title: The moderation effect of personality on healthcare utilization in Chinese people living with HIV.
abstract: There is evidence that Type D personality can predict impaired quality of life and health status in various chronic conditions. The evidence is conflicting as to whether Type D is associated with increased healthcare services, and no study has reported on the healthcare utilization of people living with HIV (PLWH) who have a Type D personality. This study investigated the impact of Type D personality on healthcare utilization in a sample of Chinese PLWH and examined physical and emotional symptoms as possible mechanisms of healthcare utilization. This was a cross-sectional study of 199 PLWH in rural China. Participants completed a survey on physical symptoms, emotional symptoms, healthcare utilization, and Type D personality. Those PLWH with a Type D personality reported more physical and emotional symptoms and healthcare utilization than patients without this personality. Among PLWH who had a Type D personality, physical symptoms had a direct effect on healthcare utilization, and emotional symptoms did not significantly mediate this association. However, among PLWH without a Type D personality, emotional symptoms significantly mediated the effects of physical symptoms on healthcare utilization. PLWH with a Type D personality reported more healthcare utilization, which was attributed to their high physical symptoms rather than their emotional symptoms. These findings suggest that PLWH with a Type D personality might be bothered by intensified emotional symptoms, which might be too severe to be associated with physical symptoms and healthcare utilization. New prospective studies should focus on the pattern of healthcare utilization among patients with a Type D personality and their intensified physical and emotional symptoms.
authors: a Department of Applied Social Sciences , City University of Hong Kong , Hong Kong , People's Republic of China.|b School of Public Health, University of Hong Kong , Hong Kong , People's Republic of China.
authors: Nancy Xiaonan
authors: NX
authors: Yu
authors: c Center of Research on Psychology in Somatic Diseases (CoRPS) , Tilburg University , Tilburg , The Netherlands.
authors: Floortje
authors: F
authors: Mols
authors: d Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors: Sunita M
authors: SM
authors: Stewart
authors: e Institute of Psychology, Chinese Academy of Sciences , Beijing , People's Republic of China.
authors: Jianxin
authors: J
authors: Zhang
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology*; D001782:Blood Donors / Q000706:statistics & numerical data; D002681:China; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology* / Q000635:transmission; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D013223:Statistics as Topic; D064415:Type D Personality
keywords: HIV; Type D personality; emotional symptoms; healthcare utilization; physical symptoms