Tuesday, June 26, 2007

CHF patients with type-D personality

CHF patients with type-D personality fail to consult for cardiac symptoms

25 June 2007

Patients with chronic heart failure (CHF) and a type-D personality fail to seek medical assistance for increased cardiac symptoms, which may explain the poor prognosis in this group of patients, researchers report.

The authors suggest that patients with CHF and type-D personality may be in need of “more intensive interventions, such as more education, to improve self-management abilities.”

Self-management and adequate consultation behavior are essential for the successful treatment of CHF. But patients with a type-D personality, characterized by high social inhibition and negative affectivity, may delay medical consultation, the team says.

Angélique Schiffer (Tilburg University, The Netherlands) and colleagues enrolled 178 outpatients with CHF, aged 80 years or less, to investigate whether type-D personality predicts poor self-management.

All the participants completed the type-D Personality Scale at baseline, and the Health Complaints Scale and the European Heart Failure Self-care Behavior Scale at 2 months of follow-up.

At follow-up, patients with a type-D personality experienced more cardiac symptoms (odds ratio [OR]=6.4, p<0.001) color="#990000">evaluated their symptoms as worrisome (OR=2.9, p<0.01), compared with patients with other types of personality.

Patients with a type-D personality also had more cardiopulmonary symptoms (p=0.002), fatigue (p<0.001), sleep problems (p<0.001), and worries about health (p=0.001) than patients without a type-D personality.

Nevertheless, patients with type-D personality were less likely to seek medical help than patients without type-D personality, the team notes.

Of the 61 patients who failed to consult for evident cardiac symptoms, 43% had a type-D personality. Of the remaining 108 patients, only 14% had a type-D personality.
After adjusting for demographics, CHF severity/etiology, time since diagnosis, and medication, type-D personality was an independent predictor for reduced consultation (OR=2.7, p<0.05).

Schiffer and co-workers conclude in the journal Heart: “Patients with CHF with a type-D personality display inadequate self-management.”

Link: Heart 2007; 93: 814-818

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