Patient-reported causes of heart failure in a large European sample

Ivy Timmermans*, Johan Denollet, Susanne S. Pedersen, Mathias Meine, Henneke Versteeg

*Corresponding author for this work

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Abstract

Background: Patients diagnosed with chronic diseases develop perceptions about their disease and its causes, which may influence health behavior and emotional well-being. This is the first study to examine patient-reported causes and their correlates in patients with heart failure. Methods: European heart failure patients (N = 595) completed questionnaires, including the Brief Illness Perceptions Questionnaire. Using deductive thematic analysis, patient-reported causes were categorized into physical, natural, behavioral, psychosocial, supernatural and other. Clinical data were collected from medical records. Results: Patients who did not report any cause (11%) were on average lower educated and participated less often in cardiac rehabilitation. The majority of the remaining patients reported physical causes (46%, mainly comorbidities), followed by behavioral (38%, mainly smoking), psychosocial (35%, mainly (work-related) stress), and natural causes (32%, mainly heredity). There were socio-demographic, clinical and psychological group differences between the various categories, and large discrepancies between prevalence of physical risk factors according to medical records and patient-reported causes; e.g. 58% had hypertension, while only 5% reported this as a cause. Multivariable analyses indicated trends towards associations between physical causes and poor health status (Odds ratio (OR) = 1.41, 95% confidence interval (95% CI) = 0.95–2.09, p = 0.09), psychosocial causes and psychological distress (OR = 1.54, 95% CI = 0.94–2.51, p = 0.09), and behavioral causes and a less threatening view of heart failure (OR = 0.64, 95% CI = 0.40–1.01, p = 0.06). Conclusion: European patients most frequently reported comorbidities, smoking, stress, and heredity as heart failure causes, but their causal understanding may be limited. There were trends towards associations between patient-reported causes and health status, psychological distress, and illness perceptions.

Original languageEnglish
JournalInternational Journal of Cardiology
Volume258
Pages (from-to)179-184
ISSN0167-5273
DOIs
Publication statusPublished - 1. May 2018

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Heredity
Odds Ratio
Confidence Intervals
Medical Records
Comorbidity
Smoking
Health Behavior
Surveys and Questionnaires
Cardiac Rehabilitation

Keywords

  • Brief illness perception questionnaire
  • Heart failure
  • Patient-reported causes

Cite this

Timmermans, Ivy ; Denollet, Johan ; Pedersen, Susanne S. ; Meine, Mathias ; Versteeg, Henneke. / Patient-reported causes of heart failure in a large European sample. In: International Journal of Cardiology. 2018 ; Vol. 258. pp. 179-184.
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abstract = "Background: Patients diagnosed with chronic diseases develop perceptions about their disease and its causes, which may influence health behavior and emotional well-being. This is the first study to examine patient-reported causes and their correlates in patients with heart failure. Methods: European heart failure patients (N = 595) completed questionnaires, including the Brief Illness Perceptions Questionnaire. Using deductive thematic analysis, patient-reported causes were categorized into physical, natural, behavioral, psychosocial, supernatural and other. Clinical data were collected from medical records. Results: Patients who did not report any cause (11{\%}) were on average lower educated and participated less often in cardiac rehabilitation. The majority of the remaining patients reported physical causes (46{\%}, mainly comorbidities), followed by behavioral (38{\%}, mainly smoking), psychosocial (35{\%}, mainly (work-related) stress), and natural causes (32{\%}, mainly heredity). There were socio-demographic, clinical and psychological group differences between the various categories, and large discrepancies between prevalence of physical risk factors according to medical records and patient-reported causes; e.g. 58{\%} had hypertension, while only 5{\%} reported this as a cause. Multivariable analyses indicated trends towards associations between physical causes and poor health status (Odds ratio (OR) = 1.41, 95{\%} confidence interval (95{\%} CI) = 0.95–2.09, p = 0.09), psychosocial causes and psychological distress (OR = 1.54, 95{\%} CI = 0.94–2.51, p = 0.09), and behavioral causes and a less threatening view of heart failure (OR = 0.64, 95{\%} CI = 0.40–1.01, p = 0.06). Conclusion: European patients most frequently reported comorbidities, smoking, stress, and heredity as heart failure causes, but their causal understanding may be limited. There were trends towards associations between patient-reported causes and health status, psychological distress, and illness perceptions.",
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Patient-reported causes of heart failure in a large European sample. / Timmermans, Ivy; Denollet, Johan; Pedersen, Susanne S.; Meine, Mathias; Versteeg, Henneke.

In: International Journal of Cardiology, Vol. 258, 01.05.2018, p. 179-184.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Patient-reported causes of heart failure in a large European sample

AU - Timmermans, Ivy

AU - Denollet, Johan

AU - Pedersen, Susanne S.

AU - Meine, Mathias

AU - Versteeg, Henneke

N1 - Copyright © 2017 Elsevier B.V. All rights reserved.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background: Patients diagnosed with chronic diseases develop perceptions about their disease and its causes, which may influence health behavior and emotional well-being. This is the first study to examine patient-reported causes and their correlates in patients with heart failure. Methods: European heart failure patients (N = 595) completed questionnaires, including the Brief Illness Perceptions Questionnaire. Using deductive thematic analysis, patient-reported causes were categorized into physical, natural, behavioral, psychosocial, supernatural and other. Clinical data were collected from medical records. Results: Patients who did not report any cause (11%) were on average lower educated and participated less often in cardiac rehabilitation. The majority of the remaining patients reported physical causes (46%, mainly comorbidities), followed by behavioral (38%, mainly smoking), psychosocial (35%, mainly (work-related) stress), and natural causes (32%, mainly heredity). There were socio-demographic, clinical and psychological group differences between the various categories, and large discrepancies between prevalence of physical risk factors according to medical records and patient-reported causes; e.g. 58% had hypertension, while only 5% reported this as a cause. Multivariable analyses indicated trends towards associations between physical causes and poor health status (Odds ratio (OR) = 1.41, 95% confidence interval (95% CI) = 0.95–2.09, p = 0.09), psychosocial causes and psychological distress (OR = 1.54, 95% CI = 0.94–2.51, p = 0.09), and behavioral causes and a less threatening view of heart failure (OR = 0.64, 95% CI = 0.40–1.01, p = 0.06). Conclusion: European patients most frequently reported comorbidities, smoking, stress, and heredity as heart failure causes, but their causal understanding may be limited. There were trends towards associations between patient-reported causes and health status, psychological distress, and illness perceptions.

AB - Background: Patients diagnosed with chronic diseases develop perceptions about their disease and its causes, which may influence health behavior and emotional well-being. This is the first study to examine patient-reported causes and their correlates in patients with heart failure. Methods: European heart failure patients (N = 595) completed questionnaires, including the Brief Illness Perceptions Questionnaire. Using deductive thematic analysis, patient-reported causes were categorized into physical, natural, behavioral, psychosocial, supernatural and other. Clinical data were collected from medical records. Results: Patients who did not report any cause (11%) were on average lower educated and participated less often in cardiac rehabilitation. The majority of the remaining patients reported physical causes (46%, mainly comorbidities), followed by behavioral (38%, mainly smoking), psychosocial (35%, mainly (work-related) stress), and natural causes (32%, mainly heredity). There were socio-demographic, clinical and psychological group differences between the various categories, and large discrepancies between prevalence of physical risk factors according to medical records and patient-reported causes; e.g. 58% had hypertension, while only 5% reported this as a cause. Multivariable analyses indicated trends towards associations between physical causes and poor health status (Odds ratio (OR) = 1.41, 95% confidence interval (95% CI) = 0.95–2.09, p = 0.09), psychosocial causes and psychological distress (OR = 1.54, 95% CI = 0.94–2.51, p = 0.09), and behavioral causes and a less threatening view of heart failure (OR = 0.64, 95% CI = 0.40–1.01, p = 0.06). Conclusion: European patients most frequently reported comorbidities, smoking, stress, and heredity as heart failure causes, but their causal understanding may be limited. There were trends towards associations between patient-reported causes and health status, psychological distress, and illness perceptions.

KW - Brief illness perception questionnaire

KW - Heart failure

KW - Patient-reported causes

U2 - 10.1016/j.ijcard.2018.01.113

DO - 10.1016/j.ijcard.2018.01.113

M3 - Journal article

C2 - 29426633

VL - 258

SP - 179

EP - 184

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -