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

Published online by Cambridge University Press:  27 March 2013

Edward Callus ,
Elisabeth M. W. J. Utens ,
Emilia Quadri ,
Cristian Ricci ,
Mario Carminati ,
Alessandro Giamberti  and
Massimo Chessa
Edward Callus*
Affiliation:
Department of Pediatric Cardiology and Adult with Congenital Heart Defect, IRCCS Policlinico San Donato, Milan, Italy
Elisabeth M. W. J. Utens
Affiliation:
Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands
Emilia Quadri
Affiliation:
Department of Pediatric Cardiology and Adult with Congenital Heart Defect, IRCCS Policlinico San Donato, Milan, Italy
Cristian Ricci
Affiliation:
Fondazione Don C.Gnocchi, Piazzale Morandi, Milan, Italy
Mario Carminati
Affiliation:
Department of Pediatric Cardiology and Adult with Congenital Heart Defect, IRCCS Policlinico San Donato, Milan, Italy
Alessandro Giamberti
Affiliation:
Department of Pediatric Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy
Massimo Chessa
Affiliation:
Department of Pediatric Cardiology and Adult with Congenital Heart Defect, IRCCS Policlinico San Donato, Milan, Italy
*
Correspondence to: Dr E. Callus, Department of Pediatric Cardiology and Adult with Congenital Heart Defect, IRCCS Policlinico San Donato, Via Morandi, 30, 20097 San Donato M.se, Milan, Italy. Tel: +3902527744707; Fax: +390252774912; E-mail: edward.callus@grupposandonato.com
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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.

Keywords

Paediatric cardiologypsychologyquality of life
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 2 , April 2014 , pp. 275 - 282
Copyright
Copyright © Cambridge University Press 2013 

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