Key result
Shifting to negative illness perceptions after valve replacement linked to ~220% higher 10-year mortality risk.
Why the study?
The association between profiles of illness perceptions and long-term survival following cardiac valve replacement surgery was unclear.
Does changing from positive to negative illness perceptions increase long-term mortality in patients following cardiac valve replacement?
Cohort (n=204)
Does changing from positive to negative illness perceptions increase long-term mortality in patients following cardiac valve replacement?
Developing negative illness perceptions over the first post-operative year following cardiac valve replacement predicts long-term mortality, highlighting the potential value of early psychosocial screening.
Answers are grounded in this paper and cite their sources.
Does not support practice change after valve surgery; hypothesis-generating for illness perception profiles in long-term survival.
OBJECTIVE: The aim of the present study was to examine whether profiles of illness perceptions are associated with 10-year survival following cardiac valve replacement surgery. METHODS: Illness perceptions were evaluated in 204 cardiac patients awaiting first-time valve replacement and again 1 year post-operatively using cluster analysis. All-cause mortality was recorded over a 10-year period. At 1 year, 136 patients were grouped into one of four profiles (stable positive, stable negative, changed from positive to negative, changed from negative to positive). RESULTS: The median follow-up was 3063 days (78 deaths). After controlling for clinical covariates, including markers of function, patients who changed illness perceptions from positive to negative beliefs 1 year post-surgery had an increased mortality risk (hazard ratio (HR) = 3.2, 95% confidence interval (CI) 1.2-8.3, p = .02) compared to patients who held positive stable perceptions. CONCLUSIONS: Following cardiac valve replacement, developing negative illness perceptions over the first post-operative year predicts long-term mortality. Early screening and intervention to alter this pattern of beliefs may be beneficial.
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Crawshaw et al. (2015) conducted a cohort in Cardiac valve replacement (n=204). Change from positive to negative illness perceptions vs. Stable positive illness perceptions was evaluated on All-cause mortality (HR 3.2, 95% CI 1.2-8.3, p=.02). Changing illness perceptions from positive to negative 1 year after cardiac valve replacement increased 10-year mortality risk compared to stable positive perceptions.
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