Chronic Patients’ Activation and Its Association with Stress, Anxiety, Depression, and Quality of Life: A Survey in Southeast Iran

Abstract

A better perception of the factors associated with patient activation, as a way to improve self-management, is the most important step in planning patient-centered education for chronic disease management. Therefore, the present study is aimed at investigating the relationship between activation, stress, anxiety, depression, and quality of life (QOL) in patients with chronic diseases. This correlational study was performed on 293 chronic patients admitted to coronary care units (CCUs) in one of the hospitals in Rafsanjan. The Patient Activation Measure (PAM), Quality of Life-BREF (WHOQOL-BREF), and Depression, Anxiety, and Stress Scale-21 Items (DASS-21) were used to collect data. The data were then analyzed using SPSS 22. A significant positive correlation was observed between general QOL and PAM ( P < 0.001 ). In addition, a significant negative correlation was found between PAM, stress ( P = 0.032 ), and depression ( P = 0.025 ). The results of multivariate linear regression indicated that only physical and psychological subscales of QOL significantly predicted PAM ( B = 0.24 ; 95% confidence interval; P value < 0.05). Owing to the fact that some subscales of QOL have a determinant role in the PAM of chronic patients, healthcare providers are recommended to plan and implement the necessary interventions to improve the QOL and the health outcomes of chronic patients.

The relationship between anxiety, stress, spiritual health, and mindfulness among patients undergoing hemodialysis: A survey during the COVID‐19 outbreak in Southeast Iran

“…Scores 0 to 14 show normal stress, scores 15 to 18 show mild stress, scores 19 to 25 show moderate stress, scores 26 to 33 show severe stress, and scores above 33 show very severe stress. Cronbach's alpha coefficient for the depression, anxiety, and stress scales was 0.81, 0.74 and 0.78, respectively in Iran 13 . In the present study, the Cronbach's alpha of stress subscale was 0.92.…”

“…Cronbach's alpha coefficient for the depression, anxiety, and stress scales was 0.81, 0.74 and 0.78, respectively in Iran. 13 In the present study, the Cronbach's alpha of stress subscale was 0.92.…”

“…A high percentage of stress and anxiety is reported in chronic patients 13 . In addition to chronic disease, hemodialysis patients face many stressors, including problems with treatment, dietary and fluid restrictions, weakness, anxiety, and depression 14 .…”

Burnout, Anxiety, Stress, and Depression Among Iranian Nurses: Before and During the First Wave of the COVID-19 Pandemic

“…In Iran, Samani and Jokar reported the retest validity to be 0.80, 0.76, and 0.77 for depression, anxiety and stress, respectively. Cronbach’s alpha coefficients were reported to be 0.81, 0.74, and 0.78, for depression, anxiety and stress, respectively ( Zakeri et al, 2021b ). In the present study, the Cronbach’s alpha coefficients of depression, anxiety, stress and the whole scale were 0.88, 0.85, 0.87, and 0.94, respectively.…”

Validating the Quality of Prenatal Care Questionnaire (QPCQ-P) in an Iranian Sample of Pregnant Mothers: A Methodological Study

“…To interpret this scale correctly, the short version's scores must be converted to the long version's scores, and then the quality of life in each domain must be interpreted from zero to 100. In Iran, Cronbach's alpha coe cient of 0.78 has been reported for this questionnaire [17].…”