Sharif-Nia Hamid, Jackson Alun C, Salehi Safoura, Miraghai Fateme, Hosseini Seyed Hamzeh
Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.
Sci Rep. 2025 Apr 7;15(1):11804. doi: 10.1038/s41598-025-96968-7.
Cardiovascular diseases are the leading cause of mortality worldwide, contributing to one-third of global deaths. Beyond physical health, heart disease is associated with cardiac distress, an emotional response that can negatively impact recovery and well-being. Understanding the psychological and social mechanisms underlying cardiac distress is crucial for improving patient outcomes. This study examines how social health (social support and social isolation) influences cardiac distress, with loneliness and repetitive negative thinking as mediators. To evaluate a theoretical model linking social health to cardiac distress, mediated by loneliness and repetitive negative thinking in patients with heart disease. A cross-sectional, correlational study was conducted in 2024 with 400 cardiac patients from two hospitals and one private clinic in Amol, Iran. Participants completed validated questionnaires assessing cardiac distress, social support, social isolation, loneliness, and repetitive negative thinking. Structural equation modeling was used for data analysis. Social isolation (r = 0.47, p < 0.001) and repetitive negative thinking (r = 0.50, p < 0.001) were significantly associated with greater cardiac distress. Social support negatively predicted both loneliness (β = - 0.32, p < 0.001) and cardiac distress (β = - 0.25, p < 0.01). Indirect effects showed that social support reduced cardiac distress by decreasing loneliness and repetitive negative thinking (β = - 0.23, p < 0.01), while social isolation increased cardiac distress through its influence on loneliness and repetitive negative thinking (β = 0.18, p = 0.05). The model explained 47.4% of the variance in cardiac distress. These findings highlight the importance of social health in managing cardiac distress among heart disease patients. Strengthening social support may alleviate loneliness and reduce repetitive negative thinking, ultimately improving emotional well-being and health outcomes. Future research should explore targeted interventions addressing these psychosocial factors to effectively reduce cardiac distress.
心血管疾病是全球主要的死亡原因，占全球死亡人数的三分之一。除了身体健康外，心脏病还与心脏困扰有关，这是一种情绪反应，会对康复和幸福感产生负面影响。了解心脏困扰背后的心理和社会机制对于改善患者预后至关重要。本研究探讨社会健康（社会支持和社会孤立）如何通过孤独感和反复消极思维作为中介来影响心脏困扰。旨在评估一个将社会健康与心脏困扰联系起来的理论模型，该模型以心脏病患者的孤独感和反复消极思维为中介。2024年，在伊朗阿莫勒的两家医院和一家私人诊所对400名心脏病患者进行了一项横断面相关性研究。参与者完成了经过验证的问卷，评估心脏困扰、社会支持、社会孤立、孤独感和反复消极思维。采用结构方程模型进行数据分析。社会孤立（r = 0.47，p < 0.001）和反复消极思维（r = 0.50，p < 0.001）与更严重的心脏困扰显著相关。社会支持对孤独感（β = -0.32，p < 0.001）和心脏困扰（β = -0.25，p < 0.01）均有负向预测作用。间接效应表明，社会支持通过减少孤独感和反复消极思维来降低心脏困扰（β = -0.23，p < 0.01），而社会孤立则通过对孤独感和反复消极思维的影响增加心脏困扰（β = 0.18，p = 0.05）。该模型解释了心脏困扰变异的47.4%。这些发现凸显了社会健康在管理心脏病患者心脏困扰方面的重要性。加强社会支持可能减轻孤独感并减少反复消极思维，最终改善情绪健康和健康结局。未来的研究应探索针对这些心理社会因素的有针对性干预措施，以有效减轻心脏困扰。
