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Home > Psychosocial and Behavioural Risk Factors of Early Onset Ischemic Heart Disease

Psychosocial and Behavioural Risk Factors of Early Onset Ischemic Heart Disease

Thesis Info

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Author

Rafique, Rafia

Program

PhD

Institute

University of the Punjab

City

Lahore

Province

Punjab

Country

Pakistan

Thesis Completing Year

2011

Thesis Completion Status

Completed

Subject

Philosophy & psychology

Language

English

Link

http://prr.hec.gov.pk/jspui/bitstream/123456789/3078/1/5525H.PDF

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676725330440

Similar


Ischemic Heart Disease (IHD) occurs to a greater extent in developed than developing countries like Pakistan. Our understanding of risk factors leading to this disease thus are largely derived from studies carried out on samples obtained from developed countries. Since prevalence oflHD in Pakistan is growing, it seems pertinent to compare risk factors across nations that have IHD prevalence. The present study therefore investigated psychological, social, behavioural and self-reported family history of IHD, disease history and anthropometric factors for the possible early onset of IHD in Pakistan. The psychological factors explored were stressful life events, perceived stress, depression, anxiety, hostility, anger, locus of control and optimism; social factors included monthly family income, education, perceived social support and social dominance; behavioural factors were smoking, number of cigarettes smoked daily and ex-smoking status, alcohol intake, physical activity and dietary patterns; self-reported disease history, included family history of IHD, diabetes and hypertension; and anthropometric variables that included waist circumference, Body Mass Index (BM1) and Waist Hip Ratio ( WHR). Case-control research design was employed, with a purpose a sample of 190 cases and 380 age and gender matched community controls who ranged in age from 35 to 55 years were recruited from five hospitals in Lahore city that run a coronary care unit or equivalent cardiology ward. The investigator carried out a preliminary study before the main study to translate, validate and assess reliability of a number of psychometric instruments, which included; Checklist of Stressful Life Events by (Rosen gren, 2004); Perceived Stress Scale (PSS) developed by Cohen, Kamarck, and Mermelstem (1983); RadlofT(1977) Center for Epidemiological Studies Short Depression Scale (CES-D 10); State-Trait Anxiety Inventory (STAI) (Trait anxiety scale) developed by Spielberger (1983); State-Trait Anger Expression Inventory (STAXI) (Trait anger scale) again developed by Spielberger (1999); Life Orientation Test (LOT-R) by Scheier, Carver, and Bridges (1994); six itemed Percicved Locus of Control Scale (PLCS) by Bobak, Pikhart, Hertzman, Rose, and Marmot (1998 & 2000); Multidimensional Scale of Perceived Social Support (MSPSS) by Zimct, Dahlem, Zimet and Farley (1988); and Personality Deviance Scales (PDS & PDS-R) developed by Bedford and Foulds, (1978), To ensure rigorous process of forward and backward translation and to achieve equivalence between the original version and translated versions of scales, Vallerand’s steps (1989) for instrument translation with slight modification were employed to decrease risks of errors and improve the precision of translations (see Figure 22, pp. 129-130). Binary logistic regression analyses models were run according to the proposed hypotheses by taking into account overall data; data of men cases and controls, as well as that of women cases and controls separately. The author also carried out Multivariate Odds Ratios (ORs) and 95% Confidence Intervals (CIs) for psychological, social, behavioural, family history of IHD and self-reported physical health factors (diabetes and hypertension) and anthropometric factors. Odd ratios represented the excess risk of exposure to a factor in cases compared with controls, without exposure. Results of the study revealed that psychological factors like stressful life events and hostility are directly associated with risk of IHD; and optimism and locus of control were significantly correlated to protective factors of IHD. Trait anger in women w as found to be associated with risk of IHD. Social factors like social support and higher level of education were negatively associated with IHD and were proposed to play a protective role especially with regards to disease onset, Among behavioural factors smoking, smoking 20 or more cigarettes daily, and even ex-smoking, significantly associated with IHD, and so did atherogenic diet rich in {eggs, salt, red meat etc.) and low in (fruits and fish) were found to be significantly associated with IHD. However useful level of 4 or more hours of physical activity per week was associated with reduced risk of IHD in men. Family history of IHD and diabetes were found to be fairly significant risk factors for men. Furthermore 25 or greater BMI was found to be significantly associated with risk of IHD in both men and women. In addition WHR > 0.84 was found to be significantly associated with risk of IHD in women but not in men. Implications for future research and primary and secondary interventions are being proposed. The study highlights two major challenges for future research. Firstly, for carrying out large scale prospective, epidemiological, longitudinal as well as interventional studies to be tailored for indigenous population and secondly development and standardization of self-reported measures to appraise psychosocial and behavioural factors of IHD prevalent within the indigenous population. In the light of present findings the author proposes a model for primary and secondary prevention of IHD. Primary prevention highlights (a) public health community based approach and (b) high risk hospital based strategies, and the secondary prevention approach provides an overview of hospital as well as community based preventive programs.
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آنکھ سے دور سہی دل کے قریں رہنے دے

آنکھ سے دُور سہی، دل کے قریں رہنے دے
میری ہر سانس میں تو خود کو مکیں رہنے دے

میں کہ اک عکس ہوں گمنام سا پس منظر ہوں
کب کہاں کیسے کسی طور کہیں رہنے دے

اک نظر مجھ پہ مرے ماہِ منیر ایسی ہو
کب طلب میں نے کیا زر یا نگیں، رہنے دے

میں ہوں اس قافلۂ عشق سے بچھڑا راہی
میرا کب ٹھور ٹھکانہ ہے کہیں، رہنے دے

تجھ سے منسوب ہوئی، تجھ سے ہی منسوب رہوں
غیر کے آگے جھکے گی یہ جبیں، رہنے دے

دل میں یا آنکھ میں یا دستِ حنائی میں فضاؔ
تیری مرضی ہے جہاں چاہے، وہیں رہنے دے

ڈیرہ غازی خان کی مذہبی و معاشرتی زندگی میں صوفیا کرام کی تعلیمات کے اثرات

Islam is the religion of peace and love for the humanity. It always ordered to his followers to treat other with kind and tolerance. The Holy prophet always proved himself the prophet of mercy as the Holy Quran Said, but we sent you as a mercy to the worlds. Islam spread through politeness. In Subcontinent the advent of Islam is a great achievement of the noble saints and sufis. D۔G Khan which was a purely Hindu area in the past and the several sufis came to this part of Punjab in the initial stage of Islam. They played glorious role in the advent of Islam in the region. Sufism is a deter-mine effort towards unity. His main purpose is to bring humanity close with one another, separated as it is into so many different units, closer together in the deeper understanding of life. The main task is to bring about brotherhood among races, nations and faiths and to respect one another's faith, scripture and teacher. Sufi is to confer Sympathy on these lives, to impart Love, Compassion and Kindhearted-ness on all creations. The Sufi message is the resonance of the same Divine message which has always come and will always come to inform humanity. This research paper highlights the services of sufis who influenced on socio religious life of the people of D۔G Khan. 

Genetics of Physio-Agronomic Traits in Maize under Water Deficit Conditions

Fifty inbred lines of maize acquired from various sources, were screened in the wirehouse for seedling traits under both normal and water deficit conditions. Six inbred lines were earmarked on the basis of various agronomic and physiological traits under water deficit condition. The inbred lines were sown in the field for making all possible crosses in diallel mating fashion. The F 1 crosses and their reciprocals alongwith the parents were sown in the field under normal and water stress environment using Randomized Complete Block Design in three replications. Normal irrigations were applied to one set of experiment, whereas 50% of the normal irrigation was applied to water stress experiment. Data for various morpho- physiological characters were recorded at different growth stages of the crop and then subjected to statistical analysis. Co-efficient of variability was found to be greater under water stress than under normal condition for majority of the seedling traits. Significant mean squares for all the parameters under normal and moisture deficit conditions depicted the presence of considerable genetic variability. Scaling tests were performed to check the adequacy of the data for analyzing additive-dominance model. The results showed that additive-dominance model was fully adequate for the traits like kernels per row, 100-kernel weight, grain yield per plant, cell membrane thermostability, stomatal conductance and canopy temperature under normal condition while plant height, ear height, days to silking, kernels per ear, 100-kernel weight, grain yield per plant, leaf temperature and canopy temperature depression under water stress condition. The data were partially adequate for the traits like ears per plant, days to tasselling, anthesis-silking interval, kernels per row, cell membrane thermostability and stomatal conductance under moisture deficit condition. Additive gene action for number of days to silking under normal water condition changed to non-additive gene action under water deficit condition. All other traits exhibited additive gene action under both conditions. Heritability estimates for yield related traits revealed maximum ability to transfer the desirable genes to the next generation. Estimation of components of variation exhibited greater estimates for GCA variance ( б 2 g) than SCA variance ( б 2 s) for majority of the traits under both conditions depicting the predominant role of additive genetic component except for days to silking and number of kernels per row under water deficit condition which displayed greater SCA variance ( б 2 s) than GCA variance ( б 2 g). Under water stress condition, the best performing crosses were NCIL-20-20 x D-109, NCIL-20-20 x OH-8 and D-114 x NCIL-20-20 and their reciprocals. Inbred lines NCIL-20-20, D-157 and D-114 proved to be high yielder parents under both normal and moisture deficit conditions. The information regarding results obtained during the current study may be used to evolve better parental inbred lines for developing various cross combinations which will be helpfull in maintaining yield sustainability in water deficit areas.