A cross-cultural comparison of the roles of emotional intelligence, metacognition, and negative coping for health-related quality of life in German versus Pakistani patients with chronic heart failure.

Abstract

Low emotional intelligence (EI) may predispose individuals to applying maladaptive coping strategies. This may maintain anxious worrying, which is highly prevalent in patients with chronic heart failure (CHF) and may affect mental (MCS) and physical component summaries (PCS) of health-related quality of life (HRQoL). The current study is a cross-sectional and cross-cultural survey. N=200 outpatients with CHF were recruited at cardiology institutes in Germany and Pakistan and assessed with self-report questionnaires. Path analysis (χ2 (4)=7.59, p=.11, GFI=.99) revealed that the expected associations between low EI and lower SF-36 MCS and PCS of HRQoL were fully mediated by negative metacognition and maladaptive coping in the Pakistani sample (p's≤.05). The German sample applied different maladaptive coping strategies, which also led to lower MCS and PCS scores, but did not mediate a direct positive effect of EI on HRQoL. The current findings support culture-independent validity of the metacognitive model but also reveal major cultural differences regarding the application and effect of specific maladaptive coping strategies. This has important implications for caregivers in a cross-cultural context and highlights the need for culture-specific tailoring of psychosocial interventions. Statement of contribution What is already known on this subject? Worry, an integral component of generalized anxiety disorder (GAD) and highly comorbid in chronic heart failure (CHF) patients, contributes to anxiety and resulting stress as evident from metacognitive model of GAD. In addition, previous literature has also established the protective role of emotional intelligence (EI) against stress, thus maintaining quality of life. What does this study add? Cross-cultural (Pakistan vs. Germany) validation of the metacognitive model of GAD. Supportive evidence for the metacognitive model in patients with CHF. Mediation of maladaptive metacognitions and negative coping in the relationship of low trait EI and low health-related quality of life.