Abstract

BackgroundThis study evaluated the association of type D personality and health-related quality of life (HRQoL) and assessed the stability of type D personality in vascular surgery patients during the year after surgery.MethodIn a prospective cohort study between 2008 and 2014, 294 patients were assessed with validated questionnaires preoperatively and at 1, 6, and 12 months after surgery. Associations between type D personality, depression, and HRQoL were analyzed by generalized estimating equation models. Type D personality was analyzed in its standard dichotomous form as well as continuous (z) scores of its two components, negative affectivity (NA) and social inhibition (SI), and their interaction term.ResultsPrevalence of type D personality varied between 18% and 25%. However, only 9% of the complete responders were classified as type D personality at all four assessments, whereas one third changed between type D classifications. Continuous scores showed greater stability over time. Dichotomized type D personality measured over time was significantly associated with impaired HRQoL, but this was not the case if measured once at baseline, like in general use. The continuous NA score and depression were also significantly associated with impaired HRQoL over time.ConclusionType D personality was not a stable trait over time. Preoperative assessment of type D personality did not predict improvement in HRQoL after vascular surgery. However, the study revealed associations between the NA component of type D personality, depression, and lower HRQoL. This indicates that measures of overall negative affect should be taken into account when assessing HRQoL patient-reported outcomes in vascular surgery patients.

Highlights

  • Surgical outcomes have traditionally focused on treatment success, morbidity, and mortality

  • This study shows that type D personality is exhibited in about 20% of vascular surgery patients across time, both before surgery and during 1-year postoperative follow-up

  • Type D personality is currently used in a dichotomous form, per definition, a person belongs to the type D personality group or to the nontype D personality group

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Summary

Introduction

Surgical outcomes have traditionally focused on treatment success, morbidity, and mortality. HRQoL is a patient-reported outcome which assesses patients’ perceived lifestyle impact of their disease and its treatments [7]. The distressed (type D) personality includes a personality trait characterized by negative affectivity (NA) and social inhibition (SI). Patients with this personality trait are likely to experience increased levels of anxiety and depressed mood across situations and time, while not sharing these emotions with others [8]. This study evaluated the association of type D personality and health-related quality of life (HRQoL) and assessed the stability of type D personality in vascular surgery patients during the year after surgery. Type D personality was analyzed in its standard dichotomous form as well as continuous (z) scores of its two components, negative affectivity (NA) and social inhibition (SI), and their interaction term

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