Inadequate consultation behavior modulates the relationship between Type D personality and impaired health status in chronic heart failure

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.