Vol.:(0123456789) 1 3
Community Mental Health Journal
https://doi.org/10.1007/s10597-018-0361-6
ORIGINAL PAPER
Interplay of Self-efcacy and Social Support in Predicting Quality
of Life in Cardiovascular Patients in Pakistan
Shameem Fatima
1
· Tahira Jibeen
2
Received: 14 October 2016 / Accepted: 12 December 2018
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract
The primary objective of the present study was to assess independent and interactive relations of perceived social support
and self-efcacy with four quality of life (QOL) domains namely physical, psychological, social, and environmental in car-
diovascular disease (CVD) patients from a South Asian region. Participants were 172 (age 22–60 years) patients recruited
from three major government sector hospitals from the ffth biggest city of South Asia. It was found that overall CVD patients
had a better QOL in psychological and environmental domains compared to social and psychological. Furthermore, fndings
from hierarchical regression analyses indicated that perceived social support and self-efcacy were positively associated
with the four QOL domains. Besides main efects, a synergistic interaction between social support and self-efcacy emerged
indicating that perceived social support was strongly associated with physical and social QOL in CVD patients who had
higher self-efcacy levels, while, perceived social support was weakly associated with the physical and social QOL in CVD
patients who had lower self-efcacy levels.
Keywords Perceived social support · Self-efcacy · Quality of life · Cardiovascular patients
Cardiovascular disease (CVD) is a major and a rising health
problem worldwide; and in next few decades, half of the
world’s cardiovascular burden is predicted to occur in
Asian-Pacifc region (Gaziano et al. 2006; Martiniuk et al.
2007; Pillai and Ganapathi 2013). Although CVD is a major
cause of mortality, morbidity, and deterioration of quality of
life(QOL), unfortunately, relatively few studies so far have
targeted issues concerning QOL in CVD patients in devel-
oping countries (The World Health Organization 2002). To
address this gap, the study analyzes the QOL and its psycho-
social determinants in South Asian CVD patients.
Currently, medical care is focused around optimizing the
QOL of patients to manage the efects of chronic diseases
(Johansson et al. 2004). Regarding cardiac rehabilitation,
the American, the European, and the Australian (American
Association of Cardiovascular and Pulmonary Rehabilitation
2013; Goble and Worcester 1999; Graham 2007) guidelines
highlight the importance of psychosocial factors to improve
patients’ QOL. The literature (e.g., Dracup et al. 1992) sug-
gests that clinical symptoms associated with heart diseases
afect QOL through impact on physical functioning, psycho-
logical qualities, and social relationships.
Previous studies indicate that perceived QOL is deter-
mined by the psychosocial factors such as social support
and self-efcacy, and socio-demographic factors in cardiac
patients (e.g., Duenas et al. 2011; Veenstra et al. 2004).
Among psychosocial factors, a supportive interpersonal
environment has been described as an important factor that
is likely to facilitate patients’ adaptation to life-threatening
and chronic illnesses (Gallant 2003; Reblin and Uchino
2008), and to improve QOL in cardiac patients (Lett et al.
2005; Molloy et al. 2008; Orth-Gomer 2000).
Self-efcacy beliefs play an active role in tackling ill-
ness consequences; people with higher self-efcacy levels
are more likely to engage in behaviors that are benefcial to
their health than are those with lower self-efcacy levels
(Arnold et al. 2005; Brink 2009; Bandura 2000, 2004). For
example, in cardiac patients, self-efcacy has been found to
* Shameem Fatima
shameem_pu@hotmail.com
Tahira Jibeen
tahiraimdadali@yahoo.com
1
Department of Humanities, COMSATS University
Islamabad, Lahore campus, Defence Road, Of Raiwind
Road, Lahore, Pakistan
2
Department of Psychology, University of Management
and Technology, Lahore, Pakistan