Volume 22, Issue 86 (11-2022)
refahj 2022, 22(86): 151-194 |
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Zanjanian M, Mousaei M, Ghasemi Z. (2022). Behavioral Style of Economic Status of Cardiovascular Patients in Javad-Al-Aemeh Heart Hospital of Mashhad. refahj. 22(86), : 5 doi:10.32598/refahj.22.86.3913.1
URL: http://refahj.uswr.ac.ir/article-1-3905-en.html
URL: http://refahj.uswr.ac.ir/article-1-3905-en.html
Keywords: Cardiovascular disease, Behavioral style, Economic burden, Socio-economic status, Living conditions, Health capital
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Extended Abstract
Introduction
Heart disease is currently the leading cause of death in most of the regions in the world including Iran. It causes 40 percent of all deaths (Rajabzadeh & et al., 2018). Studies show that social factors such as behavioral style and education on one side and economic factors such as economic capital and income on the other side can play a part in the incidence of chronic cardiovascular diseases. The spread of chronic diseases like heart disease in the society brings about considerable economic and social costs (Javadi & poorjebeli, 2019), and the evidence indicates that the cardiovascular diseases are on the increase problematically. The issue can be addressed from traditional and modern perspectives. The traditional approach considers medical issues in the light of biomedical sketches. It reasons that any biological transformation is the result of its previous biological transformation. However, this approach has been seriously challenged. On the one hand, it should be noted that many biological causes of diseases are greatly affected by social-economic factors, but on the other hand, diseases are multidimensional. Thus, biological explanation of an illness is not sufficient. As a result, social, cultural, economic, and even developmental aspects need to be considered. These factors are of great importance in the modern approach (Armstrong & Tavakoli, 2008). The present study aims to sociologically investigate the economic burden on cardiovascular patients with the aim of a change in behavioral style and its contributory factors before suffering from the disease. The study was conducted in Javad Al-Aeme Heart Hospital in Mashhad.
Method
It is a descriptive-cross-sectional study. The statistical population included the cardiac patients of Javad Al-Aeme Heart Educational, Medical, and Research Center in Mashhad in 1399. The cardiovascular patients were the case of observation and analysis. This hospital is one of the biggest cardiovascular centers in Asia and Iran providing health care to cardiac patients from all over Iran. Three wards including Male Internal Ward, Female Internal Ward, and the VIP[1] ward were used to collect data. These wards were selected due to the fact that the patients there had a higher level of willingness, consciousness, and ability in contrast to other patients. Besides, the situation was more suitable for conducting interviews and answering to questions than the other wards. The "convenience sampling'' method was used to collect the data. The sample size was measured using the Cochran formula, and 385 individuals were selected as the "sample population". The data was gathered using a questionnaire consisting of two parts. The first part included patients' demographic characteristics, such as gender, age, education, underlying diseases, cigarette and alcohol consumption, income, etc. The second part consisted of questions associated with the structure of behavioral styles, health capital, living condition, social-economic conditions, and economic burden. The validity of the questionnaire was confirmed by experts, the supervisor, and the advisor. Its reliability was estimated to be 0.789 percent using Cronbach's alpha coefficient. The questionnaires were completed by the patients of Javad Al-Aeme Heart Hospital of Mashhad. Before collecting the data, the patients were informed about the content of questions and the purpose of the study. Also, a consent form was prepared and delivered to the patients to declare their willingness to participate in the study. The data were analyzed using SPSS in the first phase and the Structural Equation Modeling technique and AMOS in the second phase.
Findings
The results of the research hypotheses based on the Structural Equation
As shown in the table above, the number of all the research structures indicated acceptable fitting of the conceptual model. Therefore, the congruence of the conceptual model with the collected data was confirmed. The fitted research model demonstrated the direct effect (factor loading-path coefficients) of the main variables of the research in the table as well.
Discussion
All in all, the results illustrate that the cardiovascular diseases have a direct correlation with behavioral style, economic-social condition, health care, living condition, and as a result with the economic burden of the disease. The findings showed that the participants' lifestyles were not suitable in terms of health care. The average score of the total index of healthy lifestyles of the cardiovascular patients in the range of 1 to 5 was obtained as 2.79, which was below the average. The results are in agreement with the findings of Mohseni-Pooya et al. (2017), Shafiee et al.(2013), Mohammadi-Zeidi et al. (2005), and Rashidi and Bahrami (2015) indicating the undesirable lifestyles of the cardiac patients. It is indicated that the factors of healthy lifestyle and health-promoting behaviors of the participants tended to become unhealthy.
Keywords: Cardiovascular disease, Behavioral style, Economic burden, Socio-economic status, Living conditions, Health capital
Introduction
Heart disease is currently the leading cause of death in most of the regions in the world including Iran. It causes 40 percent of all deaths (Rajabzadeh & et al., 2018). Studies show that social factors such as behavioral style and education on one side and economic factors such as economic capital and income on the other side can play a part in the incidence of chronic cardiovascular diseases. The spread of chronic diseases like heart disease in the society brings about considerable economic and social costs (Javadi & poorjebeli, 2019), and the evidence indicates that the cardiovascular diseases are on the increase problematically. The issue can be addressed from traditional and modern perspectives. The traditional approach considers medical issues in the light of biomedical sketches. It reasons that any biological transformation is the result of its previous biological transformation. However, this approach has been seriously challenged. On the one hand, it should be noted that many biological causes of diseases are greatly affected by social-economic factors, but on the other hand, diseases are multidimensional. Thus, biological explanation of an illness is not sufficient. As a result, social, cultural, economic, and even developmental aspects need to be considered. These factors are of great importance in the modern approach (Armstrong & Tavakoli, 2008). The present study aims to sociologically investigate the economic burden on cardiovascular patients with the aim of a change in behavioral style and its contributory factors before suffering from the disease. The study was conducted in Javad Al-Aeme Heart Hospital in Mashhad.
Method
It is a descriptive-cross-sectional study. The statistical population included the cardiac patients of Javad Al-Aeme Heart Educational, Medical, and Research Center in Mashhad in 1399. The cardiovascular patients were the case of observation and analysis. This hospital is one of the biggest cardiovascular centers in Asia and Iran providing health care to cardiac patients from all over Iran. Three wards including Male Internal Ward, Female Internal Ward, and the VIP[1] ward were used to collect data. These wards were selected due to the fact that the patients there had a higher level of willingness, consciousness, and ability in contrast to other patients. Besides, the situation was more suitable for conducting interviews and answering to questions than the other wards. The "convenience sampling'' method was used to collect the data. The sample size was measured using the Cochran formula, and 385 individuals were selected as the "sample population". The data was gathered using a questionnaire consisting of two parts. The first part included patients' demographic characteristics, such as gender, age, education, underlying diseases, cigarette and alcohol consumption, income, etc. The second part consisted of questions associated with the structure of behavioral styles, health capital, living condition, social-economic conditions, and economic burden. The validity of the questionnaire was confirmed by experts, the supervisor, and the advisor. Its reliability was estimated to be 0.789 percent using Cronbach's alpha coefficient. The questionnaires were completed by the patients of Javad Al-Aeme Heart Hospital of Mashhad. Before collecting the data, the patients were informed about the content of questions and the purpose of the study. Also, a consent form was prepared and delivered to the patients to declare their willingness to participate in the study. The data were analyzed using SPSS in the first phase and the Structural Equation Modeling technique and AMOS in the second phase.
Findings
The results of the research hypotheses based on the Structural Equation
| Hypothesis | Path Coefficients in model | Path Coefficient | T-statistics | P |
| 1 | Economic-Social condition → costs and economic burden of Patients | -0.25 | 16.68 | 0.000 |
| 2 | Living Condition → costs and economic burden of Patients | -0.31 | 20.33 | 0.000 |
| 3 | Economic-Social condition → Health Capital | 0.43 | 20.99 | 0.000 |
| 4 | Living Condition → Health Capital | 0.41 | 21.78 | 0.000 |
| 5 | Economic-Social condition → Change in Behavioral Style | 0.47 | 21.35 | 0.000 |
| 6 | Living Condition → Change in Behavioral Style | 0.38 | 19.40 | 0.000 |
| 7 | Health Capital → Change in Behavioral Style | 0.34 | 16.44 | 0.000 |
| 8 | Change in Behavioral Style → costs and economic burden of Patients | -0.49 | 9.07 | 0.000 |
As shown in the table above, the number of all the research structures indicated acceptable fitting of the conceptual model. Therefore, the congruence of the conceptual model with the collected data was confirmed. The fitted research model demonstrated the direct effect (factor loading-path coefficients) of the main variables of the research in the table as well.
Discussion
All in all, the results illustrate that the cardiovascular diseases have a direct correlation with behavioral style, economic-social condition, health care, living condition, and as a result with the economic burden of the disease. The findings showed that the participants' lifestyles were not suitable in terms of health care. The average score of the total index of healthy lifestyles of the cardiovascular patients in the range of 1 to 5 was obtained as 2.79, which was below the average. The results are in agreement with the findings of Mohseni-Pooya et al. (2017), Shafiee et al.(2013), Mohammadi-Zeidi et al. (2005), and Rashidi and Bahrami (2015) indicating the undesirable lifestyles of the cardiac patients. It is indicated that the factors of healthy lifestyle and health-promoting behaviors of the participants tended to become unhealthy.
Keywords: Cardiovascular disease, Behavioral style, Economic burden, Socio-economic status, Living conditions, Health capital
[1] Very Important Person
In the VIP Ward, the patients are hospitalized privately, or sometimes foreign patients are given medical care there.
In the VIP Ward, the patients are hospitalized privately, or sometimes foreign patients are given medical care there.
Type of Study: orginal |
Received: 2021/06/7 | Accepted: 2022/07/20 | Published: 2022/11/13
Received: 2021/06/7 | Accepted: 2022/07/20 | Published: 2022/11/13
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