International Journal of Research in Nursing

Cardiac Patients’ Causal Attributions for Coronary Heart Disease

Leila Gholizadeh, Yenna Salamonson, Mehrdad Heydari and Patricia M. Davidson

DOI : 10.3844/ijrnsp.2013.22.28

International Journal of Research in Nursing

Volume 4, Issue 1

Pages 22-28


Accurate casual attributions for CHD have been associated with more congruent risk reduction behaviours and improved health outcomes. This article aimed to assess causal attributions for Coronary Heart Disease (CHD) of Middle Eastern women diagnosed with heart disease using different risk targets and compare these attributions with participants’ actual. Using a survey methodology, 121 female patients in cardiac units of three public hospitals in Iran and Australia completed a questionnaire concerning causal attributions for CHD, as applied to themselves and women generally. Clinical data were collected from the patients’ medical record and the Depression, Anxiety and Stress Scale (the DASS) was used to assess the psychological status of participants. Despite being hospitalized with a diagnosis of CHD and having a high burden of risk factors, study participants had limited awareness of their personal risk factors. Overall, 47, 26 and 9% of participants either inaccurately denied or were uncertain of having hypercholesterolemia, diabetes and hypertension respectively. Only 6% of participants attributed their heart disease to lifestyle factors whilst above half attributed their disease to stress (55%). Participants were more likely to have accurate casual attribution when they applied the risk to women generally than themselves. Middle Eastern women in this study showed inaccurate casual attribution to CHD, particularly when they applied the risk to themselves. A clear specification of risk target is suggested when studying patients’ perceptions of risk and risk factors.


© 2013 Leila Gholizadeh, Yenna Salamonson, Mehrdad Heydari and Patricia M. Davidson. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.