Symptoms such as chest pain and breathlessness and lifelong treatment regimes are contributing
factors to poor HRQoL (Celano et al., 2012). Furthermore, outpatients
with CHD report higher stress levels due to uncertainty in disease
progression, and are at higher risk of experiencing anxiety and
depression, which translates to poorer HRQoL Patients with poor HRQoL, in turn report worsening disease
progression and poorer health outcomes (Škodová et al., 2011).