Influence of Type D Personality on Health Promoting Behaviours and Quality of Life in Stroke Patients: A Cross-Sectional Study in South Korea

Cardiovascular diseases and type D personality in patients with obstructive sleep apnea: a prospective cohort study

PURPOSE

To determine the influence of type D personality on the prevalence of cardiovascular diseases (CVD), anxiety, depression, sleep quality and insomnia in OSA patients.

METHODS

Patients planned for a polysomnography filled out the DS-14 questionnaire, Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI). History of cardiovascular diseases and current medication intake were assessed.

RESULTS

In a cohort of 948, OSA patients with type D personality did not have CVD more often (40%) compared to OSA patients without type D personality (42%) (P = 0.625). Out of 395 patients with OSA and CVD, 70% were treated for isolated arterial hypertension (AHT) and 30% for cerebrovascular and/or cardiac pathologies. Cerebrovascular and/or cardiac pathologies were significantly more prevalent in OSA patients with type D personality vs. without (39% vs. 26%; P = 0.001). In OSA patients with CVD and type D personality, medication intake was significantly higher (> 2 cardiovascular medications (P = 0.009), anxiolytics (P = 0.001), antidepressants (P = 0.011), sleep medication (P = 0.002)) as well as scores of HADS for anxiety (P < 0.0001) and depression (P < 0.0001), ISI (P = < 0.0001) and PSQI (P < 0.0001).

CONCLUSION

The prevalence of CVD in OSA patients was not related to the presence of type D personality. Apart from arterial hypertension, cerebrovascular and/or cardiac pathologies were more frequently observed in OSA patients with type D personality. In OSA patients with CVD, the presence of type D personality was associated with more depression, anxiety, insomnia, poor sleep quality and more medication intake.

Type D personality as a risk factor for 3-year cardiovascular events in patients with coronary artery disease and their spouse: a prospective cohort study

AIMS

Type D personality has been established as an independent psychological risk factor for adverse outcomes in coronary artery disease (CAD) patients. However, research on the association between Type D personality and cardiovascular events in couples is limited. This study investigated the correlation between Type D personality and cardiovascular outcomes among CAD patients and their spouses.

METHODS AND RESULTS

This prospective cohort study included 4035 CAD patients for first coronary intervention therapy and their spouses, recruited from January 2017 to July 2020. Type D personality, anxiety, depression, and baseline clinical data were assessed for both partners. The major adverse cardiac event (MACE) rate of both CAD patients and their spouses was analysed after a 3-year follow-up period. A total of 871 CAD patients and 234 spouses developed MACE during the follow-up period. The Cox proportional hazards regression analysis revealed that the Type D(+) patient/Type D(+) spouse group exhibited the highest risk of 3-year MACE in both patients [hazard ratio (HR), 3.834; 95% confidence interval (CI), 2.947-4.987; P < 0.001) and spouses (HR, 2.670; 95% CI, 1.603-4.448; P < 0.001). When analysing Type D as continuous variables, a synergistic interaction between patient and spouse negative affectivity (NA_patient × NA_spouse) was significantly associated with MACE in both CAD patients (HR, 1.746; 95% CI, 1.517-2.010; P < 0.001) and their spouses (HR, 1.992; 95% CI, 1.843-2.152; P < 0.001).

CONCLUSION

This study suggests that having Type D personality, either in the CAD patient or their spouse, is associated with an increased risk of adverse cardiovascular outcomes in both individuals. Accordingly, the assessment of Type D personality in both partners and the development of tailored, couple-centred interventions are warranted.

Relationship Between Illness Adaptation and Type D Personality in Hemodialysis Patients

INTRODUCTION

Although the impact of Type D personality on individuals with various chronic health conditions has been widely studied, its role in hemodialysis patients remains unclear. This study aimed to explore the relationship between illness adaptation and Type D personality in hemodialysis patients and to examine the sociodemographic and clinical characteristics that influence illness adaptation.

METHODS

This cross-sectional study was conducted in hemodialysis units in western Turkey from November 2021 to November 2022. Data were collected using a Personal Information Form, the Adaptation to Chronic Illness Scale, and the Type D Personality Scale. Descriptive statistics, t-tests, ANOVA, Pearson's correlation, and multivariate linear regression analysis were applied to analyze the data.

RESULTS

A total of 138 hemodialysis patients participated in the study. The mean score for adaptation to chronic illness was 80.6 ± 13.6. Among these patients, 38.4% had Type D personality. A negative correlation was found between illness adaptation and Type D personality (r = -0.683, p < 0.001). Regression analysis revealed that Type D personality (β = -0.255), gender (β = -0.087), age (β = 0.137), education level (β = 0.152), economic status (β = 0.177), and hemodialysis duration (β = 0.307) were significant predictors of illness adaptation.

CONCLUSION

Healthcare providers should offer individualized psychosocial care and counseling services to enhance illness adaptation in hemodialysis patients. In particular, strategies to improve adaptation should be tailored for patients with Type D personality traits.

Pathogenetic Mechanisms Underlying Major Adverse Cardiac Events in Personality Type D Patients after Percutaneous Coronary Intervention: The Roles of Cognitive Appraisal and Coping Strategies

BACKGROUND

This paper aimed to study the association of type D personality, coping strategies, and cognitive appraisal with annual prognosis after a percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD).

METHODS

The prospective study included 111 CAD patients who underwent a PCI. All participants, before the PCI, completed questionnaires designed to collect information about type D personality, cognitive appraisal, and coping styles. Information was also collected on the clinical and demographic characteristics of the patients. After 1 year of follow-up, the presence of major adverse cardiac events (MACEs) was assessed.

RESULTS

The presence of a MACE was noted in 38 patients, and the absence of a MACE was noted in 53 patients. In patients with type D personality, higher incidences of MACEs (54.1% versus 33.3%; p = 0.0489) and hospitalization rates (29.7% versus 7.4%; p = 0.004) were revealed. Patients with poor prognoses preferred a moderate use of the confrontation strategy than patients without a MACE (78.4% vs. 50.9%; p = 0.0082). Patients with MACEs had statistically significantly lower indicators of strong emotions (11.92 ± 5.32 versus 14.62 ± 4.83 points; p = 0.005) and future prospects (11.36 ± 3.81 versus 13.21 ± 3.41 points; p = 0.015) than patients without a MACE. In a multiple binary logistic regression model, the following factors had significant associations with MACE development: type D, moderate use of confrontation coping, moderate use of self-control coping, and strong emotions in cognitive appraisal.

CONCLUSION

This study showed that not only personality type D, but also certain coping strategies and cognitive appraisals increase the likelihood of developing a MACE after a PCI. This provides a theoretical basis for understanding the mechanism underlying type D personality and MACEs in patients after a PCI.

Socioeconomic status and health-related quality of life after stroke: a systematic review and meta-analysis

BACKGROUND

Socioeconomic status (SES) is associated with stroke occurrence and survival following stroke but its association with health-related quality of life (HRQoL) following stroke remains uncertain. We performed a systematic review and meta-analysis to examine the association between SES and HRQoL after stroke.

METHODS

PubMed, SCOPUS, EMBASE, and Web of Science were searched to identify relevant cohort and case-control studies between January 2000 and May 2022. Two authors screened titles, abstracts and full text articles. One author extracted data from all included studies. Meta-analyses were performed for studies with comparable measurements of SES and HRQoL. Random effects models were used to estimate pooled summary standardised mean differences in HRQoL by SES.

RESULTS

Out of 1,876 citations, 39 studies incorporated measurement of overall HRQoL following stroke and were included in the systematic review, with 17 studies included in the meta-analyses. Overall, reports including education, income, occupation and work status effects on HRQoL after stroke were inconsistent among all included 39 studies. In the global meta-analysis of 17 studies, HRQoL among survivors of stroke was lower in the low SES group than in the high SES group (standardised mean difference (SMD) -0.36, 95% CI -0.52, -0.20, p < 0.0001). When using education and income indicators separately, summary effects were similar to those of the global analysis (low versus high education SMD -0.38, 95% CI -0.57, -0.18, p < 0.0001; low versus high income SMD -0.39, 95% CI -0.59, -0.19, p < 0.0001).

CONCLUSIONS

Across all SES indicators, people with stroke who have lower SES have poorer overall HRQoL than those with higher SES. Accessibility and affordability of poststroke support services should be taken into consideration when planning and delivering services to people with low SES.

Prognostic value of Type D personality for post-stroke depression in ischemic stroke patients

BACKGROUND

Depression in patients with stroke has been a risk factor for adverse outcomes. Type D personality as a significant predictor of negative psychological status. However, the relationship with post-stroke depression (PSD) is still unclear.

METHODS

A prospective observational study of 533 patients with first-ever ischemic stroke was conducted between November 2020 and March 2021. Type D personality was assessed at baseline. The presence of depression was measured 3-month after discharge.

RESULTS

During 3-month follow-up, a total of 141 patients developed PSD. On multivariate logistic analysis, the main effect of negative affectivity (OR = 1.28, 95%CI = 1.03-1.61, p = 0.030) and social inhibition (OR = 1.25, 95%CI = 1.01-1.54, p = 0.039) showed significant correlation with PSD when Type D analyzed as continuous variables. Furthermore, positive effects were found for the negative affectivity and social inhibition interaction (OR = 1.31, 95 % CI =1.11-1.55, p = 0.001) on PSD.

CONCLUSIONS

Our findings suggest that Type D personality is high risk group of PSD. These findings highlight the importance of personalized interventions management in Type D individuals.

Bibliometric analysis of stroke and quality of life

Objective

To perform a bibliometric analysis of stroke and quality of life studies between 2000 and 2022 using VOSviewer and CiteSpace.

Methods

The literature data source for this study was the Web of Science Core Collection. CiteSpace and VOSviewer were used to analyze publications in relation to authors, countries, institutions, journals, references, and keywords.

Results

A total of 704 publications were obtained for the bibliometric analysis. The number of publications has gradually increased over 23 years, with an annual increase of 728.6%. Kim S is the most prolific author in the field (10 publications), and the United States and Chinese University of Hong Kong have the most publications. Stroke is the most prolific journal with the most citations per paper (91.58) and the highest impact factor (IF 2021, 10.17). The most high-frequency keywords are "stroke," "quality of life," "rehabilitation," and "depression."

Conclusion

A bibliometric analysis of stroke and quality of life over the last 23  years provides future research directions.

Relationships among Symptoms, Disability, Type D Personality, and Quality of Life in Patients with Migraine: A Cross-Sectional Study in South Korea

BACKGROUND

Type D personality as a personality vulnerable to stress consists of negative affectivity and social inhibition, and it is related to symptoms and decreased quality of life in patients with chronic illness.

AIM

This study aimed to explore the relationships among migraine symptoms, disability, type D personality, and quality of life in patients with migraine.

METHODS

A convenience sample of 135 patients with migraine was collected at the neurologic outpatient clinics of two tertiary hospitals in South Korea. Frequency and severity of migraine symptoms, Migraine Disability Assessment, type D personality, and quality of life were investigated using a structured questionnaire. A descriptive cross-sectional design was used.

RESULTS

Sixty-one (45.2%) were classified as type D personality. The intensity of the most severe migraine and Migraine Disability Assessment scores in subjects with type D personality were significantly higher than those in subjects without type D personality. In addition, the quality of life score of subjects with type D personality was significantly lower than in subjects without type D personality. The intensity of the migraine, Migraine Disability Assessment score, and type D personality were significant factors influencing quality of life on stepwise multiple regression analysis.

CONCLUSIONS

Type D personality was related to migraine symptoms, disability, and quality of life in patients with migraine.

The negative affectivity dimension of Type D personality associated with increased risk for acute ischemic stroke and white matter hyperintensity

OBJECTIVE

This study was conducted to examine the relationship among type D personality, acute ischemic stroke (AIS), and white matter hyperintensity (WMH).

METHODS

In a cross-sectional study conducted between September 2020 and June 2021, 235 patients aged 50-85 years with first-ever ischemic cerebrovascular disease, including 146 males and 89 females, were enrolled. All participants underwent the Type D Scale-14 test containing negative affectivity (NA) and social inhibition (SI) subscales. Clinical and laboratory data were also collected for analysis. The patients were divided into the AIS group (n = 148) and the transient ischemic attack (TIA) group (n = 87) according to whether there was an acute lesion.

RESULTS

Patients with type D personality had a higher frequency of AIS and LAA and a higher level of WMH. Multiple logistic regression showed that the NA score was related to a 1.11-fold increase in the odds of AIS (95% CI: 1.03-1.19). Neither NA nor SI showed a clear association with a higher frequency of LAA. Higher scores of NA (OR = 1.07, 95% CI: 1.01-1.15), SI (OR = 1.11, 95% CI: 1.03-1.19), and the interaction between the two dimensions (OR = 1.03, 95% CI: 1.01-1.05) were independently associated with an increased load of WMH.

CONCLUSION

Type D personality was related to AIS and WMH. In particular, it was NA, not SI, affected the occurrence of AIS. Our findings may provide new insights regarding behavioral vulnerability for the development of cerebrovascular disorders.

Factors Associated with a Health-promoting Lifestyle among Adults and Older Adults in the Era of COVID-19: An Integrative Review

AIM: To identify the factors associated with a health-promoting lifestyle (HPL) among adults or older adults during the COVID-19 pandemic. METHODS: On the basis of the PRISMA guidelines, primary articles published in English within the period from December 2019 to December 2021 were searched for on five databases: PubMed, Cochrane Library, Scopus, Web of Science, and CINAHL Plus with Full Text. RESULTS: The current review identified nine relevant studies with a total of 4,509 adults and older adults. We found that sociodemographic were associated with HPL among both adults and older adults in the COVID-19 era. The findings also asserted that a nurse-led lifestyle intervention is an effective program for improving the self-efficacy and HPL of older adults with chronic illnesses. CONCLUSION: According to this review’s findings, individuals and healthcare professionals should consider the sociodemographic and social factors associated with HPL among adults and older adults, it is important to improve and standardize the guidelines for home-based services so that they can be used properly to help them deal with the COVID-19 pandemic and similar health crises.