Berrie Middel1, Noha El Baz, Susanne S Pedersen, Jitse P van Dijk, Klaske Wynia, Sijmen A Reijneveld. 1. Berrie Middel, PhD Research Methodologist and Statistician, Department of Health Sciences, Division of Care and Nursing Science and Division of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, the Netherlands. Noha El Baz, PhD, RN Assistant Professor, Department of Epidemiology, University Medical Center Groningen, University of Groningen, the Netherlands, and Faculty of Nursing, Department of Emergency and Critical Care Nursing, Alexandria University, Egypt. Susanne S. Pedersen, PhD Professor, Department of Medical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, the Netherlands. Jitse P. van Dijk, MD, PhD Associate Professor, Department of Health Sciences, Division of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, the Netherlands. Klaske Wynia, PhD Assistant Professor, Department of Health Sciences, Division of Care and Nursing Science and Division of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, the Netherlands. Sijmen A. Reijneveld, MD, PhD Professor, Department of Health Sciences, Division of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, the Netherlands.
Abstract
BACKGROUND: Although coronary artery bypass graft (CABG) is known to improve health-related quality of life (HRQoL), this improvement does not seem to be realized in all patients who had undergone CABG surgery. OBJECTIVE: The aim of this study was to test the direct and indirect influence of personality trait Type D on no change-deterioration trajectories HRQoL and the mediating influence of increased symptoms of anxiety and depression. METHODS: The hypothesized influence of personality trait Type D on the relationship between increased anxiety and depression and no change-deterioration trajectories in HRQoL was tested with path analysis using structural equation modeling. RESULTS: The results of the current study show that Type D personality comprised a vulnerability factor for poor patient-reported outcomes (ie, HRQoL and distress), and despite significant and clinically relevant benefits also for Type D patients after CABG, their well-being remained poorer than that of non-Type D participants at 6 months. Increased levels of anxiety largely mediated the influence of Type D personality on no change-deterioration trajectories in both physical and mental HRQoL, whereas increased symptoms of depression explained deterioration in physical and mental HRQoL without the influence of Type D personality. CONCLUSION: There is evidence that increased symptoms of psychological distress is a strong predictor of no change-deterioration trajectories in HRQoL and that this relationship is influenced by personality trait Type D. We conclude that mediating factors, especially increased anxiety and depression, should be treated adequately in post-CABG clinical routine.
BACKGROUND: Although coronary artery bypass graft (CABG) is known to improve health-related quality of life (HRQoL), this improvement does not seem to be realized in all patients who had undergone CABG surgery. OBJECTIVE: The aim of this study was to test the direct and indirect influence of personality trait Type D on no change-deterioration trajectories HRQoL and the mediating influence of increased symptoms of anxiety and depression. METHODS: The hypothesized influence of personality trait Type D on the relationship between increased anxiety and depression and no change-deterioration trajectories in HRQoL was tested with path analysis using structural equation modeling. RESULTS: The results of the current study show that Type D personality comprised a vulnerability factor for poor patient-reported outcomes (ie, HRQoL and distress), and despite significant and clinically relevant benefits also for Type D patients after CABG, their well-being remained poorer than that of non-Type D participants at 6 months. Increased levels of anxiety largely mediated the influence of Type D personality on no change-deterioration trajectories in both physical and mental HRQoL, whereas increased symptoms of depression explained deterioration in physical and mental HRQoL without the influence of Type D personality. CONCLUSION: There is evidence that increased symptoms of psychological distress is a strong predictor of no change-deterioration trajectories in HRQoL and that this relationship is influenced by personality trait Type D. We conclude that mediating factors, especially increased anxiety and depression, should be treated adequately in post-CABG clinical routine.
Authors: Margarita Staniute; Julija Brozaitiene; Julius Burkauskas; Nijole Kazukauskiene; Narseta Mickuviene; Robertas Bunevicius Journal: Health Qual Life Outcomes Date: 2015-01-22 Impact factor: 3.186
Authors: Paula M C Mommersteeg; Lindy Arts; Wobbe Zijlstra; Jos W Widdershoven; Wilbert Aarnoudse; Johan Denollet Journal: Circ Cardiovasc Qual Outcomes Date: 2017-02-22
Authors: Anastase Tchicaya; Nathalie Lorentz; Stefaan Demarest; Jean Beissel; Daniel R Wagner Journal: Health Qual Life Outcomes Date: 2015-09-18 Impact factor: 3.186