Quality of life in coronary heart disease patients: The role of defense mechanisms and alexithymia with mediation of psychological distress

Abstract

Background: Coronary heart disease leads to negative consequences, diminished health-related quality of life, and increased mortality. Objectives: This study aimed at predicting the quality of life of patients with coronary heart disease based on defense mechanisms and alexithymia with the mediating role of psychological distress. Methods: In a cross-sectional descriptive study, 300 patients with coronary heart disease, who had referred to the specialized heart center of Ayatollah Madani governmental hospital in Khorramabad city of Lorestan were selected by the convenience sampling method from February to July 2015. Depression, anxiety, and stress scales, the mac-new health-related quality of life questionnaire for patients with heart disease, the Toronto alexithymia scale, the defensive styles scale and a demographical checklist were used for data collection. Descriptive indices were analyzed by SPSS-19 and structural equation model with AMOS was used for analysis of the inferential statistics. Results: According to the structural equation model, the path coefficient related to the effect of defensemechanismsonalexithymia (β = 0.65), alexithymia on the quality of life (β = -0.26), alexithymia on psychological distress (β = 0.51), and psychological distress on the quality of life (β = -0.58) were statistically significant (P < 0.001). However, the path of the defense mechanisms to psychological distress and the path of defense mechanisms to quality of life were not significant (P > 0.05). Conclusions: Defense mechanisms and alexithymia had a significant role in predicting the quality of life of patients with coronary heart disease. It is recommended that clinical specialists should design appropriate clinical trials or modify the current and future interventions on the basis of the results of such studies.