Farhana Haseeb, Farrah Pervaiz, Shazeena Zafar, Naila Azam, Humaira Mahmood, Rizwana Anwar.
Role of psychological stress and physical inactivity among patients of ischemic heart disease in Rawalpindi.
Pak Armed Forces Med J Jan ;69(SUPPL2):S210-15.

Background: Globally cardiovascular diseases (CVDs) especially ischemic heart disease (IHD) became the largest menace and still considering as the most common cause of death. Psychological stress and physical inactivity are the two important risk factors for IHD, but still little is known regarding their actual frequency in Pakistan. Objective: To determine the frequency of psychological stress and physical inactivity among patients of ischemic heart disease in Rawalpindi. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Study is conducted in Armed Forces Institute of Cardiology (AFIC) and Rawalpindi Institute of Cardiology (RIC) Rawalpindi Pakistan, from Apr to Oct 2018. Material and Methods: For the present study 200 known patients of IHD have been selected through non probability consecutive sampling, between 20 to 60 years of age, having ejection fraction 30-60% from OPDs of above two selected hospitals. Self-administered General Health Questionnaire (GHQ-12) is used to assess the psychological stress level and World Health Organization Disability Assessment Schedule (WHO DAS 2.0) is used to assess physical inactivity status of IHD patients. Results: According to standard cut-offs of GHQ-12 results, 28 (13%) respondents rated as normal (no stress), 18 (10%) having minimal stress, 84 (42%) rated as having moderate level of mental stress, while 70 (35%) were showed severe psychological stress, the total frequency of psychological stress in IHD patient is revealed as 82%. A considerable association has been found between psychological stress and physical inactivity in ischemic heart disease patients showing the p-value (p=0.043). On the basis of standard cut offs of WHO DAS 2.0 questionnaire, 142 (71%) were found having moderate physical inactivity and 42 (21%) were rated in severe category, only 16 (8%) rated in normal category. Total frequency of physical inactivity in IHD patients revealed as 92%. By comparing results of two, a significant association between the physical inactivity and psychological stress(p=0.009) has been found. Conclusion: The present study is showing significant association between psychological stress and physical inactivity in patients of ischemic heart disease. It is a starting point leading to awareness, discussion and action for government, physicians, patients and all stakeholders.

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