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Personality factors and depression as predictors of hospital-based health care utilization following acute myocardial infarction
Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV). Department of Cardiology, Skåne University Hospital and Lund University, Lund and Malmö, Sweden.
Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
Cardiovascular Epidemiology Research Group, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Department of Neurology, Skåne University Hospital, Lund and Malmö, Sweden.
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 4, p. 318-325Article in journal (Refereed) Published
Abstract [en]

Background: Whether personality factors and depressive traits affect patients’ utilization of health care following an acute myocardial infarction is relatively unknown. The aim of this study was to examine whether hospital-based health care utilization after a myocardial infarction was correlated with patients’ personality factors and depressive symptoms. Methods: We studied 366 myocardial infarction patients admitted to Malmö University Hospital between 2002 and 2005 who subsequently participated in a cardiac rehabilitation programme. The patients were followed for two years after their index event. We investigated whether personality factors and depressive traits were correlated with the participants’ health care utilization, defined as a) out-patient Cardiology visits and phone calls to a physician, nurse or a social worker, and b) acute visits or admissions to the Emergency or Cardiology Departments, using negative binominal regression analysis. Results: In unadjusted comparisons neuroticism predicted more out-patient contacts. This significance remained after adjusting for age, sex, smoking, alcohol consumption and size of the myocardial infarction (measured as max level on troponin-I and left ventricular ejection fraction). There were no significant correlations between other personality factors or depression and out-patient contacts. None of the personality factors or depression predicted acute admissions. Conclusion: Apart from neuroticism, personality factors did not explain utilization of health care in terms of Cardiology out-patient contacts or acute admissions in myocardial infarction patients participating in a cardiac rehabilitation programme. Neither did depressive symptoms predict more health care utilization. This might indicate a robust cardiac rehabilitation programme offered to the study subjects, minimizing the need for additional health care contacts.

Place, publisher, year, edition, pages
Sage Publications, 2017. Vol. 16, no 4, p. 318-325
Keywords [en]
Personality factors, depressive traits, myocardial infarction, health care utilization
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mau:diva-4084DOI: 10.1177/1474515116666780ISI: 000396200300007PubMedID: 27566599Scopus ID: 2-s2.0-85015094972Local ID: 22621OAI: oai:DiVA.org:mau-4084DiVA, id: diva2:1400908
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-06-17Bibliographically approved
In thesis
1. Myocardial infarction personality factors, coping strategies, depression and secondary prevention
Open this publication in new window or tab >>Myocardial infarction personality factors, coping strategies, depression and secondary prevention
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A longitudinal study with 400 patients diagnosed with myocardial infarction (MI) was conducted at the Cardiology department at Malmö University hospital in Sweden, between 2002 and 2005. The aim of the project was to identify personality and psychosocial factors, influencing patients’ actions and the prognoses after MI. The five factor model of personality, (measures on Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness), coping strategies, depressive symptoms, the impact on delay seeking emergency care, smoking habits and cardiac health care utilization were studied. This thesis reports the result from four papers. In paper I the aim was to investigate whether maladaptive behaviour in the serial Color Word Test (CWT) alone or in combination with any specific personality dimensions were associated with severity of the MI. The indicators of severity of disease were maximum levels above median of the cardiac biomarkers troponin I and creatine-kinase-MB (CKMB), Q-wave infarctions, and a left ventricular ejection fraction (LVEF). The findings showed that maladaptive behaviour in combination with low scores on extraversion was associated with higher levels in cardiac biomarkers, following an MI. Another crucial factor for the prognoses and survival after a MI is early arrival to the emergency department and rapid intervention. In paper II we analysed the correlation of personality and psychosocial factors, with the time lag between the onset of coronary symptoms and seeking emergency hospital care. There was no significant conjunction in time delay and personality factors, coping strategies and depression. In paper III we examined whether personality traits, coping strategies and symptoms of depression were related to smoking cessation after an MI. Out of the 149 patients who smoked at baseline, 2 years follow-up data was available on 133 individuals, of these 44% (n=59) still smoked and 56% (n=74) had stopped smoking during the 2 years. Those who still smoked had lower score in the personality factor agreeableness, more lived alone and were unemployed in contrast to those who had stopped smoking. They also had significantly higher coping scores as confrontational behaviour. Finally, in paper IV we examined whether personality factors and depressive symptoms predicted cardiac health care utilization over the first two years after the MI event. Those MI patients showing traits of Neuroticism at baseline had significantly higher utilization at the out-patient cardiac clinic than those without. Individuals with a high score of depressive symptoms at baseline had instead a higher utilization of social workers and telephone contacts over the two year follow-up. In conclusion, we found that the personality factors extraversion, agreeableness and neuroticism were factors that had impact on MI severity, smoking cessation and out-patient clinic contacts, while delay in seeking acute care was not affected by personality factors, depression or coping strategies. Maladaptive behaviour and a confronting coping strategy influenced MI severity and smoking cessation 2 years after an MI. Taking personality factors and coping strategies more into consideration when caring for patients in cardiac rehabilitation might be indicated.

Place, publisher, year, edition, pages
Malmö University. Faculty of Health and Society, 2016. p. 83
Series
Malmö University Health and Society Dissertations, ISSN 1653-5383 ; 1
Keywords
Acute myocardial infarction, Personality factors, Coping strategies, depression, smoking cessation, Secondary prevention
National Category
Humanities and the Arts
Identifiers
urn:nbn:se:mau:diva-7309 (URN)20214 (Local ID)9789171046666 (ISBN)9789171046673 (ISBN)20214 (Archive number)20214 (OAI)
Note

Paper IV in dissertation as manuscript with title "Personality factors and depression as predictors of health care consumption during the first two years following a myocardial infarction"

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-16Bibliographically approved

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Östman, Margareta

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