Knowledge of Stress as a Risk Factor for Coronary Heart Disease and Coping Mechanisms among Postgraduate Students in South-West Nigeria
Abstract:
Objectives: Stress has been known
to trigger spikes in blood pressure, increase heart rate variability and promote
vasoconstriction; all of which are direct contributors to coronary heart disease
causation. Given the recent decline in the age of incidence among coronary heart
disease sufferers, this study was designed to assess knowledge and perceived levels
of stress, and stress management strategies.
Methods: This cross-sectional
study involved 406 participants, randomly drawn from the postgraduate faculties
of University of Ibadan, South-West Nigeria. Data was collected using the 10-point
standardized knowledge scale for cardiovascular disease, the 10-item Perceived Stress
Scale (PSS-10) and the 28-item Brief COPE Inventory Scale.
Results: Significant associations
were observed between knowledge scores and fields of study (p = 0.002), and as well
as gender (p = 0.000). Whereas only 2.2% of the respondents were severely stressed,
most of the respondents (69.2%) were moderately stressed, and significant associations
were observed between stress levels and fields of study (p = 0.026). Although healthy
stress management strategies were widely adopted, an association was observed between
gender and substance use as well as the use of emotional support as stress management
strategies (p = 0.000 and 0.001 respectively).
Conclusions: Given the factors
found to influence choice of stress coping mechanisms, the use of targeted behavioural
change communication materials should be encouraged to help build skills for healthy
stress coping mechanisms.
References:
[1]. National
Heart, Lung and Blood Institute. Coronary Heart Disease [Internet]. [cited 2020
Jul 19]. Available from: https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease
[2].
World Health Organization, World Heart
Federation, World Stroke Organization. Global atlas on cardiovascular disease
prevention and control [Internet]. WHO. World Health Organization; 2011 [cited
2020 Jul 19]. Available from: http://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en/.
[3].
World Health Organization. The global
burden of disease: 2004 update [Internet]. World Health Organization; 2008
[cited 2020 Jul 19]. Available from: https://apps.who.int/iris/handle/10665/43942.
[4].
World Health Organization.
Cardiovascular diseases (CVDs) [Internet]. 2016 [cited 2020 Jul 19]. Available
from:
https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).
[5].
World Health Organization. Global Health
Estimates [Internet]. WHO. World Health Organization; 2016 [cited 2020 Jul 19].
Available from: http://www.who.int/healthinfo/global_burden_disease/GHE2015_Deaths_Global_2000_2015.xls?ua=1.
[6].
Institute for Health Metrics and
Evaluation. Nigeria Profile [Internet]. IHME, University of Washington; 2010
[cited 2020 Jul 19]. Available from: http://www.healthdata.org/sites/default/files/files/country_profiles/GBD/ihme_gbd_country_report_nigeria.pdf.
[7].
Marksberry K. Stress and Heart Disease
[Internet]. The American Institute of Stress. [Cited 2020 Jul 19]. Available
from: https://www.stress.org/stress-and-heart-disease.
[8].
Marksberry K. Why Reducing Stress Is
Much More Important Than Lowering Cholesterol [Internet]. The American
Institute of Stress. 2013 [cited 2020 Jul 20]. Available from: http://www.stress.org/wp-content/uploads/2011/10/STRESS-MORE-IMPORTANT-THAN-LDL.pptx.
[9].
Hemingway H, Kuper H, Marmot M.
Psychosocial Factors in the Primary and Secondary Prevention of Coronary Heart
Disease: An Updated Systematic Review of Prospective Cohort Studies. In:
Evidence-based Cardiology [Internet]. John Wiley & Sons, Ltd; 2007 [cited
2020 Jul 20]. p. 181–218. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/9780470986882.ch17.
[10]. Harvard
Health Publishing. Stress and your heart [Internet]. Harvard Health. 2013
[cited 2020 Jul 20]. Available from: https://www.health.harvard.edu/heart-health/stress-and-your-heart.
[11]. Saghir
T, Qamar N, Sial J. Coronary Angiographic Characteristics of Coronary Artery
Disease in Young Adults under Age Forty Years Compare to Those over Age Forty.
Pak Heart J [Internet]. 2012 Jul 5 [cited 2020 Jul 20]; 41(3–4). Available
from: https://www.pkheartjournal.com/index.php/pkheart/article/view/38.
[12]. Foroughi
M, Abbaszadehahranjani S, Ebrahimian M, Saieedi M, Safi M, Abtahian Z. Coronary
artery disease in Iranian young adults, similarities and differences. Open J
Epidemiol. 2014 Jan 28;4(1):19–24.
[13]. Mohammad
AM, Jehangeer HI, Shaikhow SK. Prevalence and risk factors of premature
coronary artery disease in patients undergoing coronary angiography in
Kurdistan, Iraq. BMC Cardiovasc s
[14]. Nafakhi
HAF. Coronary angiographic findings in young patients with coronary artery
disease. 2013; 5(1):6.
[15]. Asani
MO, Farouk Z, Gambo S. Prevalence of perceived stress among clinical students
of Bayero University Medical School. Niger J Basic Clin Sci. 2016 Jan 1; 13(1):55.
[16]. Omokhodion
FO, Gureje O. Psychosocial problems of clinical students in the University of
Ibadan Medical School. Afr J Med Med Sci. 2003 Mar; 32(1):55–8.
[17]. Bergman
HE, Reeve BB, Moser RP, Scholl S, Klein WMP. Development of a Comprehensive
Heart Disease Knowledge Questionnaire. Am J Health Educ Am Alliance Health Phys
Educ Recreat Dance. 2011 Mar; 42(2):74–87.
[18]. Cohen
S, Kamarck T, Mermelstein R. A Global Measure of Perceived Stress. J Health Soc
Behav. 1983; 24(4):385–96.
[19]. Carver
CS. You want to measure coping but your protocol’s too long: consider the brief
COPE. Int J Behav Med. 1997; 4(1):92–100.
[20]. Seef
S, Jeppsson A, Stafström M. What is killing? People’s knowledge about coronary
heart disease, attitude towards prevention and main risk reduction barriers in
Ismailia, Egypt (Descriptive cross-sectional study). Pan Afr Med J [Internet].
2013 Aug 16 [cited 2020 Jul 20]; 15. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853340/.
[21]. Prasuna
J. Awareness of disease and risk factors among patients with ischemic heart
disease (IHD) in Government general hospital Kurnool, Andhra Pradesh. IOSR J
Nurs Health Sci. 2013; 2(4):11–7.
[22]. Khan
N, Gomathi K, Ahmad S, Shehnaz S, Abdelzaher S, Jabbar S. Knowledge of
cardiovascular disease risk factors among the non-medical staff of a medical
university in UAE. Gulf Med J. 2013; 2:147–52.
[23]. Pandey
RA, Khadka I. Knowledge regarding preventive measures of heart disease among
the adult population in Kathmandu. Health (N Y). 2012 Sep 28; 4(9):601–6.
[24]. Shrestha
S, Gautam D. Knowledge on Risk Factors of Coronary Heart Disease among Middle
Aged Administrative Staffs of Kathmandu. J Adv Acad Res. 2016; 3(2):1–13.
[25]. Dalusung‐Angosta A. CHD knowledge and risk
factors among Filipino-Americans connected to primary care services. J Am Assoc
Nurse Pract. 2013; 25(9):503–12.
[26]. Gans
KM, Assmann SF, Sallar A, Lasater TM. Knowledge of Cardiovascular Disease
Prevention: An Analysis from Two New England Communities. Prev Med. 1999 Oct 1;
29(4):229–37.
[27]. Ismail
A, Ashur ST, Jamil AT, Lee CW, Mustafa J. Stress Level and The Common Coping
Strategies Among International Postgraduate Students at University Kebangsaan
Malaysia Medical Centre (Ukmmc), Cheras, Kuala Lumpur, MALAYSIA. 17:13.
[28]. Sharma
B, Prasad S, Pandey R, Singh J, Sodhi K, Wadhwa D. Evaluation of Stress Among
Post-Graduate Medical and Dental Students: A Pilot Study. Delhi Psychiatry J.
2013; 16(2):312 – 316.
[29]. Mane
A, Krishnakumar M, Niranjan P, Hiremath S. Differences in Perceived Stress and
Its Correlates among Students in Professional Courses. J Clin Diagn Res. 2011;
5(6):1228 – 1233.
[30]. Tavolacci
MP, Ladner J, Grigioni S, Richard L, Villet H, Dechelotte P. Prevalence and
association of perceived stress, substance use and behavioral addictions: a
cross-sectional study among university students in France, 2009–2011. BMC
Public Health. 2013 Aug 6; 13(1):724.
[31]. Ickes
MJ, Brown J, Reeves B, Zephyr PMD. Differences between Undergraduate and
Graduate Students in Stress and Coping Strategies. Californian J Health Promot.
2015 May 1; 13(1):13–25.
[32]. Talwar
P, Kumaraswamy N, Mohd Fadzil A. Perceived Social Support, Stress and Gender
Differences among University Students: A Cross Sectional Study. Malays J Psychiatry.
2013 Nov 27; 22(2):42–9.
[33]. Par
M, Hassan SA, Uba I, Baba M. Perceived Stress among International Postgraduate
Students in Malaysia. Int J Psychol Stud. 2015 Sep 29; 7(4): p1.
[34]. Oswalt
SB, Riddock CC. What to Do about Being Overwhelmed: Graduate Students, Stress
and University Services. Coll Stud Aff J. 2007; 27(1):24–44.