Background: Self-management and adequate consultation behaviour are essential for the successful treatment of chronic heart failure (CHF). Patients with a type-D personality, characterised by high social inhibition and negative affectivity, may delay medical consultation despite increased symptom levels and may be at an increased risk for adverse clinical outcomes.
Aim: To examine whether type-D personality predicts poor self-management and failure to consult for evident cardiac symptoms in patients with CHF.
Design/methods/patients: 178 outpatients with CHF (aged ⩽80 years) completed the type-D Personality Scale at baseline, and the Health Complaints Scale (symptoms) and European Heart Failure Self-care Behaviour Scale (self-management) at 2 months of follow-up. Medical information was obtained from the patients’ medical records.
Results: At follow-up, patients with a type-D personality experienced more cardiac symptoms (OR 6.4; 95% CI 2.5 to 16.3, p<0.001) and more often appraised these symptoms as worrisome (OR 2.9; 95% CI 1.3 to 6.6, p<0.01) compared with patients with a non-type-D personality. Paradoxically, patients with a type-D personality were less likely to report these symptoms to their cardiologist/nurse, as indicated by an increased risk for inadequate consultation behaviour (OR 2.7; 95% CI 1.2 to 6.0, p<0.05), adjusting for demographics, CHF severity/aetiology, time since diagnosis and medication. Accordingly, of 61 patients with CHF who failed to consult for evident cardiac symptoms, 43% had a type-D personality (n = 26). Of the remaining 108 patients with CHF, only 14% (n = 16) had a type-D personality.
Conclusion: Patients with CHF with a type-D personality display inadequate self-management. Failure to consult for increased symptom levels may partially explain the adverse effect of type-D personality on cardiac prognosis.
- CHF, chronic heart failure
- DS14, Type-D Personality Scale
- EHFScBS, European Heart Failure Self-care Behaviour Scale
- HCS, Health Complaints Scale
- KMO, Kaiser–Meyer–Olkin
- LVEF, left ventricular ejection fraction
- NYHA, New York Heart Association
- PCA, principal component analysis
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Published Online First 7 March 2007
Funding: This study was supported by grants from Medtronic, St Jude Medical and the Netherlands Heart Foundation (#2003B038).
Competing interests: None declared.