Type D Personality and Health-Related Quality of Life in Vascular Surgery Patients
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Type D Personality and Health-Related Quality of Life in Vascular Surgery Patients Elke Bouwens 1 & Felix van Lier 1 & Ellen V. Rouwet 2 & Hence J. M. Verhagen 2 & Robert Jan Stolker 1 & Sanne E. Hoeks 1
# The Author(s) 2019
Abstract Background 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. Method In 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. Results Prevalence 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. Conclusion Type 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. Keywords Patient-reported outcomes . Quality of life . Type D personality . Vascular disease
Introduction Surgical outcomes have traditionally focused on treatment success, morbidity, and mortality. In recent years, however, emphasis on health-related quality of life (HRQoL) is gaining momentum. HRQoL is a multidimensional concept that encompasses the physical, emotional, and social components associated with an illness or its treatment as perceived by the patient. Patients with peripheral artery disease or with aortic aneurysm disease, experience a diminished HRQoL due to walking disability, a physically inactive lifestyle, and * Sanne E. Hoeks [email protected] 1
Department of Anesthesiology, Erasmus MC University Medical Center Rotterdam, Erasmus MC, NA-1718, P.O. Box 2040, 3000 CA Rotterdam, Netherlands
2
Department of Vascular Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
emotional stress [1–5]. Consequently, the goal of treatment for vascular patients is not limited to relieving symptoms and prolonging life, but foremost to impro
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