Metacognitive Therapy on Mental Health, Self-efficacy and Illness Perception in Coronary Heart Disease

heart disease is caused by stenosis and coronary artery disease, is a health problem in developing and developing countries, and is one of the leading causes of death in the world, including Iran. Coronary heart disease (CHD) is among the diseases affected by psychological factors. Recently, role of disease perception has been taken into account on the life quality of people with chronic diseases. The concept of perceived illness is organized cognitive representation of the patient. One of the factors influencing the life quality of patients is self–efficacy during researches on different patients, which refers to the ability of a person to perform their caring behaviors in specific circumstances. Self–efficacy is considered as an important predictor of behavior that it acts as an independent part of a person's basic skills. Of course, it should be noted that the role of self–efficacy in initiating and maintaining health behaviors is illustrated by several studies in other subjects. Holistic philosophy about health emphasizes on the unity of various human dimensions. From the perspective, diseases are result of an irregular in physical, psychological and environmental dimensions. Therefore, all dimensions integrate and work together such as health types including physical, social and emotional health. Several studies have been carried out on the identification of risk factors for cardiovascular disease. The treatment that emphasis in this study was metacognitive therapy. The metacognitive therapy approach describes the cognitive and metacognitive factors of the underlying and continuing perspectives of psychological disorders and emotional vulnerabilities. The aim of this study was to investigate the effect of metacognitive therapy on general health, self–efficacy and perception of disease in cardiovascular patients

In this study, 30 patients were selected through purposeful sampling. Then, 15 patients were randomly assigned to the experimental group and 15 to the control group. The questionnaires included general health questionnaire, self–efficacy and perception of the disease. Data were collected before and after the implementation of 8 sessions of treatment and analyzed by SPSS 21 software and by covariance analysis.

Mean and standard deviation of pretest scores in the experimental group in the general health, self–efficacy and perceived disease variables were 63.67, 2.14, 54.8, 6.1, 54.2 and 71.7 respectively. The post–test was 46.45, 23.2, 66.13, 58.9, 58.46 and 12.28 respectively. In addition, the pre–test score in the control group was 62.22, 2.71, 64.06, 4.84, 39.26, 4.99 and 63.41 after test, 2.71, 65.73, 41.4, 40.38 and 65.2. The results of covariance analysis indicated that treatment significantly decreased anxiety and depression in general health, increased autoimmunity and perceived illness (p<0.001).

As a result, metacognitive therapy could be an effective treatment for general health, self–efficacy and modulation of perception of disease in patients with coronary artery disease.