Prediction of Family Functioning in Patients Candidate for Open-Heart Surgery Based on Interpersonal Dependency and Demographic Factors
Keywords:
family functioning, interpersonal dependency, demographic factorsAbstract
This study aimed to predict family functioning in patients who are candidates for open-heart surgery based on interpersonal dependency and demographic variables. This descriptive-analytical study was conducted on 250 patients scheduled for open-heart surgery in cardiac centers. Participants were selected through simple random sampling based on predetermined inclusion criteria. Data were collected using the McMaster Family Assessment Device (FAD) and the Hirschfeld Interpersonal Dependency Questionnaire, along with a demographic checklist. Questionnaires were administered manually and online. Data cleaning and screening procedures were performed prior to statistical analysis. Descriptive and inferential analyses were conducted using SPSS, including correlations, multicollinearity tests, and multiple regression analysis (enter method). Family functioning served as the criterion variable, while interpersonal dependency and demographic characteristics were entered as predictors. Interpersonal dependency (β = 0.44, p = .001), education (β = 0.23, p = .040), age (β = 0.21, p = .014), and marital status (β = –0.17, p = .012) were significant predictors of family functioning. The regression model was significant (F(14, 235) = 6.79, p = .001), explaining 21% of the variance in family functioning (R² = 0.207). Multicollinearity diagnostics indicated acceptable tolerance and VIF values for all predictors. Other demographic variables—including spouse’s education, illness duration, number of children, income, occupation, and type of illness—were not significant predictors. Correlation analysis also showed a significant association between interpersonal dependency (r = 0.31) and family functioning (p < .05). Interpersonal dependency, education level, age, and marital status are significant predictors of family functioning among patients awaiting open-heart surgery, highlighting the importance of psychosocial and relational factors in treatment planning and preoperative care.
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1. Clements L, Frazier SK, Moser DK, Lennie TA, Chung ML. The Mediator Effects of Depressive Symptoms on the Relationship between Family Functioning and Quality of Life in Caregivers of Patients with Heart Failure. Heart & Lung: The Journal of Cardiopulmonary and Acute Care. 2020;49(6):737-44. doi: 10.1016/j.hrtlng.2020.08.011.
2. Piamjariyakul U, Wang K, Smith M. Family Caregiving of Patients With Heart Failure and Vascular Dementia in Rural Appalachia: A Mixed-Methods Study. Western Journal of Nursing Research. 2024;46(5):344-55. doi: 10.1177/01939459241242536.
3. Abbasi K, Mohammadi E, Sadeghian H, Gholami Fesharaki M. Quality of Life in Patients with Heart Failure. Iranian Journal of Nursing Research. 2016;11(2):10-23.
4. Peng Y, Wang J, Sun G, Liu S. Family hardiness in patients with heart failure: exploring protective factors and identifying the mediator. Psychology Research and Behavior Management. 2021:355-64. doi: 10.2147/PRBM.S301765.
5. Hawrilenko M, Gray TD, Córdova JV. The heart of change: Acceptance and intimacy mediate treatment response in a brief couple's intervention. Journal of Family Psychology: JFP: Journal of the Division of Family Psychology of the American Psychological Association (Division 43). 2016;30(1):93-103. doi: 10.1037/fam0000160.
6. Wu J, Sun C, Zhang S, Ren X. Relationship between depression and family function in old patients with coronary heart disease. Sichuan da xue xue bao Yi xue ban= Journal of Sichuan University Medical science edition. 2012;43(3):401-3.
7. Moon JH, Seo E. Sense of coherence promotion and occupational and family stress mitigation may improve heart health behaviors in middle-aged working women: a structural equation modelling approach. Frontiers in Public Health. 2024;12. doi: 10.3389/fpubh.2024.1333867.
8. Chronopoulou N, Zaravinos-Tsakos F, Kolaitis G, Giannakopoulos G. Maternal Psychopathology and Family Functioning as Predictors of Externalizing Behavior in Adolescents: A Cross-Sectional Study in Greece. Adolescents. 2025;5(2):17. doi: 10.3390/adolescents5020017.
9. Junaid S, Batool SS, Nazir R, Nayyar A. Relationship Between Peer Pressure and Risk Taking Behavior Among Adolescents: Moderating Role of Family Functioning. Res J Social Affairs. 2025;3(1):121-8. doi: 10.71317/rjsa.003.01.0056.
10. Zhang X, Huang X, Chen Q, Song Y, Jiang X, Zhou J, et al. Analysis of deviant behaviors and family functions in the population at risk of internet addiction among primary and secondary school students in Chengdu city, Sichuan province of China. Frontiers in Public Health. 2024;12:1498466. doi: 10.3389/fpubh.2024.1498466.
11. Scully C, McLaughlin J, Fitzgerald A. The relationship between adverse childhood experiences, family functioning, and mental health problems among children and adolescents: a systematic review. Journal of Family Therapy. 2020;42(2):291-316.
12. Westrupp EM, Bennett C, Berkowitz T, Youssef GJ, Toumbourou JW, Tucker R, et al. Child, parent, and family mental health and functioning in Australia during COVID-19: comparison to pre-pandemic data. European Child & Adolescent Psychiatry. 2023;32(2):317-30. doi: 10.1007/s00787-021-01861-z.
13. Wen L, Huang W, Liang X, Zhang S. Strengths Knowledge Defend Against Depression: The Contribution of University Students’ Family Functioning During COVID-19. Psychological Reports. 2025. doi: 10.1177/00332941251315445.
14. Shamsaei F, Amirfakhraei A, Taghinejad N. Predicting Psychological Well-being Based on Social Support and Family Functioning in Recovered COVID-19 Patients. Journal of Health and Care. 2024;26(1):43-51. doi: 10.61186/jhc.26.1.43.
15. Zhu W. Sleep Quality as a Mediator Between Family Function and Life Satisfaction Among Chinese Older Adults in Nursing Home. BMC Geriatrics. 2024;24(1). doi: 10.1186/s12877-024-04996-1.
16. Xue J-M, Yang L, Sun F, Su J. Family Function and Depression in Older Adults With Chronic Comorbidities: The Chain‐mediated Role of Cognitive Fusion and Coping Styles. Psychogeriatrics. 2024;25(1). doi: 10.1111/psyg.13217.
17. Naderi N, Khalili Y, Ansarifar A, Ghadrdost B, Bakhshi A. The effect of supportive interventions on resilience and quality of life among family caregivers of people with advanced heart failure. IJCN. 2018;7(2):22-3.
18. Naderi N, Khalili Y, Ansari-Far A, Ghaddaroust B, Bakhshi A. The impact of supportive interventions on resilience and quality of life in family caregivers of patients with advanced heart failure. Cardiovascular Nursing Journal. 2018;7(2):21-33.
19. Kordshooli KR, Rakhshan M, Ghanbari A. The Effect of Family-Centered Empowerment Model on the Illness Perception in Heart Failure Patients: A Randomized Controlled Clinical Trial. Journal of Caring Sciences. 2018. doi: 10.15171/jcs.2018.029.
20. Farahmandi MH, Bakhshipour A, Jajarmi M. The Effectiveness of Meaning Therapy on Family Functioning and Marital Satisfaction of Couples with Marital Conflicts. Applied Psychological Research. 2025;16(2):271-86.
21. Alexander K. Managing the Challenges of Adolescence Through Improved Family Functioning. The Brown University Child and Adolescent Behavior Letter. 2025;41(6):1-4. doi: 10.1002/cbl.30871.
22. Yang Y, Liu Q, Wang Z. The Relationship Between Family Functioning and Adolescents' Symptoms of Generalized Stress Response: The Mediating Roles of Character Strengths and Perceived Stress. Journal of Adolescence. 2025. doi: 10.1002/jad.12485.
23. Zhang J, Duan X, Yan Y, Tan Y, Wu T, Xie Y, et al. Family Functioning and Adolescent Mental Health: The Mediating Role of Bullying Victimization and Resilience. Behavioral Sciences. 2024;14(8):664. doi: 10.3390/bs14080664.
24. Sevari K, Terahi R. Comparison of Family Functioning, Social Support and Irrational Beliefs in Addicted Addicts Undergoing Compulsory Treatment and Self-Reported Addicts in Treatment Centers. Social Psychology Research. 2024;13(52):85-98.
25. Babakhanipour H, Mahdavian A, Bahari F. The Comparison of Family Functioning and Parent's Marital Satisfaction among the Adolescents with and without Suicide Attempt. Journal of Research in Behavioural Sciences. 2018;16(1):8-14.
26. Zhang X, Cui L, Han ZR, Yan J. The Heart of Parenting: Parent HR Dynamics and Negative Parenting While Resolving Conflict With Child. Journal of Family Psychology. 2017;31(2):129-38. doi: 10.1037/fam0000285.
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Copyright (c) 2026 Parisa Taherpoor (Author); Hooman Namvar; Seyed Hamid Atashpour (Author)
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