{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:27:07Z","timestamp":1787027227043,"version":"build-2736575974"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Health-related quality of life (HRQoL) is an important treatment target in patients with coronary heart disease (CHD) and is associated with poor outcomes. Therefore, it is of clinical importance to identify the key determinants of HRQoL among these patients. There is, however, limited knowledge of how a comprehensive set of psychosocial factors influence HRQoL. We aimed to determine the relative associations of clinical and psychosocial factors with mental and physical components of HRQoL in a sample of CHD outpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 1,042 patients 2\u201336 (mean 16) months after a CHD event recruited from two general Norwegian hospitals with a combined catchment area making up 7% of the Norwegian population, representative with regards to demographic and clinical factors. We collected data on HRQoL, demographics, comorbidities, coronary risk factors, and psychosocial factors. HRQoL was assessed using the Short Form 12 (SF12), which comprises a Mental Component Scale (MCS), and the Physical Component Scale (PCS). Crude and multi-adjusted linear regression analyses were used to investigate the association between covariates and MCS and PCS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean age was 61 [standard deviation (SD) 10] years, 20% were females, 18% had type D personality, 20% significant depression symptoms, 14% significant symptoms of anxiety whereas 45% reported insomnia. The presence of type D personality (\u03b2: \u22120.19), significant symptoms of depression (\u03b2: \u22120.15), and the presence of insomnia (\u03b2: \u22120.13) were negatively associated with MCS, but not PCS in multi-adjusted analyses. The presence of chronic kidney disease (\u03b2: \u22120.11) was associated with reduced MCS, whereas the presence of chronic obstructive pulmonary disease (\u03b2: \u22120.08) and low physical activity (\u03b2: \u22120.14) were negatively associated with PCS. Younger age was associated with lower MCS, whereas older age was associated with lower PCS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>We conclude that Type D personality, depressive symptoms, insomnia, and chronic kidney disease were the strongest determinants of the mental component of HRQoL. Assessing and managing these psychological factors among CHD outpatients may improve their mental HRQoL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2023.1119093","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T01:12:36Z","timestamp":1686273156000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Predictors of health-related quality of life in outpatients with coronary heart disease"],"prefix":"10.3389","volume":"14","author":[{"given":"Lars Aasteb\u00f8l","family":"Fr\u00f8jd","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Munkhaugen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costas","family":"Papageorgiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Sverre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torbj\u00f8rn","family":"Moum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toril","family":"Dammen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"653","DOI":"10.15537\/smj.2018.7.21352","article-title":"Determinants of quality of life as measured with variants of SF-36 in patients with predialysis chronic kidney disease.","volume":"39","author":"Alhaji","year":"2018","journal-title":"Saudi. Med. J."},{"key":"B2","doi-asserted-by":"crossref","DOI":"10.1016\/j.smrv.2022.101646","article-title":"Effects of cognitive behavioral therapy for insomnia (CBT-I) on quality of life: a systematic review and meta-analysis.","volume":"64","author":"Alimoradi","year":"2022","journal-title":"Sleep Med. Rev."},{"key":"B3","year":"2000","journal-title":"Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR"},{"key":"B4","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/S0022-3999(01)00296-3","article-title":"The validity of the hospital anxiety and depression scale. An updated literature review.","volume":"52","author":"Bjelland","year":"2002","journal-title":"J. Psychosom. Res."},{"key":"B5","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The pittsburgh sleep quality index: a new instrument for psychiatric practice and research.","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res."},{"key":"B6","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1136\/heartjnl-2019-315460","article-title":"Significantly increased risk of all-cause mortality among cardiac patients feeling lonely.","volume":"106","author":"Christensen","year":"2020","journal-title":"Heart"},{"key":"B7","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1536\/ihj.54.258","article-title":"Clinical correlates of insomnia in patients with acute coronary syndrome.","volume":"54","author":"Coryell","year":"2013","journal-title":"Int. Heart J."},{"key":"B8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jpsychores.2017.12.012","article-title":"Cognitive behavioural therapy for insomnia (CBT-I) to treat depression: a systematic review.","volume":"106","author":"Cunningham","year":"2018","journal-title":"J. Psychosom. Res."},{"key":"B9","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.psym.2016.11.002","article-title":"Prevalence and determinants of insomnia after a myocardial infarction.","volume":"58","author":"Da Costa","year":"2017","journal-title":"Psychosomatics"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.948081","article-title":"The attention training technique reduces anxiety and depression in patients with coronary heart disease: a pilot feasibility study.","volume":"13","author":"Dammen","year":"2022","journal-title":"Front. Psychol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.jval.2013.10.010","article-title":"EQ-5D versus SF-12 in coronary patients: are they interchangeable?","volume":"17","author":"De Smedt","year":"2014","journal-title":"Value Health"},{"key":"B12","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1016\/s0022-3999(00)00177-x","article-title":"Type D personality. A potential risk factor refined.","volume":"49","author":"Denollet","year":"2000","journal-title":"J. Psychosom. Res."},{"key":"B13","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/01.psy.0000149256.81953.49","article-title":"DS14: standard assessment of negative affectivity, social inhibition, and Type D personality.","volume":"67","author":"Denollet","year":"2005","journal-title":"Psychosom. Med."},{"key":"B14","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease.","volume":"11","author":"Dibben","year":"2021","journal-title":"Cochrane Database Syst. Rev."},{"key":"B15","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1080\/15402002.2016.1228638","article-title":"Association between health-related quality of life, obesity, fitness, and sleep quality in young adults: the cuenca adult study.","volume":"16","author":"Franquelo-Morales","year":"2018","journal-title":"Behav. Sleep Med."},{"key":"B16","doi-asserted-by":"crossref","DOI":"10.1093\/sleepadvances\/zpac007","article-title":"Insomnia as a predictor of recurrent cardiovascular events in patients with coronary heart disease.","volume":"3","author":"Fr\u00f8jd","year":"2022","journal-title":"SLEEP Advances"},{"key":"B17","doi-asserted-by":"crossref","first-page":"931","DOI":"10.5664\/jcsm.9082","article-title":"Insomnia in patients with coronary heart disease: prevalence and correlates.","volume":"17","author":"Fr\u00f8jd","year":"2021","journal-title":"J. Clin. Sleep Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1016\/s0895-4356(98)00109-7","article-title":"Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA project. International quality of life assessment.","volume":"51","author":"Gandek","year":"1998","journal-title":"J. Clin. Epidemiol."},{"key":"B19","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.chest.2017.01.026","article-title":"Insomnia and risk of cardiovascular disease.","volume":"152","author":"Javaheri","year":"2017","journal-title":"Chest"},{"key":"B20","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1177\/1474515119847544","article-title":"Predictive model for quality of life in patients with recurrent coronary artery disease.","volume":"18","author":"Jo","year":"2019","journal-title":"Eur. J. Cardiovasc. Nurs."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-018-1048-x","article-title":"Type D personality as a risk factor in coronary heart disease: a review of current evidence.","volume":"20","author":"Kupper","year":"2018","journal-title":"Curr. Cardiol. Rep."},{"key":"B22","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1177\/1403494807085373","article-title":"Reliability and validity of self-reported physical activity in the Nord-Tr\u00f8ndelag Health Study: HUNT 1.","volume":"36","author":"Kurtze","year":"2008","journal-title":"Scand. J. Public Health"},{"key":"B23","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1080\/13548506.2015.1040032","article-title":"Relationship between sleep disturbance, depression and anxiety in the 12 months following a cardiac event.","volume":"21","author":"Le Grande","year":"2016","journal-title":"Psychol. Health Med."},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsac205","article-title":"Co-occurring insomnia and anxiety: a randomized controlled trial of internet cognitive behavioral therapy for insomnia versus internet cognitive behavioral therapy for anxiety.","volume":"46","author":"Mason","year":"2022","journal-title":"Sleep"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182312835","article-title":"Association of subjective quality and quantity of sleep with quality of life among a general population.","volume":"18","author":"Matsui","year":"2021","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B26","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1080\/00015385.2019.1653568","article-title":"Mood disorders impaired quality of life but not the mortality or morbidity risk in stable coronary heart disease patients.","volume":"75","author":"Mayer","year":"2020","journal-title":"Acta Cardiol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1616","DOI":"10.1592\/phco.22.17.1616.34121","article-title":"Health-related quality of life in patients 7 months after a myocardial infarction: factors affecting the Short Form-12.","volume":"22","author":"McBurney","year":"2002","journal-title":"Pharmacotherapy"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-84554-6","article-title":"Health-related quality of life and its related factors in coronary heart disease patients: results from the Henan rural cohort study.","volume":"11","author":"Mei","year":"2021","journal-title":"Sci. Rep."},{"key":"B29","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1161\/CIRCRESAHA.116.309115","article-title":"Decline in cardiovascular mortality.","volume":"120","author":"Mensah","year":"2017","journal-title":"Circ. Res."},{"key":"B30","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s11920-022-01326-3","article-title":"Moderators of cognitive behavioral treatment for insomnia on depression and anxiety outcomes.","volume":"24","author":"Mirchandaney","year":"2022","journal-title":"Curr. Psychiatry Rep."},{"key":"B31","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s11136-009-9455-5","article-title":"Normative data of the SF-12 health survey with validation using postmyocardial infarction patients in the Dutch population.","volume":"18","author":"Mols","year":"2009","journal-title":"Qual. Life Res."},{"key":"B32","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.apnr.2013.11.008","article-title":"Health-related quality of life and its predictors among outpatients with coronary heart disease in Singapore.","volume":"27","author":"Muhammad","year":"2014","journal-title":"Appl. Nurs. Res."},{"key":"B33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/14017431.2015.1111408","article-title":"The role of medical and psychosocial factors for unfavourable coronary risk factor control.","volume":"50","author":"Munkhaugen","year":"2016","journal-title":"Scand. Cardiovasc. J."},{"key":"B34","doi-asserted-by":"crossref","first-page":"485","DOI":"10.7326\/0003-4819-131-7-199910050-00002","article-title":"Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome.","volume":"131","author":"Netzer","year":"1999","journal-title":"Ann. Intern. Med."},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0158163","article-title":"A single, one-off measure of depression and anxiety predicts future symptoms, higher healthcare costs, and lower quality of life in coronary heart disease patients: analysis from a multi-wave, primary care cohort study.","volume":"11","author":"Palacios","year":"2016","journal-title":"PLoS One"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jpsychores.2017.10.015","article-title":"Depression and anxiety symptom trajectories in coronary heart disease: associations with measures of disability and impact on 3-year health care costs.","volume":"104","author":"Palacios","year":"2018","journal-title":"J. Psychosom. Res."},{"key":"B37","doi-asserted-by":"crossref","first-page":"691","DOI":"10.2466\/pms.107.3.691-706","article-title":"A new scale for measuring insomnia: the Bergen insomnia scale.","volume":"107","author":"Pallesen","year":"2008","journal-title":"Percept. Mot. Skills"},{"key":"B38","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1177\/1403494816688375","article-title":"Reproducibility of an extensive self-report questionnaire used in secondary coronary prevention.","volume":"45","author":"Peersen","year":"2017","journal-title":"Scand. J. Public Health"},{"key":"B39","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.ijcard.2007.10.016","article-title":"Understanding sex differences in health-related quality of life following myocardial infarction.","volume":"130","author":"Pettersen","year":"2008","journal-title":"Int. J. Cardiol."},{"key":"B40","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1111\/jsr.12594","article-title":"European guideline for the diagnosis and treatment of insomnia.","volume":"26","author":"Riemann","year":"2017","journal-title":"J. Sleep Res."},{"key":"B41","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990\u20132019: update from the GBD 2019 study.","volume":"76","author":"Roth","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1080\/08964289.2021.1895050","article-title":"Poor sleep quality predicts decline in physical health functioning in patients with coronary heart disease and moderating role of social support.","volume":"48","author":"Shen","year":"2022","journal-title":"Behav. Med."},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsw079","article-title":"Changes in sleep duration, quality, and medication use are prospectively associated with health and well-being: analysis of the UK household longitudinal study.","volume":"40","author":"Tang","year":"2017","journal-title":"Sleep"},{"key":"B44","article-title":"Psychological and pharmacological interventions for depression in patients with coronary artery disease.","volume":"12","author":"Tully","year":"2021","journal-title":"Cochrane Database Syst. Rev."},{"key":"B45","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","article-title":"2021 ESC guidelines on cardiovascular disease prevention in clinical practice: developed by the task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies with the special contribution of the European Association of Preventive Cardiology (EAPC).","volume":"42","author":"Visseren","year":"2021","journal-title":"Eur. Heart J."},{"key":"B46","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1016\/s0895-4356(98)00081-x","article-title":"Overview of the SF-36 health survey and the international quality of life Assessment (IQOLA) Project.","volume":"51","author":"Ware","year":"1998","journal-title":"J. Clin. Epidemiol."},{"key":"B47","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","article-title":"A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity.","volume":"34","author":"Ware","year":"1996","journal-title":"Med. Care"},{"key":"B48","author":"Ware","year":"1994","journal-title":"SF-36 Physical and Mental Summary Scales: a user\u2018s manual."},{"key":"B49","author":"Ware","year":"1995","journal-title":"SF-12: How to Score the SF-12 Physical and Mental Health Summary scales."},{"key":"B50","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1161\/CIRCULATIONAHA.120.052428","article-title":"Improving the effectiveness of psychological interventions for depression and anxiety in cardiac rehabilitation: PATHWAY\u2014a single-blind, parallel, randomized, controlled trial of group metacognitive therapy.","volume":"144","author":"Wells","year":"2021","journal-title":"Circulation"},{"key":"B51","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1080\/14017430410003903","article-title":"Patients with ischemic heart disease: quality of life predicts long-term mortality.","volume":"39","author":"Westin","year":"2005","journal-title":"Scand. Cardiovasc. J."},{"key":"B52","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1161\/CIRCULATIONAHA.107.752006","article-title":"Patient-reported health status in coronary heart disease in the United States: age, sex, racial, and ethnic differences.","volume":"118","author":"Xie","year":"2008","journal-title":"Circulation"},{"key":"B53","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale.","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr. Scand."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1119093\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T01:13:00Z","timestamp":1686273180000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1119093\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,9]]},"references-count":53,"alternative-id":["10.3389\/fpsyg.2023.1119093"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2023.1119093","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,9]]},"article-number":"1119093"}}