title: 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.
  
  
  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.
authors.affiliation: CoRPS, Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands.
authors.forename: Aline J
authors.initials: AJ
authors.lastname: Pelle
authors.forename: Angélique A
authors.initials: AA
authors.lastname: Schiffer
authors.forename: Otto R
authors.initials: OR
authors.lastname: Smith
authors.forename: Jos W
authors.initials: JW
authors.lastname: Widdershoven
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
mesh_terms: D000368:Aged; D032763:Behavior Control / Q000379:methods / Q000523:psychology*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006333:Heart Failure / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality / Q000145:classification* / Q000502:physiology*; D010555:Personality Inventory; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires