{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:58:41Z","timestamp":1791298721675,"version":"4.1.0"},"reference-count":68,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T00:00:00Z","timestamp":1562630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001655","name":"Deutscher Akademischer Austauschdienst","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001655","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["British J Health Psychol"],"published-print":{"date-parts":[[2019,11]]},"abstract":"\n Objectives<\/jats:title>\n \n Low emotional intelligence (\n EI<\/jats:styled-content>\n ) may predispose individuals to applying maladaptive coping strategies. This may maintain anxious worrying, which is highly prevalent in patients with chronic heart failure (\n CHF<\/jats:styled-content>\n ) and may affect mental (\n MCS<\/jats:styled-content>\n ) and physical component summaries (\n PCS<\/jats:styled-content>\n ) of health\u2010related quality of life (\n HRQ<\/jats:styled-content>\n oL).\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n The current study is a cross\u2010sectional and cross\u2010cultural survey.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n N\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 200 outpatients with\n CHF<\/jats:styled-content>\n were recruited at cardiology institutes in Germany and Pakistan and assessed with self\u2010report questionnaires.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Path analysis (\u03c7\n 2<\/jats:sup>\n (4)\u00a0=\u00a07.59,\n p\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n .11,\n GFI<\/jats:styled-content>\n \u00a0=\u00a0.99) revealed that the expected associations between low\n EI<\/jats:styled-content>\n and lower\n SF<\/jats:styled-content>\n \u201036\n MCS<\/jats:styled-content>\n and\n PCS<\/jats:styled-content>\n of\n HRQ<\/jats:styled-content>\n oL were fully mediated by negative metacognition and maladaptive coping in the Pakistani sample (\n p<\/jats:italic>\n 's\u00a0\u2264\u00a0.05). The German sample applied different maladaptive coping strategies, which also led to lower\n MCS<\/jats:styled-content>\n and\n PCS<\/jats:styled-content>\n scores, but did not mediate a direct positive effect of\n EI<\/jats:styled-content>\n on\n HRQ<\/jats:styled-content>\n oL.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The current findings support culture\u2010independent validity of the metacognitive model but also reveal major cultural differences regarding the application and effect of specific maladaptive coping strategies. This has important implications for caregivers in a cross\u2010cultural context and highlights the need for culture\u2010specific tailoring of psychosocial interventions.<\/jats:p>\n <\/jats:sec>\n \n \n \n \n \n Statement of contribution<\/jats:title>\n <\/jats:caption>\n \n \n What is already known on this subject?<\/jats:bold>\n <\/jats:italic>\n <\/jats:p>\n \n Worry, an integral component of generalized anxiety disorder (\n GAD<\/jats:styled-content>\n ) and highly comorbid in chronic heart failure (\n CHF<\/jats:styled-content>\n ) patients, contributes to anxiety and resulting stress as evident from metacognitive model of\n GAD<\/jats:styled-content>\n . In addition, previous literature has also established the protective role of emotional intelligence (\n EI<\/jats:styled-content>\n ) against stress, thus maintaining quality of life.\n <\/jats:p>\n \n \n What does this study add?<\/jats:bold>\n <\/jats:italic>\n <\/jats:p>\n \n \n \n \n Cross\u2010cultural (Pakistan vs. Germany) validation of the metacognitive model of\n GAD<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:list-item>\n \n Supportive evidence for the metacognitive model in patients with CHF.<\/jats:p>\n <\/jats:list-item>\n \n \n Mediation of maladaptive metacognitions and negative coping in the relationship of low trait\n EI<\/jats:styled-content>\n and low health\u2010related quality of life.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bjhp.12381","type":"journal-article","created":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T01:09:48Z","timestamp":1562720988000},"page":"828-846","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["A cross\u2010cultural comparison of the roles of emotional intelligence, metacognition, and negative coping for health\u2010related quality of life in German versus Pakistani patients with chronic heart failure"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3763-4392","authenticated-orcid":false,"given":"Hina","family":"Ghafoor","sequence":"first","affiliation":[{"name":"Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy) University of W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana Altaf","family":"Ahmad","sequence":"additional","affiliation":[{"name":"CPE Institute of Cardiology Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Nordbeck","sequence":"additional","affiliation":[{"name":"Comprehensive Heart Failure Center, University and University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Ritter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nephrology and Pulmonology Klinikum Brandenburg Medical School Brandenburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Pauli","sequence":"additional","affiliation":[{"name":"Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy) University of W\u00fcrzburg Germany"},{"name":"Comprehensive Heart Failure Center, University and University Hospital W\u00fcrzburg W\u00fcrzburg Germany"},{"name":"Center of Mental Health University of W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0550-2440","authenticated-orcid":false,"given":"Stefan M.","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy) University of W\u00fcrzburg Germany"},{"name":"Comprehensive Heart Failure Center, University and University Hospital W\u00fcrzburg W\u00fcrzburg Germany"},{"name":"Clinical Psychology, Psychotherapy, and Experimental Psychopathology Johannes Gutenberg University Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,9]]},"reference":[{"issue":"02","key":"e_1_2_7_2_1","first-page":"67","article-title":"Prevalence of risk factors in patients with heart failure with normal ejection fraction (HFNEF)","volume":"47","author":"Ahmad F.","year":"2014","journal-title":"Pakistan Heart Journal"},{"key":"e_1_2_7_3_1","volume-title":"Angstsensitivit\u00e4ts\u2010index","author":"Alpers G. 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