1. Clinical and psychological characteristics predict future healthcare use in adults with congenital heart disease
- Author
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Mirjam A. G. Sprangers, Mariet S. Hulsbergen-Zwarts, Leo G. H. Brunninkhuis, Thijs H. W. M. Plokker, Dounya Schoormans, Joost P. van Melle, Barbara J.M. Mulder, Arie P. J. van Dijk, Petronella G. Pieper, Gertjan T. Sieswerda, Hubert W. Vliegen, Medical Psychology, CCA -Cancer Center Amsterdam, APH - Amsterdam Public Health, ACS - Amsterdam Cardiovascular Sciences, Cardiology, Medical and Clinical Psychology, and Cardiovascular Centre (CVC)
- Subjects
Male ,Gerontology ,HELP-SEEKING ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,Disease ,030204 cardiovascular system & hematology ,0302 clinical medicine ,QUALITY-OF-LIFE ,Surveys and Questionnaires ,Health care ,YOUNG-ADULTS ,ANXIETY ,Longitudinal Studies ,030212 general & internal medicine ,media_common ,Aged, 80 and over ,Middle Aged ,Medical–Surgical Nursing ,Anxiety ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Attitude to Health ,Adult ,Heart Defects, Congenital ,medicine.medical_specialty ,type D personality ,Adolescent ,Patients ,Referral ,media_common.quotation_subject ,D PERSONALITY ,Young Adult ,03 medical and health sciences ,Optimism ,Quality of life (healthcare) ,Predictive Value of Tests ,HOSPITAL UTILIZATION ,medicine ,Humans ,Personality ,CARDIAC-DISEASE ,Psychiatry ,Aged ,Congenital heart disease ,Advanced and Specialized Nursing ,illness perceptions ,business.industry ,Type D personality ,healthcare use ,Patient Acceptance of Health Care ,DEPRESSION SCALE ,quality of life ,business ,PATIENT SELF-MANAGEMENT - Abstract
Background: To deliver adequate care to patients with congenital heart disease (CHD), it is important to know which patients use what type of care. This knowledge is valuable, as modification of these factors may be used as means to regulate healthcare use. Our objective was to examine the predictive value of psychological characteristics for future healthcare use, independent of clinical characteristics.Methods: In total 845 adult CHD-patients participated in a longitudinal questionnaire study, with a two-year follow-up period. Linear regression analyses with negative binomial log link function were performed predicting healthcare used during the previous year. Psychological predictors were Type D personality, quality of life (QoL), depressive symptoms, trait-anxiety, happiness, optimism, and illness perceptions, independent of the number of co-morbidities, disease complexity and functional status. To control for clustering we included the variable type of centre (regional versus tertiary referral).Results: Patients who reported more healthcare use had a complex defect, a poor functional status, no Type D personality, and a poor QoL. They moreover felt their CHD had a severe impact on their life and believed their CHD could be managed by themselves or treatment.Conclusions: Healthcare use is not entirely determined by disease complexity and functional status but also by psychological patient characteristics. It can by hypothesised that reducing the negative impact experienced and informing patients about strategies to manage their CHD, will modify their future healthcare use. Additional research is necessary to examine this possibility.
- Published
- 2016