Discussion
acute myocardial infarction, illness, illness perception, metabolic syndrome, hypertension
ACUTE MYOCARDIAL INFARCTION, MYOCARDIAL INFARCTION, DISEASE, METABOLIC SYNDROME, BLOOD, HYPERTENSION
To the best of our knowledge, no study has been carried out to determine the effect of interventions based on Leventhal’s self-regulatory model on the illness perception and lifestyle of patients with hypertension. Therefore, the present study aimed to fill this lacuna. The results showed that intervention based on the present model improved illness perception in the subscales of the identity, timeline acute/chronic, personal control, treatment control, illness coherence, and timeline cyclical. However, it had no significant effect on the consequences and emotional representations.As suggested by the present study's findings, the illness perception-based intervention improved the illness coherence subscale in the study of Broadbent et al. (2009) in the spouses of patients with myocardial infarction [In addition, participants in the present study better perceived their illness identity after the intervention, including the symptoms and the disease timeline, acute/chronic. This is in line with the study's findings by Yan et al. [The present study's findings confirmed the results obtained by Lee et al. in patients with injury [As in the study by Rakhshan et al. [The results of the present study indicated that after the intervention, the scores of total lifestyles and its subscales, except for spiritual and social health, increased in the intervention group, as compared with the control group. Likewise, in Yan et al.’s study, an educational program based on Leventhal’s model improved nutrition and physical activity in patients after myocardial infarction [Blood pressure is affected by environmental factors such as noise and air pollution. Therefore, patients should be informed to avoid exposure to these factors [In the present study, the psychological health subscale did not improve after the research intervention. Similarly, Rakhshan et al. found that education based on perception in patients with metabolic syndrome did not affect stress management, although it improved all areas of lifestyle [The present study's overall lifestyle score was improved, probably due to increased perception. In their systematic review study, French et al. showed that patients with acute myocardial infarction and a positive perception of identity, consequences, cure/control, and illness coherence feel the need for cardiac rehabilitation [In contrast to the results of the present study, Rakhshan et al. found that education based on Leventhal perception improved the domains of lifestyle but did not affect the subscales of perception [The results of this study can help healthcare providers to improve the healthy lifestyle of patients with hypertension by identifying the possible role of subscales of illness perception, including identity, acute/chronic timeline, personal control, treatment control, disease coherence, and cyclical timeline. Also, the use of Leventhal’s self-regulatory model in the educational curriculum of medical science students can be considered. Moreover, It is suggested that healthcare providers should design and implement the educational program based on the model to improve the lifestyle of patients with hypertension.The present study helped to improve the illness perception, including subscales of identity, timeline acute/chronic, personal control, treatment control, illness coherence, and timeline cyclical, as well as the lifestyle of patients with hypertension. Moreover, the presence of an external academic observer and the active participation of patients in the research were considered the strengths of this study.There were some limitations in carrying out the study, including the lack of a specific questionnaire for measuring the illness perception and lifestyle of patients with hypertension, the short duration of follow-up to determine possible long-lasting effects for maintaining a healthy lifestyle. However, the main limitation of the study was the lack of blinding of the study, mostly due to the nature of the intervention. Although the external academic supervisor supervised the research process, the findingsould be interpreted cautiously.