The contribution of illness perception to psychological distress in heart failure patients

Abstract

Background: The influences on the psychological well-being of heart failure (HF) patients have received limited attention. Illness perceptions are a specific set of cognitive representations that have been shown to predict health-related outcomes in other patient groups. This study sought to explore the role of illness perceptions in the psychological well-being of HF patients by creating a profile of illness perceptions in HF and examining their relations with anxiety and depression. Methods: Participants were 95 consecutive outpatients. Indices of psychological well-being were depression and anxiety, measured using the Hospital Anxiety and Depression Scale (HADS). Illness perceptions were measured using the Illness Perception Questionnaire -Revised (IPQ-R). Functional status was also determined using the New York Heart Association (NYHA) classification. Results: Illness perceptions were associated with indices of psychological well-being. Regression analyses showed that illness perceptions accounted for a significant proportion of the variance in both depression and anxiety. The contribution of illness perceptions was greater than that made by traditional covariates (socio-demographic variables and functional status). Conclusions: Results highlight dynamic interrelations between perceptions of illness and mental health indices. They also suggest that in considering the role of illness perceptions in psychological well-being, the primary focus should be on the overall dynamic of an individual's illness experience rather than on specific illness dimensions. Findings highlight the potential role of illness perceptions in depression and anxiety in HF. This has implications for interventions to maximise psychological well-being in this patient group.

To what extent do disease severity and illness perceptions explain depression, anxiety and quality of life in hidradenitis suppurativa?

“…In line with past research in alopecia and other long‐term conditions, more negative illness beliefs were significantly intercorrelated with higher depression and anxiety and impaired QoL scores. Furthermore, after controlling for HS severity and demographics (age and gender) in multivariate analyses, illness perceptions explained more variance than disease severity and demographic factors together, for depression, anxiety and QoL.…”

“…Increasing evidence among other chronic illnesses indicates that the individual's subjective beliefs about their condition are strongly related to health outcomes including depression, anxiety, QoL and recovery . These beliefs, which are collectively referred to as illness perceptions, comprise the patient's own ideas about the nature, cause, controllability, time course and consequences of their condition .…”

“…These beliefs, which are collectively referred to as illness perceptions, comprise the patient's own ideas about the nature, cause, controllability, time course and consequences of their condition . Compared with clinical assessments of disease severity and demographics, illness perceptions have been found to be more strongly related to depression, anxiety and QoL in alopecia, heart failure and multiple sclerosis . Thus, patients’ illness perceptions may contribute to health outcomes more significantly than HS severity.…”

Self‐reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross‐sectional study

“…Only one other study was found using ESAS in outpatients with advanced or terminal HF, and participants in that Italian study were even more symptomatic, with shortness of breath being present in all participants compared with 77% in our study. 36 Patient-reported health status, as measured with the EQ-5Dvas, was similar (mean 66) to Swedish patients' health status from a large Swedish registry study (mean 63) using data from 2008-13. 35 A report from Ireland, a country that was also hit hard by the economic crisis, reported a considerably higher prevalence of both depression and anxiety.…”

“…35 A report from Ireland, a country that was also hit hard by the economic crisis, reported a considerably higher prevalence of both depression and anxiety. 36 Patient-reported health status, as measured with the EQ-5Dvas, was similar (mean 66) to Swedish patients' health status from a large Swedish registry study (mean 63) using data from 2008-13. 37 When comparing the health status of our Icelandic HF patients with the health status of similar outpatient populations before and after the economic crisis, the picture is complex.…”