Indian Journal of Health and Wellbeing © 2015 Indian Association of Health,

2015, 6(8), 795-799 Research and Welfare

http://www.iahrw.com/index.php/home/journal_detail/19#list ISSN-p-2229-5356,e-2321-3698

A psychological study on helplessness and general wellbeing

among adult patients of different chronic illnesses
Jessicinta P. Coelho and Kamayani Mathur
Department of Psychology, Gujarat University, Ahmedabad, Gujarat

Chronic illness is any disorder that persists over a long period and affects the physical, emotional, intellectual,
vocational, social and spiritual functioning. (Medical dictionary, 2009). The objective of the present study was to
measure the helplessness and general wellbeing in adult patients of Arthritis, Essential Hypertension and Obesity.
The total consisted of 120 subjects aged 18 years and above selected from the various hospitals of Ahmedabad city
using the purposive sampling technique and were equally divided into 3 groups of chronic illnesses. The
Helplessness scale (Mathur & Bhatnagar, 2012) and the P.G.I General Wellbeing Scale (Verma & Verma, 1989)
were administered to the subjects. The student's t-test was used to statistically analyze the data. The results indicated
that the female patients of arthritis and obesity showed more helplessness as compared to the male patients. Whereas
the male patients of essential hypertension showed more helplessness as compared to the female patients of
essential hypertension. The patients of obesity showed more helplessness as compared to the patients of arthritis and
essential hypertension. The male patients of all the three chronic illness groups showed a better wellbeing level as
compared to the female patients of all the three groups. The results on the general wellbeing measure indicated that
there was no difference among the three groups of chronic illnesses.

Keywords: helplessness, general wellbeing, arthritis, essential hypertension, obesity

A chronic condition is a human health condition or disease that is
persistent or otherwise long-lasting in its effects or a disease that
comes with time. The term chronic is usually applied when the
course of the disease lasts for more than three months. Common
chronic diseases include arthritis, asthma, cancer, Chronic
Obstructive Pulmonary Disease (COPD), diabetes and viral diseases
such as Hepatitis C and HIV/AIDS.
A chronic disease is one lasting 3 months or more, by the definition
of the U.S. National Center for Health Statistics. Chronic diseases
generally cannot be prevented by vaccines or cured by medication,
nor do they just disappear. Eighty-eight percent of Americans over 65
years of age have at least one chronic health condition (as of 1998)
(Medicinenet, 2015).There are many types of chronic illnesses out of
which Arthritis, Essential Hypertension and Obesity have been
selected for my study. Arthritis is the inflammation of a joint usually
accompanied by pain, swelling and stiffness resulting from infection,
trauma, degenerative changes, metabolic disturbances or other
causes. (Medical dictionary, 2007). The prevalence of arthritis in
India is 15 % (2011) Study conducted on patients of arthritis by
Nagyova, Stewart et al. (2005): The aim of this study was to
determine whether self -esteem and adjustment to disease can
mediate the association between pain and psychological wellbeing in
patients with Arthritis. The findings provide evidence for
consideration that psychosocial interventions, focused on increasing
the self esteem and improving the adjustment to disease, may reduce
the impact of pain on patients' psychological well-being and quality
of life in general. Recent research now casts doubt on the accuracy
and value of a “rheumatoid arthritis personality”, at least as a cause of
arthritis (Smith et al., 1995). However, cognitive distortions and
feelings of helplessness can aggravate depression and other
Correspondence should be sent to Jessicinta P. Coelho
Department of Psychology, Gujarat University, Ahmedabad, Gujarat
E-mail: jessicintac@gmail.com
emotional responses to arthritis (Clemmey & Nicassio et al., 1997),
gaps in social support may also be a consequence (Fyrand et al.,
2002).
Essential hypertension is high blood pressure. Blood pressure is
the force of the blood pushing against the walls of the arteries as it
flows through them. Arteries are the blood vessels that carry
oxygenated blood from the heart to the body's tissues. (Medical
dictionary, 2009). The prevalence of essential hypertension is 23 %
in men and 22.6 % in women (2012). In one study it was noted that
people without pre-existing signs of hypertension show large and
reliable blood pressure responses to stressors, primarily when they
must make an active behavioral response to that stress (Sherwood et
al., 1995)people with borderline hypertension show a similar
pattern, although they also show exaggerated stress-induced
cardiovascular responses to stress at a relatively young age
(Matthews et al.,1993)and a stronger blood pressure response to
laboratory stressors than do people with normal blood pressure
(Tuomisto, 1997).
Obesity is an abnormal accumulation of body fat, usually 20% or
more over an individual's ideal body weight. Obesity is associated
with increased risk of illness, disability and death. (Medical
dictionary, 2008). The prevalence of obesity is 11% (2008). A Study
conducted on morbid obese patients by Rebecca Marzocchi, et al
conclude that results on Orwell-97 was, much higher in females, and
similarly the generic OGWB was indicative of poorer HRQOL in
females. PGWB was positively associated with age without any
effect of BMI. The association with age was maintained in females,
not in males. Both Orwell-97 and PGWB were associated with both
BES and BDI in both genders.
Learned helplessness is a psychological condition which can
cause a person to feel completely powerless to change his/her
circumstance for the better. It is defined as the failure to engage in
behaviors that will allow an organism to escape from or avoid an
aversive stimulus (Seligman, 1975).
 COELHO AND MATHUR/ A PSYCHOLOGICAL STUDY ON HELPLESSNESS 796

Subjective wellbeing (SWB) is the general evaluation of one's Instruments

quality of life (Deiner, 2009). The World Health Organization
defines Quality of life as “an individual's perception of their position
in life in the context of the culture and value system in which they live
and in relation to their goals, expectations, standards and concerns. It
is a broad ranging concept affected in a complex way by the person's
physical health, psychological state, personal beliefs, social
relationships and their relationship to salient features of their
environment” (Oort, 2005). Roger Graham et al. (2008) described in
their study the effect of exercise on psychological well-being among
individuals with chronic illnesses and disabilities such as stroke,
cancer, diabetes and arthritis. The results indicated that exercise
offers a powerful means to actively manage mood problems
associated with disability , to preserve and cultivate personal identity
in a positive manner and to connect with others and one's own body in
ways which limit the development of illness related psychological
distress.
Objective of the study
The objective of the present study was to measure the helplessness
and general wellbeing in adult patients of chronic illnesses i.e.
Arthritis, Essential Hypertension and Obesity.
Method
Participants
The total sample of 135 patients aged 18 years and above both from
rural and urban populations were approached out of which 15 were
discarded and finally 120 gave consent to be a part of the study. The
subjects were selected by purposive sampling method from various
hospitals of Ahmedabad city and equally divided into 3 groups
namely Arthritis, Essential Hypertension and Obesity.
The Helplessness Scale: developed by Mathur and Bhatnagar
(2012). Reliability co-efficient of the scale was assessed on a sample
of 600 of different areas by Test Retest method. In male reliability
ranges .77 to.88 and in female .75 to .80 and is significant at .01 level
of significance. Concurrent validity co-efficient was measured by
comparing experts' observation score. Validity ranges in male.76 to
.79 and in female .78 to .81. A high score indicated high helplessness
and vice versa.
P.G.I General Wellbeing Scale developed by Verma and Verma
(1989). The P.G.I General Wellbeing measure is a modified form of
general wellbeing schedule developed by Dupuy in 1970.
Reliability was measured by Kuder- Richardson formula 20 (KR-
20) was found to be .98 and test-retest reliability was .91.the validity
of the test was determined by correlating this test with other test.
Correlation with other test varies low to high. A high score indicated
better wellbeing and vice versa.
Procedure
The superintendents of the various hospitals of Ahmedabad city
were approached and the objectives of the study were explained to
them. After seeking their permission the patients were approached.
Rapport was established and confidentiality was ensured to them.
Tools were administered with appropriate instructions on separate
days. Scoring was done as per the respective manuals.
Statistical analysis
The data of the present research study was analyzed using the student's't'
test. The mean and the standard deviation for the Helplessness scale and
the PGI General Wellbeing scale were analyzed.
Results

Table1: Showing the mean and standard deviation of the Helplessness Scale and the
P.G.I. General Wellbeing Measure for the male and female patients of Arthritis,
Essential hypertension and Obesity.
Type of Patient Males Females T
M SD M SD
Arthritis 54.15 9.86 65.55 14.46 2.91**
Helplessness Essential Hypertension 61.45 8.35 55.50 8.65 2.21*
Obesity 59.50 8.92 67.30 7.88 2.92**
P.G.I. General Arthritis 14.65 3.03 10.60 5.13 3.03**
Wellbeing Essential Hypertension 14.35 3.59 9.40 4.54 3.82**
Obesity 13.85 3.82 10.95 4.66 2.15*
*p .05, **p .01 NS (Not significant)

Table 1 shows the mean and standard deviation for the helplessness
scale of the patients of arthritis, essential hypertension and obesity in
relation to gender. The t-value is 2.91, 2.21 and 2.92 respectively
which is significant at 0.01,0.05 and 0.01 level of significance. It
means that there is a significant difference in the level of helplessness
between the male and female patients of all the three illness groups.
The table depicts the mean and standard deviation for the P.G.I.
general wellbeing measure for the patients of arthritis, essential
hypertension and obesity in relation to gender. The t-value is 3.03,
3.82 and 2.15 respectively which is significant at0.01, 0.01 and 0.05
level of significance. It means that there is a significant difference in
the level of general wellbeing between the male and female patients
of all the three illness groups.
797 Indian Journal of Health and Wellbeing 2015, 6(8), 795-799

Table 2: showing the mean and standard deviation of the Helplessness Scale and the
P.G.I. General Wellbeing Measure for the male and female patients of Arthritis and
Essential Hypertension.
Gender Type of Patient t
Arthritis Essential Hypertension
M SD M SD
Helplessness Males 54.15 9.86 61.45 8.35 2.52*
Females 65.55 14.46 55.5 8.65 2.66**
P.G.I. General Males 14.65 3.03 14.35 3.59 0.28
Wellbeing Females 10.6 5.13 9.4 4.54 0.78 NS
*p .05, **p .01 NS (Not significant)

Table 2 shows the mean and standard deviation for the helplessness
scale of the patients of arthritis and essential hypertension in relation
to gender. The t-value is 2.52 and 2.66 respectively which is
significant at 0.05and 0.01 level of significance. It means that there is
a significant difference in the level of helplessness between the male
and female patients of arthritis and essential hypertension. The table
depicts the mean and standard deviation for the P.G.I. general
wellbeing measure for the patients of arthritis and essential
hypertension in relation to gender. The t-value is 0.28 and 0.78
respectively which is not significant. It means that there is no
significant difference in the level of general wellbeing between the
patients of arthritis and essential hypertension in relation to gender.

Table 3: showing the mean and standard deviation of the Helplessness Scale and the
P.G.I. General Wellbeing Measure for the male and female patients of Essential
Hypertension and Obesity.
Gender Type of Patient t
Essential Hypertension Obesity
M SD M SD

Helplessness Males 61.45 8.35 59.5 8.92 0.71NS

Females 55.5 8.65 67.3 7.88 4.50**
P.G.I. General Males 14.35 3.59 13.85 3.82 0.42NS
Wellbeing Females 9.40 4.54 10.95 4.66 1.06NS
*p .05, **p .01 NS (Not significant)

Table 3 shows the mean and standard deviation for the helplessness
scale of the patients of essential hypertension and obesity in relation
to gender. The t-value is .071 which is not significant and 4.50 which
is significant at 0.01 level of significance. It means that there is a
significant difference in the level of helplessness between the female
patients of essential hypertension and obesity but no difference is
seen for the male patients. The table depicts the mean and standard
deviation for the P.G.I. general wellbeing measure for the patients of
essential hypertension and obesity in relation to gender. The t-value
is 0.42 and 1.06 respectively which is not significant. It means that
there is no significant difference in the level of general wellbeing
between the patients of essential hypertension and obesity in relation
to gender.

Table 4: showing the mean and standard deviation of the Helplessness Scale and the
P.G.I. General Wellbeing Measure for the patients of Essential Hypertension and Obesity.
Gender Type of Patient t
Essential Hypertension Obesity
M SD M SD
Helplessness N (40) 58.47 9.01 63.4 9.28 2.40*
P.G.I. General N (40) 11.87 4.78 12.4 4.50 0.50NS
Wellbeing
*p .05, **p .01 NS (Not significant)
 COELHO AND MATHUR/ A PSYCHOLOGICAL STUDY ON HELPLESSNESS
Table 4 shows the mean and standard deviation for the helplessness
scale of the patients of essential hypertension and obesity. The t-
value is 2.40 which is significant at 0.05 level of significance and for
the general wellbeing measure it is 0.50 which is not significant. It
means that there is a significant difference in the level of helplessness
between the patients of essential hypertension and obesity but no
difference is seen in the level of general wellbeing between the
patients of essential hypertension and obesity in relation to gender.
Discussion
In the overall scores on the helplessness scale among the patients of
arthritis and patients of obesity, the patients of obesity are more
helpless as compared to the patients of arthritis. Obesity has a lot of
influence on the self esteem and self concept of the person. Not being
able to lose weight and not being easily accepted by family members
and relatives creates a feeling of worthlessness and depression. They
turn to food when they can't deal with the stresses of life. This might
increase their weight and in turn lead to vicious cycle. They begin to
believe that nothing can be done by them to lose their weight which
increases their feeling of helplessness.
In the overall scores on the helplessness scale among the patients
of essential hypertension and patients of obesity, the patients of
obesity are more helpless as compared to the patients of essential
hypertension. There are a lot of complications and restrictions that
accompany obesity. The patients of obesity have a problem in
carrying out physical activities like walking, standing for long hours
etc due to their excessive body weight. They might have other
chronic diseases like arthritis, cardiac problems, sleep apnea etc
which might increase their sense of being physically impaired and a
sense of dependency. Whereas the patients of essential hypertension
have no other chronic disease that accompany essential hypertension
and can lead a normal life. They can adhere to their dietary
restrictions unlike the patients of obesity who find it difficult to
control their intake of food. Thus they might be more helpless.
From the overall scores on the P. G.I. general wellbeing measure it
can be seen that the patients of arthritis have a better level of
wellbeing as compared to patients of essential hypertension because
the patients of arthritis keep a check on their diet and also engage in
physiotherapy and exercise which helps them to cope with the
disease and thereby increase their sense of wellbeing.
Not much of a difference is found among patients of arthritis and
obesity on their wellbeing scores because both these chronic diseases
are interlinked and one might cause the other. With the diagnosis of
arthritis performing any physical activity might be difficult for the
person which leads to restricted physical mobility which might lead
to weight gain or obesity. Obese patients find it difficult to walk or
exercise due to their excessive body weight which might lead to joint
pain causing the symptoms of arthritis. Thus there is not much of a
difference seen in the level of wellbeing within the two groups.
Conclusion
● Male arthritic patients differ significantly on helplessness as
compared to female arthritic patients.
● Male essential hypertensive patients differ significantly on
helplessness as compared to female hypertensive patients.
● Male obese patients differ significantly on helplessness as
compared to female obese patients.
● Male arthritic patients differ significantly on helplessness as
798
compared to male essential hypertensive patients.
● The female arthritic patients differ significantly on helplessness
as compared to female essential hypertensive patients.
● The female arthritic patients differ significantly on helplessness
as compared to female obese patients
● The patients of the essential hypertensive group differ
significantly from the obese group with regards to their
helplessness scores.
● Male arthritic patients differ significantly on the PGI general
wellbeing measure as compared to female arthritic patients.
● Male essential hypertensive patients differ significantly on PGI
general wellbeing measure as compared to female hypertensive
patients.
● Male obese patients differ significantly on PGI general wellbeing
measure as compared to female obese patients.
Limitations of the study
● The present study was carried out on a small sample hence
generalizations cannot be done on the population as a whole.
● The patients were selected from various hospitals of Ahmedabad
city only.
● The age of onset of the disease was not taken into consideration.
● Some of the patients suffered from all the 3 diseases.
The type of treatment the patient was receiving was not taken into
consideration.
Practical implications of the study
● The findings of the present study can be useful to researchers
working on similar topics.
● The results can be used to understand the psychology of the
patients and help them give counseling.
● This research can be used by doctors when providing therapy or
medication to the patient.
● The findings of the present study can be useful to the family
members of the patients to help them understand the patient
better.
● The findings of the present study can be useful to the patients
themselves to help them cope better with the disease.
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