DOI: https://doi.org/10.53350/pjmhs22164460 ORIGINAL ARTICLE 460 P J M H S Vol. 16, No. 04, APR 2022 Quality of Life, Perceived Social Support and Death Anxiety Among People Having Cardiovascular Disorders: A Cross-Sectional Study MUHAMMAD HASHIM 1 , WAQAR AZIM 2 , WAJID HUSSAIN 3 , FAZAL UR REHMAN 4 , ABDUL SALAM 5 , MUHAMMAD RAFIQUE 6 1 Assistant Professor Cardiology, Civil Hospital, BMCH Quetta Pakistan 2 Registrar Cardiology, Sandeman Provincial Hospital Quetta Pakistan 3 Post Fellow Cardiac Imaging, National Institute of Cardiovascular Diseases Karachi Pakistan 4 Associate Professor Cardiology, Civil Hospital, BMCH Quetta Pakistan 5 Clinical fellow Cardiology, National Institute of Cardiovascular Diseases Karachi Pakistan 6 Assistant Professor Cardiology, Shaheed Mohtarma Benazir Bhutto Medical College layari Karachi Pakistan Corresponding author: Muhammad Hashim, Email: khanhashoo@gmail.com ABSTRACT Aim: To assess the quality of life, perceived social support, and death anxiety among people having cardiovascular disorders Study type: A Cross-sectional study Place and Duration: This study was conducted at Civil Hospital, BMCH Quetta Pakistan from June 2020 to June 2021 Methodology: This study was designed to evaluate the correlation between quality of life, hope, and death anxiety among people having cardiovascular disorders. We gathered data by using a convenience sampling technique for 4 months. We used the questionnaire method for our survey. Our questionnaire was based on five sections including basic demographic, the 17- item McGill QoL (MQoL) Questionnaire, Herth hope to score, Thorson-Powell Death Anxiety Scale (TPDAS), and Death depression scale (DDS). Results: Out of 500 participants half of them were female (52.4%), most of the participants were married with no formal education and belonged to poor or middle-class families. Participants with intermediate education levels who were financially dependent on the government had a better quality of life than others. We observed that patients with myocardial infarction (MI) had higher levels of anxiety. Furthermore, we observed that patients with a belief in life after death had higher death anxiety than those who don't believe. Conclusion: Our results concluded a positive association among quality of life and hope. We examined that social support plays a vital role in managing CVD disorders. However, patients with myocardial infarction had high levels of death anxiety than others. Keywords: Cardiovascular disorders, coronary artery disease, myocardial infarction, death anxiety, quality of life, social support. INTRODUCTION Cardiovascular disease is the main cause of death worldwide. Every year, approximately 17.9 million deaths are reported. Coronary heart disease, cerebrovascular illness, rheumatic heart disease, and other diseases are among them. The global index reported that coronary artery disease cause 17.3 million deaths per year which will increase to 23.6 million deaths in 2030. Cardiovascular disorders are more prevalent in Asian and Middle Eastern regions. 1, 2 A study conducted by Zipes 1 reported that the prevalence of CAD is sharply increasing in these regions. Meanwhile, studies conducted in the United States and the European region also reported similar patterns of prevalence. However, high mortality ratio of CAD is reported in Iran (39.3% every year). 2 Cardiovascular disorders affect the patient's quality of life. 3 Quality of life is defined by the World Health Organization as an individual's view of his or her position or status in life. 4 A negative association between quality of life and physical impairment has been found in studies related to CAD patients. Bucket et al., 5 examined the association of poor quality of life with the risk of hospitalization and death. Physical symptoms of CAD create disturbance in the sexual and social life of patients. 6 Due to the loss of functioning patients rely on their families and loss their independence. Patients with CAD reported fatigue, decreased muscle strength, and dyspnea which leads to disruption in daily life activities. 7 After a diagnosis of CAD patients, the mental condition is also affected due to stress, anxiety, and depression along with social issues like limited social participation and need for social support. These changes affect the person's perception related to the quality of life. The long duration of cardiovascular illnesses and treatment side effects were also found to have a negative impact on quality of life. 8 However, studies reported improvement in the quality of life of CAD patients due to increase social support, spiritual beliefs, and level of education. 8 Cardiovascular disorders pose challenges to many factors including hope. Hope is one of the important coping mechanisms that provide strength to patients. 9 Maintaining hope in chronic illness plays a vital role in treatment. A study by Van Allen 10 observed a positive association between hope and quality of life in obese patients. A study by Shifren 11 observed that hope reduces anxiety and depression. Hope increases motivation during times of illness in patients with chronic illness. 12 Empirical evidence point to the benefits of hope on chronic illnesses however no single study has been produced yet to evaluate the impact of hope and quality of life on CVD patients. 13 We planned this study to fill this gap. Our study aimed to evaluate the quality of life, social support, hope, and death anxiety among patients having cardiovascular disorders. METHODOLOGY This cross-sectional study was designed to evaluate the correlation between quality of life, hope and death anxiety among hospitalized patients having cardiovascular disorders. Permission was taken from the ethical review committee of the institute. We gathered data by using a convenience sampling technique for 4 months. All the CAD patients with steady vital signs diagnosed by qualified doctors were included. Patients with stable vital signs, stable angina, and stable cardiac hemodynamics were included. Patients who were hospitalized at least for 24 hours were included. However, patients with any psychological problems including anxiety, and depression before the survey data were excluded. By using the previous study of Wang et al., 14 With an 80 percent power and a 95 percent confidence level, we determined our sample size. We required at least 500 participants. Before the survey, we gathered informed consent from the participants and translated our research goals, objectives, and survey instruments into easy words so that they can easily fill the document. We used the questionnaire method for our survey. Our questionnaire was based on five sections including basic demographic, the 17-item McGill QoL (MQoL) Questionnaire, Herth hope to score, Thorson-Powell Death Anxiety Scale (TPDAS), and Death depression scale (DDS). The demographic datasheet includes the information related to participant age, gender, marital status, level of education, sources of income, and socioeconomic status. We measured social support using experimentally validated analysis scales provided by the nursing researchers. This scale was simplified by