Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




Background: Depressive symptomology is an independent risk factor for cardiovascular disease. Over 15% of persons with cardiovascular disease have depressive symptoms, and women are twice as likely to experience these symptoms as men. Depressive symptoms in women “ at risk ” for cardiovascular disease has not been well studied.

Purpose: This study investigated the relationship between depressive symptoms, health-promoting lifestyle behaviors, heart disease risk awareness, cardiac risk, and quality of life in women at risk for cardiovascular disease. Whether the effect of depressive symptoms on quality of life was mediated by cardiac risk and/or health-promoting lifestyle behaviors was also examined.

Methods: The Wilson–Cleary Health–Related Quality of Life Model and the Health Promotion Model guided this cross–sectional correlational descriptive study. The convenience sample included 125 women recruited from women's cardiac health screening events. Women were able to read, write, and speak English, and did not have pre–existing heart disease, dementia, drug dependency, alcoholism, or diagnosed mental illness other than depression.

Measurement: The Center for Epidemiological Studies Depression Scale, Ferrans – Powers Quality of LIfe Index © Generic Version-III, Health – Promoting Lifestyle Profile II; and questions related to heart disease risk, awareness of heart disease risk, health history and demographics comprised the study measurements Body mass index, percent body fat, and a lipid profile were also measured.

Results: Over one third (33.6%) of the women reported significant depressive symptoms. Depressive symptoms were not associated with cardiac risk or risk awareness but were inversely associated with health–promoting lifestyle behaviors (OR = .92, 95% CI .88, .97, p < .001) and quality of life (OR = .85, 95% CI .79, .92, p < .001) and depressive symptomology. Health–promoting lifestyle behaviors but not cardiac risk mediated the association between depressive symptoms and quality of life.

Conclusions: Depressive symptoms contribute significantly to health–promoting lifestyle behaviors and quality of life for women. Early detection and treatment of depression symptoms would be important for participation in healthy lifestyle behaviors which could result in improved quality of life.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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