Abstract
Background
Psychological risk factors for impaired health outcomes have been acknowledged in
chronic heart failure (CHF), with Type D personality being such a risk factor. Inadequate
consultation behavior, a specific aspect of self-management, might be one mechanism
in explaining the adverse effect of Type D on health outcomes. In this study we examined
the relationship between Type D personality, impaired disease-specific health status,
and inadequate consultation behavior.
Methods and results
CHF outpatients (n=313) completed the Type D Scale (DS14) at baseline, and the European Heart Failure
Self-care Behaviour Scale (EHFScBS) and the Minnesota Living with Heart Failure Questionnaire
(MLWHFQ) at 6-month follow-up. Type D personality independently predicted inadequate
consultation behavior (OR=1.80, 95%CI [1.03–3.16], p=.04) and impaired health status (OR=3.61, 95%CI [1.93–6.74], p<.001) at 6-month follow-up, adjusting for demographic and clinical variables. Inadequate
consultation behavior (OR=1.80, 95%CI [1.11–2.94], p=.02) and NYHA-class (OR=2.83, 95%CI [1.17–4.71], p<.001) were associated with impaired health status, after controlling for demographics,
clinical variables, and Type D personality. Post-hoc multivariable analysis pointed
out that Type D patients who displayed inadequate consultation behavior were at a
6-fold increased risk of reporting impaired health status, compared to the reference
group of non-Type D patients who displayed adequate consultation behavior (OR=6.06, 95%CI [2.53–14.52], p<.001).
Conclusions
These findings provide evidence for inadequate behavior as a mechanism that may explain
the link between Type D personality and impaired health status. Future studies are
warranted to elaborate on these findings.
Keywords
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Article info
Publication history
Published online: January 27, 2009
Accepted:
December 13,
2008
Received:
September 3,
2008
Identification
Copyright
© 2008 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
