1372. https://doi.org/10.1093/eurheartj/eht462
Hermele, S., Olivo, E. L., Namerow, P., & Oz, M. C. (2007). Illness representations and psychological distress in patients undergoing coronary artery bypass graft surgery. Psychology, Health and Medicine, 12(5), 580-591. https://doi.org/10.1080/13548500601162705
Hirani, S. P., & Newman, S. P. (2005). Patients’ beliefs about their cardiovascular disease. Heart, 91(9), 1235-1239. http://dx.doi.org/10.1136/hrt.2003.025262
Juergens, M. C., Seekatz, B., Moosdorf, R. G., Petrie, K. J., & Rief, W. (2010). Illness beliefs before cardiac surgery predict disability, quality of life, and depression 3 months later. Journal of Psychosomatic Research, 68(6), 553-560. https://doi.org/10.1016/j.jpsychores.2009.10.004
Karademas, E. C., & Hondronikola, I. (2010). The impact of illness acceptance and helplessness to subjective health, and their stability over time: A prospective study in a sample of cardiac patients. Psychology, Health & Medicine, 15(3), 336-346.
Kwan, Y. H., Koh, E. T., Leong, K. P., Wee, H.-L., & Tan Tock Seng Rheumatoid Arthritis Study, G. (2014). Association between helplessness, disability, and disease activity with health-related quality of life among rheumatoid arthritis patients in a multiethnic Asian population. Rheumatology International, 34(8), 1085-1093. https://doi.org/10.1007/s00296-013-2938-2
Lane, D., Carroll, D., Ring, C., Beevers, D. G., & Lip, G. Y. H. (2000). Effects of depression and anxiety on mortality and quality-of-life 4 months after myocardial infarction. Journal of Psychosomatic Research, 49(4), 229-238. https://doi.org/10.1016/S0022-3999(00)00170-7
Leventhal, H., Diefenbach, M., & Leventhal, E. A. (1992). Illness cognition: Using common sense to understand treatment adherence and affect cognition interactions. Cognitive Therapy and Research, 16(2), 143-163. https://doi.org/10.1007/BF01173486
Lichtman, J. H., Froelicher, E. S., Blumenthal, J. A., Carney, R. M., Doering, L. V., Frasure-Smith, N., . . . Sheps, D. S. (2014). Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: Systematic review and recommendations: A scientific statement from the American Heart Association. Circulation, 129(12), 1350-1369. https://doi.org/10.1161/CIR.0000000000000019
Mensah, G. A., Roth, G. A., & Fuster, V. (2019). The global burden of cardiovascular diseases and risk factors: 2020 and beyond. Journal of the American College of Cardiology, 74(20), 2529-2532. https://doi.org/10.1016/j.jacc.2019.10.009
Müller-Tasch, T., Peters-Klimm, F., Schellberg, D., Holzapfel, N., Barth, A., Jünger, J., . . . Herzog, W. (2007). Depression is a major determinant of quality of life in patients with chronic systolic heart failure in general practice. Journal of Cardiac Failure, 13(10), 818-824. https://doi.org/10.1016/j.cardfail.2007.07.008
Nur'aeni, A., Mirwanti, R., Anna, A., & Nurhidayah, I. (2019). Determinant factors of depression in patients with coronary heart disease. Jurnal Keperawatan Padjadjaran, 7(3). https://doi.org/DOI:10.24198/jkp
Nuraeni, A., Mirwanti, R., & Anna, A. (2018). Relationship of spiritual-wellbeing with anxiety and depression in patients with cardiac heart disease. Belitung Nursing Journal, 4(1), 45-50. https://doi.org/10.33546/bnj.231
Nuraeni, A., Mirwanti, R., Anna, A., Prawesti, A., & Emaliyawati, E. (2016). Faktor yang mempengaruhi kualitas hidup pasien dengan penyakit jantung koroner [Factors affecting quality of life of patients with coronary heart disease]. Jurnal Keperawatan Padjadjaran, 4(2), 107–116.
Nuraeni, A., Praptiwi, A., & Nurhidayah, I. (2020). Depression, recurrence, and perceptions of physical fitness among CHD patients: A comparison based on participation in phase II cardiac rehabilitation program. Jurnal Keperawatan Padjadjaran, 8(3). https://doi.org/10.24198/jkp.v8i3.1471
Ogden, J. (2012). Health psychology: A textbook UK: McGraw-Hill Education.
Shin, E. S., Hwang, S. Y., Jeong, M. H., & Lee, E. S. (2013). Relationships of factors affecting self-care compliance in acute coronary syndrome patients following percutaneous coronary intervention. Asian Nursing Research, 7(4), 205-211. https://doi.org/10.1016/j.anr.2013.10.003
Smallheer, B. A. (2011). Learned helplessness and depressive symptoms in patients following acute myocardial infarction. (Doctor of Philosophy Dissertation), Vanderbilt University, Nashville, Tennessee. Retrieved from https://www.proquest.com/openview/866a856724dbd283a0be66b0bbbb3614/1?pq-origsite=gscholar&cbl=18750
Smallheer, B. A., Vollman, M., & Dietrich, M. S. (2018). Learned helplessness and depressive symptoms following myocardial infarction. Clinical Nursing Research, 27(5), 597-616. https://doi.org/10.1177/1054773816689752
Su, J. J., & Yu, D. S. F. (2019). Effectiveness of eHealth cardiac rehabilitation on health outcomes of coronary heart disease patients: A randomized controlled trial protocol. BMC Cardiovascular Disorders, 19(1), 1-10. https://doi.org/10.1186/s12872-019-1262-5
Su, J. J., Yu, D. S. F., & Paguio, J. T. (2020). Effect of eHealth cardiac rehabilitation on health outcomes of coronary heart disease patients: A systematic review and meta‐analysis. Journal of Advanced Nursing, 76(3), 754-772. https://doi.org/10.1111/jan.14272
Sutantri, S., Cuthill, F., & Holloway, A. (2019). ‘A bridge to normal’: A qualitative study of Indonesian women’s attendance in a phase two cardiac rehabilitation programme. European Journal of Cardiovascular Nursing, 18(8), 744-752. https://doi.org/10.1177/1474515119864208
Theofilou, P. (2011). Noncompliance with medical regimen in haemodialysis treatment: A case study. Case Reports in Nephrology, 2011, 476038. https://doi.org/10.1155/2011/476038
Turan Kavradim, S., Özer, Z., & Boz, İ. (2020). Effectiveness of telehealth interventions as a part of secondary prevention in coronary artery disease: A systematic review and meta‐analysis. Scandinavian Journal of Caring Sciences, 34(3), 585-603. https://doi.org/10.1111/scs.12785
Uli, R. E., Satyana, R. P. U., Zomer, E., Magliano, D., Liew, D., & Ademi, Z. (2020). Health and productivity burden of coronary heart disease in the working Indonesian population using life-table modelling. BMJ Open, 10(9), e039221. http://dx.doi.org/10.1136/bmjopen-2020-039221
Vaccarino, V., Badimon, L., Bremner, J. D., Cenko, E., Cubedo, J., Dorobantu, M., . . . Milicic, D. (2020). Depression and coronary heart disease: 2018 position paper of the ESC working group on coronary pathophysiology and microcirculation. European Heart Journal, 41(17), 1687-1696. https://doi.org/10.1093/eurheartj/ehy913
Wang, L., Wu, X., Du, J., Cao, W., & Sun, S. (2021). Global burden of ischemic heart disease attributable to ambient PM2. 5 pollution from 1990 to 2017. Chemosphere, 263, 128134. https://doi.org/10.1016/j.chemosphere.2020.128134
Whang, W., Kubzansky, L. D., Kawachi, I., Rexrode, K. M., Kroenke, C. H., Glynn, R. J., . . . Albert, C. M. (2009). Depression and risk of sudden cardiac death and coronary heart disease in women: Results from the Nurses' Health Study. Journal of the American College of Cardiology, 53(11), 950-958. https://doi.org/10.1016/j.jacc.2008.10.060
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.