Factors Affecting for Lifestyle Adoption in Patients with Myocardial Infarction

Factors Affecting for Lifestyle Adoption in Patients with Myocardial Infarction | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Factors Affecting for Lifestyle Adoption in Patients with Myocardial Infarction hossein mohsenipouya, Yadollah Jannati, Ali Ghaemian, Jamshid Yazdani-Charati This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-20017/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Epidemiological transition of acute and infectious diseases to non-communicable ones, aging population, together with rapid lifestyle changes all have given rise to prevalence rate of cardiovascular diseases (CVDs). Thus, it is of utmost importance to reflect on lifestyles especially in this period. The main purpose of this study was to assess lifestyle in patients affected with myocardial infarction (MI). Methods This cross-sectional study was examining health-related lifestyle behaviors in patients with MI in 2019. To this end, a total number of 176 patients were selected using purposive and convenience sampling methods. The research instrument was also the Health-Promoting Lifestyle Profile II (HPLP-II) as a standardized self-report questionnaire. To analyze the data, the IBM SPSS Statistics software (version 22) software and the generalized linear models were used. Moreover, the level of significance was set at 0.05 in this study. Results The results of Wilks’ lambda distribution revealed that the effect of gender on the linear combination of the dependent variable (i.e. lifestyle) was significant and 11.4% of changes in this variable had resulted from variation in gender. Besides, the results demonstrated that health responsibility scores in men were on average 2.703 lower than those obtained by women. This relationship was also significant and its effect size was by 3.3% (p = 0.016). Conclusions and recommendations: It was concluded that the concept of lifestyle can be an analysis tool to better understand differences between genders, as an effective variable in adopting a healthy lifestyle, especially in patients suffering from MI. Cardiac & Cardiovascular Systems Cardiothoracic Surgery Lifestyle Myocardial Infarction Gender Introduction The prevalence rate of cardiovascular diseases (CVDs) in developing countries is on the rise because of aging population and rapid lifestyle changes, in particular, tobacco use, high-fat food intake, lack of physical activity and exercise, as well as adoption of industrial lifestyle [ 1 ]. Nowadays, CVDs are known as the world’s leading cause of death. Estimates in 2015 in this respect had also established that 17.7 million people had died from CVDs, accounting for 31% of global mortality. Statistics had further revealed that 7.4 million people had lost their lives caused by coronary artery disease and 6.7 million people had died due to myocardial infarction (MI) [ 2 ]. Mortality and recurrent MI are thus considered as the main clinical outcomes following an acute heart attack. Ability to perform daily living activities, level of comfort, and lifestyle behaviors after a heart attack among patients are also taken into account as important factors affecting their survival [ 3 ]. Moreover, evidence has demonstrated that lifestyle can shape individuals’ health status and longevity [ 4 ]. Epidemiological studies have further reported that healthy lifestyle such as proper diet, no tobacco use, healthy weight maintenance, and physical activity can play a role in controlling cardiovascular risk factors [ 5 ]. The World Health Organization (WHO) also recognizes the concept of lifestyle based on definable patterns of behavior resulting from interactions between personal characteristics, social relationships, environmental conditions, and socioeconomic situations [ 6 ]. In fact, lifestyle refers to routine daily living activities accepted automatically by individuals, so they can affect health status [ 7 ]. To pick a lifestyle to maintain and promote one’s health and to prevent diseases, individuals take several measures including proper diet adherence, enough sleep, rest, physical activity and exercise, weight control, as well as no tobacco use, and immunization against diseases [ 8 ]. It should be noted that health-promoting lifestyle consists of six behavioral aspects of physical activity, nutrition, health responsibility, spiritual growth, interpersonal relations, and stress management [ 9 ]. In this line, the results of the study by Manavifar et al. (2019) had found that lifestyle in patients with hypertension referred to clinics affiliated to Islamic Azad University of Mashhad was not at a favorable level. In terms of physical activity, majority of the patients had also answered “never” to items about regular, vigorous, or even moderate exercise. In addition, more than half of the patients had insufficient information about sodium and oil intake with regard to nutrition [ 9 ]. The findings reported by Mohseni-Pouya et al. had correspondingly demonstrated a significant relationship between lifestyle and prevalence rate of coronary artery disease in patients affected with CVDs [ 10 ]. Moreover, Mansourian et al. (2012) had revealed a significant difference between lifestyle (i.e. physical activity, spiritual growth, interpersonal relations, and stress management) and high blood pressure [ 11 ]. On the other hand, epidemiological transition of acute and infectious diseases to non-communicable ones as the leading cause of mortality and health disorders has made the assessment of lifestyle an essential issue especially in this period [ 12 ]. Considering the importance of lifestyle and its effect in helping individuals have access to favorable health status, the present study was conducted to assess factors affecting for lifestyle adoption in palliative care of in patients affected with myocardial infarction admitted to Mazandaran Heart Center, Iran, in 2019. Methods This study was a descriptive-analytical cross-sectional research assessing health-related lifestyle behaviors in patients affected with MI in 2019. Ethics committee Mazandaran university of Medical Science approved this study with the ethical code no.IR.MAZUMS.REC.13971105. To observe the research ethics, a letter of introduction was initially received from the Vice-Chancellor’s Office for Research and Technology at Mazandaran University of Medical Sciences and then submitted to the head of Mazandaran Heart Center. After introducing oneself to study samples, the researcher also explained the main research objectives and obtained an informed consent from them. In this study, the designed research instrument was distributed among 176 patients selected via purposive and convenience sampling methods. The patients were further informed that they were free to participate in the project or withdraw. To ensure confidentiality of data, the patients’ names were not mentioned on the information forms. The inclusion criteria were willingness to participate in the study, no emergency critical conditions, complete alertness during the study, no mental illnesses, and at least 5 days of being affected with MI. As well, the exclusion criteria were unwillingness to be involved in the study and being in emergency critical conditions. According to the formula for determining sample size, a total number of 176 patients participated in this study. The sample size was correspondingly calculated based on research results by Leifheit-Limson et al. as follows [ 16 ]: The main research instruments were a demographic characteristics form (including age, gender, marital status, and level of education) and the 52-item Health-Promoting Lifestyle Profile II (HPLP-II) as a standardized self-report questionnaire, used in the study by Mohseni-Pouya et al., reflecting on six aspects of lifestyle i.e. health responsibility, nutrition, spiritual growth, interpersonal relations (each one with 9 items) as well as physical activity and stress management (each one with 8 items) using a Likert-type scale containing “never (1)”, “sometimes (2)”, “often (3)”, and “always (4)”. The total score of lifestyle could also range from 52 to 208. The validity of this research instrument was measured by 10 experts through content validity method. Cronbach’s alpha coefficient was also calculated to determine internal validity, which was 0.83 and at a desirable level. The data were collected based on medical records and through direct interviews with patients in the ward. The data analysis was further conducted using the IBM SPSS Statistics (version 22) software and statistical tests of mean, frequency, and generalized linear models (GLMs). The level of significance was finally set at 0.05 in this study. Results The findings illustrated that the mean age in men and women was 56.21 ± 5.31 and 55.14 ± 4.81 respectively. As well, 72.9% of the male patients and 89.2% of the females were married. Among the six aspects of lifestyle, physical activity was the poorest behavior demonstrated by the patients. Table 1 Frequency distribution of demographic characteristics of patients with MI Variable Number(percent) Gender Male 178(72.9) Female 48(27.3) Status of marriage No marriage 8(4.6) died of Wife 11(6.3) marriage 157(89.2) Educational level Uunderdiploma 66(37.5) Diploma 42(23.9) Advanced Diploma 15(8.5) bachelor 19(10.8) Master's degree 18(10.2) Others 16(9.1) Job Governmental 25(14.2) Private 29(16.3) Self-employed 35(19.9) Retired 41(23.3) housewife 38(21.6) Others 8(4.5) The results of Wilks’ lambda distribution in 0.886, F(6.176) = 3.62, and p = 0.002, as well as partial eta-squared = 0.114 revealed that the effect of gender on the linear combination of the dependent variable (i.e. lifestyle) was significant and 11.4% of the changes in the given variable had resulted from variation in gender. For this purpose, independent T-test was employed to specify the significance source, whose results are outlined in Table 3 . Table 2 Comparison of aspects of lifestyle in terms of gender among patients with MI in 2019 using Hotelling’s T-squared distribution (T 2 ) Variable Gender Mean Std. Deviation p-value Partial Eta Squared Responsibility Male 23.10 6.80 0.002 0.114 Female 25.81 5.73 Physical Activity Male 16.51 5.86 Female 18.62 10.69 Nutrition Male 25.95 4.50 Female 26.58 5.03 spirituality Male 29.09 5.99 Female 27.89 7.09 Communication Male 28.12 4.71 Female 29.47 4.10 Stress Management Male 21.91 6.76 Female 22.79 5.15 The results in Table 3 showed that the score of health responsibility in men compared with women was on average 2.703 lower. So, this relationship was significant and its effect size was reported by 3.3% (p = 0.016). Considering other variables, no statistically significant difference was found between both genders. Table 3 Estimation of effects of gender on aspects of lifestyle in patients with MI in 2019 Variable β Std. Error P-Value Partial Eta Squared Responsibility -2.703 1.106 .016 .033 Physical Activity -2.109 1.267 .098 .016 Nutrition − .630 .788 .425 .004 Spirituality 1.198 1.068 .264 .007 Communications -1.354 .771 .081 .017 Stress Management − .878 1.079 .417 .004 According to the results in Table 4 , no significant difference was established between the total score of lifestyle in both genders, namely, lifestyle scores in men and women were 151.18 ± 29.69 and 144.71 ± 25.51; respectively. Table 4 Comparison of total score of lifestyle in men and women affected with MI in 2019 Variable Gender (Number) Mean Std. Deviation P-Value Life Style Male (128) 144.71 25.51 0.154 Female (48) 151.18 29.69 Discussion In this study, factors affecting for lifestyle adoption in palliative care of patients with MI were investigated. The results showed that the effect of gender on the linear combination of the dependent variable (i.e. lifestyle) was significant and 11.4% of changes in this variable had resulted from variation in gender. In this study, lifestyle scores obtained by women (151.18 ± 29.69) were higher than those of men (144.71 ± 25.51). The results of this study were also consistent with the findings reported by Abedi et al. (2013) in which a significant relationship had been observed between lifestyle and gender and also men’s lifestyle had been poorer than that in women [ 13 ]. In the study by Manavifar et al. (2010), women in all age groups had been more active than men, maybe due to their health consciousness behaviors [ 14 ]. In the given study, the total score of health-promoting lifestyle behaviors was lower in women than in men, but it was not statistically significant. It seems that this discrepancy might be attributable to the small sample size (i.e. 67 female patients with hypertension) [ 9 ]. However, in the study by Babak, the total score of lifestyle in older men had been reported significantly higher than that in women. It looks as if such a difference was the result of factors such as level of education as well as socioeconomic characteristics in men [ 15 ]. In the present study, only 27.3% of the patients were women, which could be considered as a limitation; so it was recommended to select a larger sample size of female patients in further research. In this study, the lowest mean score was related to physical activity, which meant that these patients did not have a good level of health-promoting lifestyle behaviors in this aspect. In the studies by Azadbakht [ 16 ], Manavifar [ 9 ], Barough [ 17 ], and Mansourian [ 11 ], majority of the individuals had poor lifestyle with regard to physical activity and exercise. Also, in the study by Sargazi et al. (2012), only 38% of the elderly aged over 65 years had reported moderate to vigorous physical activity [ 18 ]. This could be due to factors such as underdevelopment of sports culture in this age group, lack of sports facilities around city, and problems of commuting by older individuals in the city. In this study, the score of health responsibility in men was on average 2.703 lower than that in women. This relationship was also significant with the effect size of 3.3% (p = 0.016). Health responsibility means that individuals reach a perception of what activities can be performed for being healthy [ 19 ]. The results of the present study also demonstrated that men had poor health responsibility than women. The findings of various investigations had further revealed that women had adopted significantly better behaviors than men in terms of health responsibility, nutrition, interpersonal relations, and spiritual growth in health-promoting lifestyle [ 20 ]. Research findings by Fuhrer had also shown that women compared with men had healthier lifestyles. For example, men had alcohol consumption by 2.21 times more than women, and they were smoking 16 times more likely than women [ 21 ]. Conclusion The results of the present study implied that the concept of lifestyle could be an analysis tool to better understand differences between genders as an effective variable in adopting a healthy lifestyle, especially in patients with MI. Therefore, there is a need to expand research and education programs about lifestyle in this group of patients and approve appropriate policies in this respect. Declarations Ethics approval and consent to participate This study was the result of the project approved with the ethical code no.IR.MAZUMS.REC.13971105. The researcher explained the main research objectives and obtained an informed consent from them. Consent for publication: Not applicable. Availability of data and materials: "The dataset(s) supporting the conclusions of this article is (are) included within the article (and its additional file(s))." Competing interests The authors declare that they have no competing interests. Funding The author(s) received no financial support for the research, authorship, and/or publication of this article. Authors’contributions HM were supervisors and principal investigators of the study and drafted the manuscript. YJ was an advisor of the study. JY participated in the statistical analysis. AG contributed to the design and assisted in the preparation of the final version of the manuscript. All authors read and approved the final version of the manuscript . Acknowledgements We gratefully acknowledge the patients who devoted their time to the research. The authors are grateful to the Vice Chancellor for research, Mazandaran University of Medical Science. Authors' Information Hossein MohseniPouya: Assistant Professor, Department of Nursing, School of Nursing, Mazandaran University of Medical Sciences, Sari, Iran. Email: [email protected] Yadollah Jannati: Assistant Professor, Department of Nursing, School of Nursing, Mazandaran University of Medical Sciences, Sari, Iran. Email: [email protected] Ali Ghaemian: Department of Cardiology, School of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Email: [email protected] Jamshid Yazdani-Charati: Associate Professor, School of Health, Department of Biostatistics, Mazandaran University of Medical Sciences, Sari, Iran. Email: [email protected] References Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med . 2016;4(13). Organization WH. Cardiovascular diseases (CVDs). Fact sheet, updated May 2017. Oldridge N, Höfer S, McGee H, Conroy R, Doyle F, Saner H, HeartQoL Project Investigators). The HeartQoL: Part I. Development of a new core health-related quality of life questionnaire for patients with ischemic heart disease. Eur J Prev Cardiol. 2014 Jan;21(1):90–7. Kuan G, Kueh YC, Abdullah N, Tai EL. Psychometric properties of the health-promoting lifestyle profile II: cross-cultural validation of the Malay language version. BMC Public Health. 2019 Dec;19(1):751. Lie I, Bunch EH, Smeby NA, Arnesen H, Hamilton G. Patients’ experiences with symptoms and needs in the early rehabilitation phase after coronary artery bypass grafting. Eur J Cardiovasc Nurs. 2012;11(1):14–24. Jing W, Willis R, Feng Z. Factors influencing quality of life of elderly people with dementia and care implications: A systematic review. Arch Gerontol Geriatr. 2016 Sep;1;66:23–41. Wolever RQ, Caldwell KL, McKernan LC, Hillinger MG. Integrative medicine strategies for changing healthbehaviors: Support for primary care. Prim Care. 2017;44(2):229–45. Yandarani M, Mansourian M, Ansarifar A, Mohamadi F, Safari O, Yousefi J, et al. Lifestyle and hypertension in rural population of Tangestan town. Iran J Chronic Dis Manag . 2019;7(4):226–32. Manavifar M, Asaei E. Evaluation the lifestyle of patients with hypertension who reffered to heart clinices dependent on Islamic azad university of mashhad. RJMS. 2019;26(3):51–8. Mohseni Pouya H, Hajimiri K, Esmaeili Shahmirzadi S, Golshani S, Amrei H, Seifi Makrani A. Relationship between Health Promoting Behaviors and Severity of Coronary Artery Stenosis in Angiography Department in Mazandaran Heart Center. Journal of Mazandaran University of Medical Sciences(jmums). 2015;25(130):19–29. Mansoorian M, Qorbani M, Shafieyan N, Asayesh H, Shafieyan Z, Maghsodloo D. Association between life style and hypertension in rural population of Gorgan. Journal of health promotion management. 2012 Apr;10(2):23–8. 1(. Díaz-Gutiérrez J, Ruiz-Canela M, Gea A, Fernández-Montero A, Martínez-González M. Association between a healthy lifestyle score and the risk of cardiovascular disease in the SUN Cohort. Revista Española de Cardiología (English Edition). 2018;71(12):1001–9. Abedi HA, Nazari H, Abdeyazdan GH, Bik Mohammadi S. A survey on the the lifestyle of the heart desease patients after discharge from hospital in urmia seyyed alshohada in 1391. The Journal of Urmia Nursing Midwifery Faculty. 2014;11(12):944–54. Kwaśniewska M, Kaczmarczyk-Chałas K, Pikala M, Kozakiewicz K, Pająk A, Tykarski A, et al. Socio-demographic and lifestyle correlates of commuting activity in Poland. Preventive medicine. 2010;50(5–6):257–61. Babak A, Davari S, Aghdak P, Pirhaji O. Assessment of Healthy Lifestyle among Elderly in Isfahan, Iran. Journal of Isfahan Medical School(JIMS) . 2011;29(149). Azadbakht M, Garmaroodi G, Taheri Tanjani P, Sahaf R, Shojaeizade D, Gheisvandi E. Health Promoting Self-Care Behaviors and Its Related Factors in Elderly: Application of Health Belief Model. Journal of Education Community Health(JECH). 2014;1(2):20–9. Baroogh N, Teimouri F, Saffari M, Sadeh SH, Mehran A. Hypertension and lifestyle in 24–65 year old people in Qazvin Kosar region in 2007. Pajoohandeh Journal. 2010 Nov;15(5):193–8. 15(. Sargazi M, Salehi S, Naji SA. A study on the health promoting behaviors regarding hospitalized older adults' health in Zahedan. Journal of Zabol University of Medical Sciences Health Services. 2012;4(2):73–84. Solhi M, Rezazadeh A, Azam K, Khoushemehri G. Application of theory of planned behavior in prediction of health responsibility, spiritual health and interpersonal relations in high school girl students in Tabriz. Razi journal of medical sciences(RJMS). 2014;21(121):9–17. Purafkari N. Investigating Factors Affecting Social Health in Paveh City. Islamic Azad University Journal of Social Sciences shoshtar. 2012;6(18):41–60. Fuhrer R, Stansfeld SA. How genderaffects patterns of social relations and their impact on health: a comparison of one or multiple sources of support from “close persons”. Soc Sci Med. 2002;54(5):811–25. Supplementary Files OUTPUT.xlsm Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-20017","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":497464,"identity":"21e7ab10-05fc-42b0-ade8-bd8369bb29e3","order_by":1,"name":"hossein mohsenipouya","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0003-2066-4835","institution":"Mazandaran University of Medical Sciences","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"hossein","middleName":"","lastName":"mohsenipouya","suffix":""},{"id":497465,"identity":"56914950-01d1-4996-a5fb-60c95c82b2c9","order_by":2,"name":"Yadollah Jannati","email":"","orcid":"","institution":"Mazandaran University of Medical Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yadollah","middleName":"","lastName":"Jannati","suffix":""},{"id":497466,"identity":"30a6b190-b191-445d-a87e-2f41b495302b","order_by":3,"name":"Ali Ghaemian","email":"","orcid":"","institution":"Mazandaran University of Medical Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ali","middleName":"","lastName":"Ghaemian","suffix":""},{"id":497467,"identity":"940c4e55-45bb-4143-b2e2-c460c0791206","order_by":4,"name":"Jamshid Yazdani-Charati","email":"","orcid":"","institution":"Mazandaran University of Medical Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jamshid","middleName":"","lastName":"Yazdani-Charati","suffix":""}],"badges":[],"createdAt":"2020-03-28 11:45:54","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-20017/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-20017/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":13499654,"identity":"943b567b-9d3a-40fb-8f3a-4e4cbe7399f7","added_by":"auto","created_at":"2021-09-16 23:02:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":315746,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-20017/v1/37100fd0-150f-40a5-a223-dc541d4ef0af.pdf"},{"id":943708,"identity":"e30c2038-2f0f-4e9f-8dd5-cca59d7ccc38","added_by":"auto","created_at":"2020-04-21 21:10:12","extension":"xlsm","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":186626,"visible":true,"origin":"","legend":"","description":"","filename":"OUTPUT.xlsm","url":"https://assets-eu.researchsquare.com/files/rs-20017/v1/OUTPUT.xlsm"}],"financialInterests":"","formattedTitle":"Factors Affecting for Lifestyle Adoption in Patients with Myocardial Infarction","fulltext":[{"header":"Introduction","content":" \u003cp\u003eThe prevalence rate of cardiovascular diseases (CVDs) in developing countries is on the rise because of aging population and rapid lifestyle changes, in particular, tobacco use, high-fat food intake, lack of physical activity and exercise, as well as adoption of industrial lifestyle [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Nowadays, CVDs are known as the world\u0026rsquo;s leading cause of death. Estimates in 2015 in this respect had also established that 17.7\u0026nbsp;million people had died from CVDs, accounting for 31% of global mortality. Statistics had further revealed that 7.4\u0026nbsp;million people had lost their lives caused by coronary artery disease and 6.7\u0026nbsp;million people had died due to myocardial infarction (MI) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Mortality and recurrent MI are thus considered as the main clinical outcomes following an acute heart attack. Ability to perform daily living activities, level of comfort, and lifestyle behaviors after a heart attack among patients are also taken into account as important factors affecting their survival [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Moreover, evidence has demonstrated that lifestyle can shape individuals\u0026rsquo; health status and longevity [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Epidemiological studies have further reported that healthy lifestyle such as proper diet, no tobacco use, healthy weight maintenance, and physical activity can play a role in controlling cardiovascular risk factors [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe World Health Organization (WHO) also recognizes the concept of lifestyle based on definable patterns of behavior resulting from interactions between personal characteristics, social relationships, environmental conditions, and socioeconomic situations [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In fact, lifestyle refers to routine daily living activities accepted automatically by individuals, so they can affect health status [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. To pick a lifestyle to maintain and promote one\u0026rsquo;s health and to prevent diseases, individuals take several measures including proper diet adherence, enough sleep, rest, physical activity and exercise, weight control, as well as no tobacco use, and immunization against diseases [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. It should be noted that health-promoting lifestyle consists of six behavioral aspects of physical activity, nutrition, health responsibility, spiritual growth, interpersonal relations, and stress management [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn this line, the results of the study by Manavifar et al. (2019) had found that lifestyle in patients with hypertension referred to clinics affiliated to Islamic Azad University of Mashhad was not at a favorable level. In terms of physical activity, majority of the patients had also answered \u0026ldquo;never\u0026rdquo; to items about regular, vigorous, or even moderate exercise. In addition, more than half of the patients had insufficient information about sodium and oil intake with regard to nutrition [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The findings reported by Mohseni-Pouya et al. had correspondingly demonstrated a significant relationship between lifestyle and prevalence rate of coronary artery disease in patients affected with CVDs [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Moreover, Mansourian et al. (2012) had revealed a significant difference between lifestyle (i.e. physical activity, spiritual growth, interpersonal relations, and stress management) and high blood pressure [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOn the other hand, epidemiological transition of acute and infectious diseases to non-communicable ones as the leading cause of mortality and health disorders has made the assessment of lifestyle an essential issue especially in this period [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Considering the importance of lifestyle and its effect in helping individuals have access to favorable health status, the present study was conducted to assess factors affecting for lifestyle adoption in palliative care of in patients affected with myocardial infarction admitted to Mazandaran Heart Center, Iran, in 2019.\u003c/p\u003e "},{"header":"Methods","content":" \u003cp\u003eThis study was a descriptive-analytical cross-sectional research assessing health-related lifestyle behaviors in patients affected with MI in 2019. Ethics committee Mazandaran university of Medical Science approved this study with the ethical code no.IR.MAZUMS.REC.13971105. To observe the research ethics, a letter of introduction was initially received from the Vice-Chancellor\u0026rsquo;s Office for Research and Technology at Mazandaran University of Medical Sciences and then submitted to the head of Mazandaran Heart Center. After introducing oneself to study samples, the researcher also explained the main research objectives and obtained an informed consent from them. In this study, the designed research instrument was distributed among 176 patients selected via purposive and convenience sampling methods. The patients were further informed that they were free to participate in the project or withdraw. To ensure confidentiality of data, the patients\u0026rsquo; names were not mentioned on the information forms. The inclusion criteria were willingness to participate in the study, no emergency critical conditions, complete alertness during the study, no mental illnesses, and at least 5 days of being affected with MI. As well, the exclusion criteria were unwillingness to be involved in the study and being in emergency critical conditions. According to the formula for determining sample size, a total number of 176 patients participated in this study. The sample size was correspondingly calculated based on research results by Leifheit-Limson et al. as follows [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]:\u003c/p\u003e\u003cp\u003e\u003cimg 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\" style=\"width: 474px;\"\u003e\u003c/p\u003e\u003cp\u003eThe main research instruments were a demographic characteristics form (including age, gender, marital status, and level of education) and the 52-item Health-Promoting Lifestyle Profile II (HPLP-II) as a standardized self-report questionnaire, used in the study by Mohseni-Pouya et al., reflecting on six aspects of lifestyle i.e. health responsibility, nutrition, spiritual growth, interpersonal relations (each one with 9 items) as well as physical activity and stress management (each one with 8 items) using a Likert-type scale containing \u0026ldquo;never (1)\u0026rdquo;, \u0026ldquo;sometimes (2)\u0026rdquo;, \u0026ldquo;often (3)\u0026rdquo;, and \u0026ldquo;always (4)\u0026rdquo;. The total score of lifestyle could also range from 52 to 208. The validity of this research instrument was measured by 10 experts through content validity method. Cronbach\u0026rsquo;s alpha coefficient was also calculated to determine internal validity, which was 0.83 and at a desirable level.\u003c/p\u003e \u003cp\u003eThe data were collected based on medical records and through direct interviews with patients in the ward. The data analysis was further conducted using the IBM SPSS Statistics (version 22) software and statistical tests of mean, frequency, and generalized linear models (GLMs). The level of significance was finally set at 0.05 in this study.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe findings illustrated that the mean age in men and women was 56.21\u0026thinsp;\u0026plusmn;\u0026thinsp;5.31 and 55.14\u0026thinsp;\u0026plusmn;\u0026thinsp;4.81 respectively. As well, 72.9% of the male patients and 89.2% of the females were married. Among the six aspects of lifestyle, physical activity was the poorest behavior demonstrated by the patients.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency distribution of demographic characteristics of patients with MI\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber(percent)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e178(72.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48(27.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eStatus of marriage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo marriage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(4.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003edied of Wife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(6.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emarriage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e157(89.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eEducational level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUunderdiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66(37.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42(23.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdvanced Diploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15(8.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ebachelor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(10.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaster's degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18(10.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(9.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eJob\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGovernmental\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(14.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrivate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29(16.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35(19.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41(23.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ehousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38(21.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(4.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe results of Wilks\u0026rsquo; lambda distribution in 0.886, F(6.176)\u0026thinsp;=\u0026thinsp;3.62, and p\u0026thinsp;=\u0026thinsp;0.002, as well as partial eta-squared\u0026thinsp;=\u0026thinsp;0.114 revealed that the effect of gender on the linear combination of the dependent variable (i.e. lifestyle) was significant and 11.4% of the changes in the given variable had resulted from variation in gender. For this purpose, independent T-test was employed to specify the significance source, whose results are outlined in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of aspects of lifestyle in terms of gender among patients with MI in 2019 using Hotelling\u0026rsquo;s T-squared distribution (T\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStd. Deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePartial Eta Squared\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eResponsibility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"11\" rowspan=\"12\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"11\" rowspan=\"12\"\u003e \u003cp\u003e0.114\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePhysical Activity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNutrition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003espirituality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCommunication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStress Management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe results in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e showed that the score of health responsibility in men compared with women was on average 2.703 lower. So, this relationship was significant and its effect size was reported by 3.3% (p\u0026thinsp;=\u0026thinsp;0.016). Considering other variables, no statistically significant difference was found between both genders.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eEstimation of effects of gender on aspects of lifestyle in patients with MI in 2019\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStd. Error\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePartial Eta Squared\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResponsibility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-2.703\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.033\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical Activity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-2.109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNutrition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.630\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.788\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.425\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpirituality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.198\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.068\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.354\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.771\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStress Management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.878\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.079\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.417\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAccording to the results in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, no significant difference was established between the total score of lifestyle in both genders, namely, lifestyle scores in men and women were 151.18\u0026thinsp;\u0026plusmn;\u0026thinsp;29.69 and 144.71\u0026thinsp;\u0026plusmn;\u0026thinsp;25.51; respectively.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of total score of lifestyle in men and women affected with MI in 2019\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender (Number)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStd. Deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLife Style\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale (128)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e144.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.154\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale (48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e151.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e "},{"header":"Discussion","content":"\u003cp\u003eIn this study, factors affecting for lifestyle adoption in palliative care of patients with MI were investigated. The results showed that the effect of gender on the linear combination of the dependent variable (i.e. lifestyle) was significant and 11.4% of changes in this variable had resulted from variation in gender. In this study, lifestyle scores obtained by women (151.18\u0026thinsp;\u0026plusmn;\u0026thinsp;29.69) were higher than those of men (144.71\u0026thinsp;\u0026plusmn;\u0026thinsp;25.51).\u003c/p\u003e \u003cp\u003eThe results of this study were also consistent with the findings reported by Abedi et al. (2013) in which a significant relationship had been observed between lifestyle and gender and also men\u0026rsquo;s lifestyle had been poorer than that in women [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In the study by Manavifar et al. (2010), women in all age groups had been more active than men, maybe due to their health consciousness behaviors [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In the given study, the total score of health-promoting lifestyle behaviors was lower in women than in men, but it was not statistically significant. It seems that this discrepancy might be attributable to the small sample size (i.e. 67 female patients with hypertension) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. However, in the study by Babak, the total score of lifestyle in older men had been reported significantly higher than that in women. It looks as if such a difference was the result of factors such as level of education as well as socioeconomic characteristics in men [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the present study, only 27.3% of the patients were women, which could be considered as a limitation; so it was recommended to select a larger sample size of female patients in further research.\u003c/p\u003e \u003cp\u003eIn this study, the lowest mean score was related to physical activity, which meant that these patients did not have a good level of health-promoting lifestyle behaviors in this aspect. In the studies by Azadbakht [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], Manavifar [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], Barough [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], and Mansourian [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], majority of the individuals had poor lifestyle with regard to physical activity and exercise. Also, in the study by Sargazi et al. (2012), only 38% of the elderly aged over 65\u0026nbsp;years had reported moderate to vigorous physical activity [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. This could be due to factors such as underdevelopment of sports culture in this age group, lack of sports facilities around city, and problems of commuting by older individuals in the city.\u003c/p\u003e \u003cp\u003eIn this study, the score of health responsibility in men was on average 2.703 lower than that in women. This relationship was also significant with the effect size of 3.3% (p\u0026thinsp;=\u0026thinsp;0.016). Health responsibility means that individuals reach a perception of what activities can be performed for being healthy [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The results of the present study also demonstrated that men had poor health responsibility than women. The findings of various investigations had further revealed that women had adopted significantly better behaviors than men in terms of health responsibility, nutrition, interpersonal relations, and spiritual growth in health-promoting lifestyle [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Research findings by Fuhrer had also shown that women compared with men had healthier lifestyles. For example, men had alcohol consumption by 2.21 times more than women, and they were smoking 16 times more likely than women [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe results of the present study implied that the concept of lifestyle could be an analysis tool to better understand differences between genders as an effective variable in adopting a healthy lifestyle, especially in patients with MI. Therefore, there is a need to expand research and education programs about lifestyle in this group of patients and approve appropriate policies in this respect.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was the result of the project approved with the ethical code no.IR.MAZUMS.REC.13971105. The researcher explained the main research objectives and obtained an informed consent from them.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials: \u003c/strong\u003e\"The dataset(s) supporting the conclusions of this article is (are) included within the article (and its additional file(s)).\"\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003cbr /\u003e \u003c/strong\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author(s) received no financial support for the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo;contributions\u003c/strong\u003e\u003cbr /\u003e HM were supervisors and principal investigators of the study and drafted the manuscript. YJ was an advisor of the study.\u0026nbsp; JY participated in the statistical analysis. AG contributed to the design and assisted in the preparation of the final version of the manuscript. All authors read and approved the final version of the manuscript\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003cbr /\u003e \u003c/strong\u003eWe gratefully acknowledge the patients who devoted their time to the\u003cbr /\u003e research. The authors are grateful to the Vice Chancellor for research, Mazandaran University of Medical Science.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' Information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHossein MohseniPouya: Assistant Professor, Department of Nursing, School of Nursing, Mazandaran University of Medical Sciences, Sari, Iran. \u003cstrong\u003eEmail:\u0026nbsp; [email protected]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYadollah Jannati: Assistant Professor, Department of Nursing, School of Nursing, Mazandaran University of Medical Sciences, Sari, Iran. \u003cstrong\u003eEmail: [email protected]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAli Ghaemian: Department of Cardiology, School of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran. \u003cstrong\u003eEmail: [email protected]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJamshid Yazdani-Charati: Associate Professor, School of Health, Department of Biostatistics, Mazandaran University of Medical Sciences, Sari, Iran. \u003cstrong\u003eEmail: [email protected]\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e \u003cspan\u003eSanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. 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Journal of Education Community Health(JECH). 2014;1(2):20\u0026ndash;9.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eBaroogh N, Teimouri F, Saffari M, Sadeh SH, Mehran A. Hypertension and lifestyle in 24\u0026ndash;65 year old people in Qazvin Kosar region in 2007. Pajoohandeh Journal. 2010 Nov;15(5):193\u0026ndash;8. 15(.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eSargazi M, Salehi S, Naji SA. A study on the health promoting behaviors regarding hospitalized older adults' health in Zahedan. Journal of Zabol University of Medical Sciences Health Services. 2012;4(2):73\u0026ndash;84.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eSolhi M, Rezazadeh A, Azam K, Khoushemehri G. Application of theory of planned behavior in prediction of health responsibility, spiritual health and interpersonal relations in high school girl students in Tabriz. Razi journal of medical sciences(RJMS). 2014;21(121):9\u0026ndash;17.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003ePurafkari N. Investigating Factors Affecting Social Health in Paveh City. Islamic Azad University Journal of Social Sciences shoshtar. 2012;6(18):41\u0026ndash;60.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eFuhrer R, Stansfeld SA. How genderaffects patterns of social relations and their impact on health: a comparison of one or multiple sources of support from \u0026ldquo;close persons\u0026rdquo;. Soc Sci Med. 2002;54(5):811\u0026ndash;25.\u003c/span\u003e \u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Lifestyle, Myocardial Infarction, Gender","lastPublishedDoi":"10.21203/rs.3.rs-20017/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-20017/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEpidemiological transition of acute and infectious diseases to non-communicable ones, aging population, together with rapid lifestyle changes all have given rise to prevalence rate of cardiovascular diseases (CVDs). Thus, it is of utmost importance to reflect on lifestyles especially in this period. The main purpose of this study was to assess lifestyle in patients affected with myocardial infarction (MI).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis cross-sectional study was examining health-related lifestyle behaviors in patients with MI in 2019. To this end, a total number of 176 patients were selected using purposive and convenience sampling methods. The research instrument was also the Health-Promoting Lifestyle Profile II (HPLP-II) as a standardized self-report questionnaire. To analyze the data, the IBM SPSS Statistics software (version 22) software and the generalized linear models were used. Moreover, the level of significance was set at 0.05 in this study.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe results of Wilks\u0026rsquo; lambda distribution revealed that the effect of gender on the linear combination of the dependent variable (i.e. lifestyle) was significant and 11.4% of changes in this variable had resulted from variation in gender. Besides, the results demonstrated that health responsibility scores in men were on average 2.703 lower than those obtained by women. This relationship was also significant and its effect size was by 3.3% (p\u0026thinsp;=\u0026thinsp;0.016).\u003c/p\u003e\u003ch2\u003eConclusions and recommendations:\u003c/h2\u003e \u003cp\u003eIt was concluded that the concept of lifestyle can be an analysis tool to better understand differences between genders, as an effective variable in adopting a healthy lifestyle, especially in patients suffering from MI.\u003c/p\u003e","manuscriptTitle":"Factors Affecting for Lifestyle Adoption in Patients with Myocardial Infarction","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-04-21 21:10:10","doi":"10.21203/rs.3.rs-20017/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"baa7eb95-7894-4d35-adc7-c8ccb76f3cc4","owner":[],"postedDate":"April 21st, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":86591,"name":"Cardiac \u0026 Cardiovascular Systems"},{"id":86592,"name":"Cardiothoracic Surgery"}],"tags":[],"updatedAt":"2020-05-01T15:46:19+00:00","versionOfRecord":[],"versionCreatedAt":"2020-04-21 21:10:10","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-20017","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-20017","identity":"rs-20017","version":["v1"]},"buildId":"FbvkV6FR0MCFSLy54lSbu","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}