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Psychosocial risk factors, such as perceived stress, not only increase the risk of cardiovascular disease, but also act as barriers for treatment adherence and cardiac rehabilitation. In this study, we examined the predictive role of perceptions for illness to perceived stress in Iranian patients participating in a cardiac rehabilitation program. A cross-sectional study was conducted in 2017 to determine correlations of demographic variables and domains of illness perception with perceived stress, and to develop a predictive model for perceived stress. In total, 150 patients with cardiovascular disease, who were admitted to a cardiac rehabilitation center, completed the questionnaires. (i) demographic and health-related characteristics; (ii) the Perceived Stress Scale-14; and (iii) the Brief Illness Perception Questionnaire. The mean perceived stress was 16.2 (8.4), and five illness perception subscalestimeline, personal control, treatment control, understanding and emotional responsewere associated with increased perceived stress. Variables in the multi-variate predictive model accounted for 48% of the total variance in perceived stress. The results demonstrated the value of assessing and managing the patients' perceptions of illness to reduce their perceived stress, which could support adherence to cardiac rehabilitation programs. K E Y W O R D S cardiac rehabilitation, cardiovascular, Iran, psychosocial risk factor, stress

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Introduction: Empathy, spiritual intelligence and social responsibility are Factors affecting on expanding the quality of nursing services and can have a basic role on the patients' rights. This study aimed to investigate the relationship between empathy and spiritual intelligence with nurses' attitudes towards the rights of patients with mediation of social responsibility. Methods: This descriptive-correlational study based on the structural model was conducted on 300 nurses in west Azerbaijan in 2016. Data gathering instruments included the Jefferson empathy scale, Salkovskis responsibility scale, King spiritual intelligence scale and the questionnaire of patients' rights of Hoshmand et al. Data were analyzed using descriptive (frequency, percentage, mean, standard deviation) and inferential (Pearson correlation coefficient and Path analysis) statistics with SPSS and Amos-22 software. Results: The results showed a significant direct effect of empathy (P = 0.04, r = 0.05), spiritual intelligence (P = 0.04, r =-0.19), and social responsibility (P = 0.001, r = 0.62) on nurses' attitudes towards the rights of patients. The results also showed an indirect effect of empathy (P = 0. 05) and spiritual intelligence (P = 0. 03) on nurses' attitudes towards the rights of patients with mediation of the social responsibility. Also, 40% of the variance of the nurses' attitudes towards the rights of patients was determined using empathy, spiritual intelligence and responsibility. Conclusions: It seems that increasing empathy, spiritual intelligence and responsibility can improve the nurses' attitudes towards the rights of patients. In order to consider the rights of patients, it is recommended that necessary actions be performed in training empathy, spiritual intelligence and social responsibility among nurses.