The impact of actual and perceived disease severity on pre-operative psychological well-being and illness behaviour in adult congenital heart disease patients

Cardiol Young. 2014 Apr;24(2):275-82. doi: 10.1017/S1047951113000218. Epub 2013 Mar 27.

Abstract

Objectives: The purpose of this study was to investigate whether the objective medical parameters related to congenital heart disease and patients' ratings of cardiac disease severity were related to psychological well-being and illness behaviour during the pre-operative period.

Methods: A total of 143 patients (63 male patients; 16-73 years old) with congenital heart disease evaluated the severity of their cardiac condition using a numerical rating scale ranging from 0, indicating the least severe condition, to 100, indicating the most severe condition. Psychological well-being was assessed using the Psychological General Well-Being Index (total score ≤ 60 indicating severe distress) and illness behaviour using the Illness Behavior Questionnaire.

Results: Pre-operative psychological well-being was not related to the objective medical parameters reflecting cardiac disease severity. In contrast, total psychological well-being scores correlated significantly with patients' subjective ratings of disease severity (p < 0.001). When compared with the reference values from the Italian population, the mean scores of the patients on psychological well-being were similar. As regards the Illness Behavior Questionnaire, the scores on denial were higher and those on hypochondria were lower compared with other hospitalised patients.

Conclusions: This study shows that the perception of cardiac disease severity, and not the medical parameters in congenital heart disease, is related to the patients' pre-operative psychological state. Thus, more importance needs to be given to assessing the patients' pre-operative perception and psychological state independently of cardiac severity. Targeted interventions with regard to the cardiac condition are recommended.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Attitude to Health*
  • Denial, Psychological
  • Female
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / psychology*
  • Heart Defects, Congenital / surgery
  • Humans
  • Hypochondriasis / psychology
  • Illness Behavior*
  • Male
  • Middle Aged
  • Personal Satisfaction
  • Preoperative Period*
  • Quality of Life
  • Severity of Illness Index
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires
  • Young Adult