Predictors of Perceived Health Competence Among Patients with Chronic Coronary Heart Artery Disease

Background and aim: Despite rapid diagnostic and therapeutic advances, patients with chronic coronary artery disease (CCAD) should adopt self-care behaviors. This study aimed to determine predictors of perceived health competence among CCAD patients in Tehran, Iran in 2019-2020. Materials and Methods: This cross-sectional study was conducted among 700 patients with CCAD referred to Shahid-Rajaie Cardiovascular Center in Tehran selected using the available sampling method. Data were collected using the perceived health competence scale (PHCS), 12-item quality of life scale and Modanloo's adherence to treatment scale questionnaires. The content validity ratio and content validity index were used to determine validity, and the Cronbach's alpha to determine reliability, of the PHCS questionnaire. Data analysis was performed using descriptive statistics, Pearson correlation coefficient, Structural Equation Modeling (SEM), the software being SPSS25. Results: The multivariate regression analysis showed that perceived health competence had statistically significant direct associations with physical (β = 1.08, p< 0.001) and psychological (β = 0.85, p< 0.001) domains of quality of life, commitment to treatment (β = 0.12, p =0.01), willingness to participate in treatment (β = 0.12, p = 0.05) and uncertainty about implementation (p = 0.1, p‹ 0.001) of adherence to treatment. There was a significant indirect association between age and perceived health competence (β = -0.13, p = 0.03). Conclusion: Based on the findings, considering a “very good” and a “poor” mean score for adherence and the quality of life among the patients, respectively, adopting strategies for promoting quality of life in both the physical and mental dimensions can lead to improvements in perceived health competence in cardiovascular patients. In addition, it seems that focusing on subscales of “willingness to participate in treatment” might help in improving the patients' perceived health competence.