Background. Cardiovascular disease is a health issue caused by heart problems, such as coronary heart disease, heart failure, hypertension, or stroke. Based on World Health Organization data, heart disease is the number one cause of death in the world. Every year, many people die from cardiovascular disease when compared to other causes. An estimated 17.7 million people die of cardiovascular disease in 2015, representing 31% of deaths worldwide. In Indonesia, there are around 63% of people who die unhealthily. Of these percentages, more than 9 million deaths were caused by cardiovascular disease. In heart disease patient, health-related quality of life (HRQoL) is one of the important context of prevention and treatment in heart disease. HRQoL refers to the impact of health conditions and symptoms that individuals have on quality of life. HRQOL also represents the patient's evaluation of the impact of the disease on their physical function and well-being. HRQoL indicates the patient's perception of general, physical and mental health status, and describes the health aspects of a population. HRQoL also evaluates how individual welfare over time can be affected by illness, disability, or a disorder. One of the main goals of cardiovascular care is optimal HRQoL for patients and families who provide care for patients. Studies found that for patients with chronic diseases, psychosocial factors such as understanding of disease, social support, anxiety and depression are important things to note. More specifically, it was suggested that anxiety is the most common thing that occurs in individuals with heart disease. The prevalence of anxiety disorders is substantially greater in the population of cardiovascular diseases than in the general population. Anxiety has a high prevalence, which is around 70% to 80%, and can survive in the long term from 20% to 25% in individuals who have heart problems. Besides anxiety, HRQoL in heart disease patients also caused by other factors, such as coping. Coping done by people with heart disease can affect their quality of life. Meanwhile, illness perception can also affect HRQoL. For example, individuals who have positive mind about their disease can increase HRQoL. This shows a continuity between illness perception and coping strategies. It can be said that the illness perception possessed by individuals will influence the ability of coping strategies, whereas the ability of coping strategies will influence psychological aspects, one of which is the quality of life of individuals. Based on the explanation above, it is postulated that individuals who suffer from heart disease are susceptible to anxiety, where the high level of anxiety will reduce the level of HRQoL. However, there is a possibility that individuals who have anxiety still manage to have acceptable HRQoL. This is presumably due to other factors, namely the ability of adaptive coping strategies and the illness perception. This study aims to assess factors affecting HRQoL, which are anxiety, illness perception, and coping behavior in cardiovascular patients.

Methods. This study will consist approximately of 100 adult participants, having a heart disease for more than 1 year. The data collection will use Patient Health Questionnaire 4 (PHQ-4) as the measurement for anxiety, and Short Form 12 version 2 (SF12v2) to measure HRQoL. To find other psychosocial factors in heart disease patients, Brief Cope (BC) and Brief Illness Perception will be use as well to measure coping strategies and illness perception, respectively.

Results. It is expected that anxiety will directly affect HRQoL. It is also expected that anxiety will indirectly affect HRQoL through coping strategies, in which coping strategies are influenced by illness perception.

Conclusions. Conclusions can be drawn upon the completion of the study.

Add-on Values. The results are expected to describe factors affecting HRQoL in heart disease patients. The findings are also expected become a basis on heart disease intervention targeting HRQoL.

Keywords: Anxiety, Health-related Quality of Life, Illness Perception, Coping, Cardiovascular Psychology

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