Personality traits, quality of life and perceived health in adolescents with congenital heart disease

The mediating effect of perceived stress on the relationship between big five personality traits and suboptimal health status in Chinese population: a nationwide survey in the framework of predictive, preventive, and personalized medicine

Background

The effects of psychological factors on suboptimal health status (SHS) have been widely described; however, mechanisms behind the complex relationships among the Big Five personality traits and SHS are unclear. Identifying people with specific traits who are susceptible to SHS will help improve life quality and reduce the chronic disease burden under the framework of predictive, preventive, and personalized medicine (PPPM / 3PM). This study investigated the relationships among personality traits and SHS. It also explored whether perceived stress plays a mediating role in SHS development.

Method

A nationwide cross-sectional survey based on multistage random sampling was conducted in 148 cities in China between June 20 and August 31, 2022. Personality traits, perceived stress, and SHS were evaluated using the Big Five Inventory-10 (BFI-10), the 4-item Perceived Stress Scale (PSS-4), and the Short-Form Suboptimal Health Status Questionnaire (SHSQ-SF), respectively. Pearson's correlation analysis was employed to examine the associations between personality traits, perceived stress, and SHS. Structural equation modeling (SEM) was used to discern the mediating role of perceived stress in the relationships among personality traits and SHS.

Result

A total of 22,897 participants were enrolled in this study, among whom the prevalence of SHS was 52.9%. SHS was negatively correlated with three trait dimensions (i.e., extraversion, agreeableness, and conscientiousness) but positively correlated with neuroticism. Meanwhile, stress was negatively correlated with extraversion, agreeableness, conscientiousness, and openness, whereas it was positively correlated with neuroticism. The SEM results showed that, when adjusting for covariates (i.e., gender, age, BMI, educational level, current residence, marital status, and occupational status), higher agreeableness (β =  - 0.049, P < 0.001) and conscientiousness (β =  - 0.103, P < 0.001) led to lower SHS prevalence, higher neuroticism (β = 0.130, P < 0.001), and openness (β = 0.026, P < 0.001) caused SHS to be more prevalent. Perceived stress played a partial mediating role in the relationships among personality traits and SHS, respectively, contributing 41.3%, 35.9%, and 32.5% to the total effects of agreeableness, conscientiousness, and neuroticism on SHS. Additionally, the mediating impact of stress was significant even though extraversion had no direct effect on SHS.

Conclusion

This study revealed a high prevalence of SHS in Chinese residents. Personality traits significantly influenced SHS rates, which perceived stress tended to mediate. From a PPPM perspective, early screening and targeted intervention for people with neuroticism (as well as stress alleviation) might contribute to health enhancement and chronic disease prevention.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13167-023-00349-x.

The relationship between big five personality and quality of life of people with disabilities: The mediating effect of social support

Objective

The quality of life of people with disabilities is of great significance to social stability and development. Increasing the quality of life among the disabled has become a worldwide topic. This study aims to examine the relationship between the big five personality and quality of life and the mediating effects of social support indicators in people with disabilities.

Methods

This was a cross-sectional study with 358 people with disabilities (193 women and 165 men). A questionnaire was utilized to measure big five personality, social support, and quality of life variables. Pearson's correlation analysis and structural equation modeling were used to examine the relation among big five personality, social support, and quality of life.

Results

QOL was positively correlated with social support (r = 0.402, p < 0.001), extraversion (r = 0.324, p < 0.001), agreeableness (r = 0.474, p < 0.001), conscientiousness (r = 0.482, p < 0.001), and openness (r = 0.498, p < 0.001). QOL was negatively correlated with neuroticism (r = -0.186, p < 0.001). The mediating effect of social support on the relationship between neuroticism and the quality of life of people with disabilities was not significant. Social support significantly mediated the relationship between extraversion, agreeableness, conscientiousness, openness, and quality of life. Overall, positive personality traits (extraversion, agreeableness, conscientiousness, and openness) in the Big Five Personality of people with disabilities could increase their quality of life by Perceiving social support. But social support could not significantly mediate the relationship between neuroticism and the quality of life of people with disabilities.

Conclusion

These new findings suggest that combining individual factors (personality) and environmental factors (social support) can better improve the quality of life of people with disabilities.

Big Five Personality Traits and Predicting Mental Health among Iranian Older Adults

Aging has been a major issue for experts, policymakers, and even the general public in recent years. There is a growing body of evidence highlighting the role of personality traits in the health of older adults, but this evidence is still in its infancy. This study aimed to investigate the role of the big five personality traits in predicting the mental health among older adults. In this cross-sectional study, 150 community-residing older adults were selected and completed the Ten Item Personality Inventory, Multidimensional Scale of Perceived Social Support, Adult Hope Scale, and Short-Form Health Survey. According to the results, extraversion and openness to experience can explain 11% of the variances of hope, extraversion and conscientiousness account for 16% of the variances in perceived social support, and all the big five personality traits together predict 34% of the variances in the health-related quality of life. Given the role of personality traits in predicting the mental health of older adults, counselors and psychologists working with these people can pay attention to the personality traits of older adults in designing their psychological, educational, and research programs to achieve more desirable outcomes.

Advances in Managing Transition to Adulthood for Adolescents With Congenital Heart Disease: A Practical Approach to Transition Program Design: A Scientific Statement From the American Heart Association

It is now expected that most individuals with congenital heart disease will survive to adulthood, including those with complex heart conditions. Maintaining lifelong medical care requires those with congenital heart disease to eventually transfer from pediatric to adult-oriented health care systems. Developing health care transition skills and gaining independence in managing one's own health care is imperative to this process and to ongoing medical and psychosocial success. This scientific statement reviews the recent evidence regarding transition and provides resources, components, and suggestions for development of congenital heart disease transition programs with the goals of improving patient knowledge, self-management, and self-efficacy skills to the level they are capable to eventually integrate smoothly into adult-oriented health care. Specifically, the scientific statement updates 3 sections relevant to transition programming. First, there is a review of specific factors to consider, including social determinants of health, psychosocial well-being, and neurocognitive status. The second section reviews costs of inadequate transition including the public health burden and the impairment in individual quality of life. Finally, the last section discusses considerations and suggestions for transition program design including communication platforms, a family-centered approach, and individual models. Although this scientific statement reviews recent literature surrounding transitions of care for individuals with congenital heart disease there remain significant knowledge gaps. As a field, we have yet to determine ideal timing and methods of transition, and barriers to transition and transfer remain, particularly for the underserved populations. The consequences of poor health care transition are great and garnering outcomes and information through organized, multifaceted, collaborative approaches to transition is critical to improving the lifelong care of individuals with congenital heart disease.

Personality, Coping and Developmental Conditions in Female Adolescents and Young Adults with Type 1 Diabetes: Influence on Metabolic Control and Quality of Life

Objective

To assess personality factors, coping, developmental conditions and quality of life in female adolescents and young adults with type 1 diabetes (T1D) and high vs.low HbA1c.

Methods

Patients were approached at the Department for Pediatrics, Medical University of Vienna; n = 129 female adolescents (10 to 23 years, mean age 15.21 ± 2.91) with type 1 diabetes were included. HIGH-A1c was defined as HbA1c > 7.5%, LOW-A1c as HbA1c ≤ 7.5% and compared to a sample of 56 age-matched female healthy controls. Self-rating questionnaires were used to assess psychosocial factors: Children's Depression Inventory (CDI); Junior Temperament and Character Inventory (J-TCI); Eating Disorders Inventory-2 (EDI-2); KIDCOPE; Subjective Family Image Test (SFIT) and Inventory of Life Quality in Children and Adolescents(ILC).

Results

T1D patients with HIGH-A1c were younger at the age of diabetes onset, had a longer diabetes duration, a higher maximum BMI, higher depression score, and higher frequency of diabetic ketoacidosis in the last year. They showed significantly higher levels of fatigue, lower levels of taking responsibility, lower ability to set goals and lower self-acceptance, as well as higher levels of ineffectiveness, lower levels of emotional attachment within the family, in particular with the fathers, and used negative coping strategies more often compared to patients with LOW-A1c. Furthermore, they reported significantly higher burden of illness and lower quality of life.

Conclusions

Disadvantageous personality and coping styles as well as developmental conditions should be addressed in the treatment of female adolescents with T1D with management problems.

Poverty, quality of life and psychological wellbeing in adults with congenital heart disease in Chile

The objective of this study was to assess the quality of life and psychological wellbeing of adults with congenital heart disease (CHD) in Chile, and to identify other associated factors. The study enrolled 68 patients aged between 18 and 72 (median 29), 35 being females. They completed a questionnaire, which included a quality of life assessment tool (the Medical Outcome Study 36-Item Short Form Health Survey), a number of psychological scales (the General Health Questionnaire, the Basic Psychological Needs Scales and the Beck Hopelessness Scale), a socioeconomic survey, and some clinical data. CHD patients reported worse scores in those scales assessing physical dimensions of quality of life (physical function (70.5), physical role functioning (64), vitality (65.3)), and general quality of life (58.6), than in emotional or social dimensions. Female gender was associated with lower scores in physical function (59.12 versus 82.66; p<0.01) and physical role functioning (53.68 versus 75; p<0.05); poverty was associated with worse results in physical function (61.92 versus 82.96; p<0.01), role physical (53.21 versus 79.63; p<0.01), vitality (60.89 versus 71.67; p<0.05), social role functioning (70.19 versus 82.87; p<0.05) and bodily pain (65.77 versus 81.2; p<0.05). Furthermore, we found that psychological scales had an association with quality of life, but clinical variables did not show significant correlations to any dimension. Poverty has an impact on the quality of life of CHD patients. This population only has a decrease in the quality of life physical dimensions, suggesting that quality of life depends on many different factors.

Personality functioning in adults with refractory epilepsy and community adults: Implications for health-related quality of life

INTRODUCTION

Prior research has shown that people with epilepsy are at risk for a poorer health-related quality of life (HRQOL). However, patients differ greatly in how well they adjust to their epilepsy. To better understand these differences, the present study examined the role of personality. More specifically, we examined mean-level differences in Big Five personality traits between adults with refractory epilepsy and a community sample and related these traits to patients' HRQOL.

METHODS

A total of 121 adults with refractory epilepsy (18-40 years old, 56% women) completed questionnaires on the Big Five personality traits, HRQOL, and seizure frequency and severity. Patients' Big Five scores were compared to those of a community sample matched on sex and age using paired samples t-tests. We conducted hierarchical regression analyses to examine associations between personality and HRQOL, while controlling for the effects of sex, age, age at diagnosis, seizure frequency, and seizure severity.

RESULTS

Patients reported higher levels of neuroticism and lower levels of openness as compared to controls. In patients, seizure severity was positively related to neuroticism and negatively related to agreeableness. Finally, patients high in neuroticism and low in conscientiousness generally reported a poorer HRQOL.

CONCLUSION

In the present study, small personality differences were observed between adults with refractory epilepsy and a community sample. Patients' personality was found to play an important role in adjusting to epilepsy, even after controlling for seizure frequency and severity. Personality assessment may help healthcare professionals in identifying patients at risk for poor HRQOL later in life.

Quality-of-life research in adult patients with congenital heart disease: current status and the way forward

Over the past four decades, the number of papers on quality of life (QoL) in congenital heart disease (CHD) has grown exponentially. However, firm conclusions have been hard to draw, because conceptual issues occurred and methodological differences prevented direct comparisons of studies. In general, QoL in CHD patients is good and it can be even better than in healthy peers when measured as life satisfaction. When QoL is measured as physical functioning, patients with complex CHD do worse than patients with moderate or mild defects or healthy individuals. APPROACH-IS was a large-scale international project that confirmed international variations in QoL, with Australian patients reporting the best QoL. Poor QoL was predicted by older age, being a job seeker, unemployed or disabled, never having married and those with worse functional status. Perceived illness and religion and spirituality were also significant predictors for QoL. On the other hand, country-specific characteristics and healthcare system factors did not play a significant role in explaining variances in QoL of patients with CHD around the globe. Future studies should rely on a sound conceptual basis, use longitudinal research designs, be conducted in international, multi-centre settings and evaluate interventions that promote patients' QoL.

The Role of Personality in Daily Food Allergy Experiences

Food allergies present numerous challenges to coping in everyday life. Even simple things like planning a lunch with a friend can be stressful for people with food allergies. But are some people more adversely impacted by having a food allergy than other people? This paper addressed this question by investigating whether individual differences in the Big Five personality traits (neuroticism, extraversion, openness, agreeableness, and conscientiousness) are related to food allergy-related problems in everyday life among adults with food allergies. Participants were 108 adults (85% female; mean age = 40.2; age range 18–87) with a physician-diagnosed food allergy [most commonly to gluten (54.6%), peanuts (21.3%), cow's milk (16.7%), and shellfish/seafood (16.7%)]. Participants completed an initial online survey that measured demographics, food allergy information, and personality traits using the Big Five Inventory (John et al., 1991). For 2 weeks, participants completed a daily online survey that queried the occurrence of 25 food allergy issues that day and participants' overall stress and mood that day. Neuroticism did not predict more frequent allergy issues or greater stress/poorer mood on days with more allergy issues. Instead, higher openness to experience predicted a range of issues including going hungry because there is no safe food available, problems finding suitable foods when grocery shopping, feeling anxious at social occasions involving food, being excluded, and feeling embarrassed and poorly understood about their food allergy. Conscientious people were less embarrassed or self-conscious about their food allergy, but they had more problems eating out, and their positive mood was more impaired by allergy issues than their less conscientious peers. Extraversion and agreeableness played minor roles. Personality testing can identify people that may have difficulty living with food allergies–such as those higher in openness to experience.

Nurses' Perceptions of Quality of Life for Adolescents with Congenital Heart Disease

The purpose of this study was to understand nurses' perceptions and experiences regarding Quality of Life (QOL) of adolescents with complex congenital heart disease (CHD). Interpretive, hermeneutic, phenomenology was used to explore the perceptions and experiences of nurses who care for adolescents with complex CHD. The participants included 6 female registered nurses with experience taking care of adolescents with complex CHD. Data were collected using semi-structured interviews. Data analysis revealed 4 themes: QOL depends on how the psychological and social issues are interwoven with the physical; finding that balance between overprotection and too much freedom; setting goals to envision a future; and not being defined by a CHD. These results indicate that understanding nurses' perspectives and experiences may contribute to effective guidance for adolescents with complex CHD transitioning into adulthood.

The mediating role of resilience in the relationship between personality and adjustment to disease in patients with a drainage enterostomy

An understanding of what variables are involved in a better adjustment to chronic disease makes it possible to implement more suitable community healthcare interventions. It also allows the design of educational programmes aimed at increasing the independence of these patients, thereby enabling them to achieve a better health status. Both the personality and the resilience of the patient have been shown to play an important role in the process of adjusting to the new living conditions that result from having a chronic disease. Yet, to date, little research has been conducted in this area. This study uses structural equation modelling to explore the relationships among the personality factors, resilience and the variables of adjustment to disease (i.e. quality of life and level of self-care). The sample consists of 125 patients with a drainage enterostomy. Results show that the relationship model with the best fit is the one that considers resilience as a mediating variable in the relation between personality and disease adjustment variables. The implications of the findings and the limitations of the study are also discussed.

Key factors in children's competence to consent to clinical research

Background

Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children’s consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children’s competence to consent to clinical research and to what extent they explain the variation in competence judgments.

Methods

From January 1, 2012 through January 1, 2014, pediatric patients aged 6 to 18 years, eligible for clinical research studies were enrolled prospectively at various in- and outpatient pediatric departments. Children’s competence to consent was assessed by MacArthur Competence Assessment Tool for Clinical Research. Potential determining child variables included age, gender, intelligence, disease experience, ethnicity and socio-economic status (SES). We used logistic regression analysis and change in explained variance in competence judgments to quantify the contribution of a child variable to the total explained variance. Contextual factors included risk and complexity of the decision to participate, parental competence judgment and the child’s or parents decision to participate.

Results

Out of 209 eligible patients, 161 were included (mean age, 10.6 years, 47.2 % male). Age, SES, intelligence, ethnicity, complexity, parental competence judgment and trial participation were univariately associated with competence (P < 0.05). Total explained variance in competence judgments was 71.5 %. Only age and intelligence significantly and independently explained the variance in competence judgments, explaining 56.6 % and 12.7 % of the total variance respectively. SES, male gender, disease experience and ethnicity each explained less than 1 % of the variance in competence judgments. Contextual factors together explained an extra 2.8 % (P > 0.05).

Conclusions

Age is the factor that explaines most of to the variance in children’s competence to consent, followed by intelligence. Experience with disease did not affect competence in this study, nor did other variables.

Clinical trial registration

Development and use of a standardized instrument for assessing children’s competence to consent in drug trials: Are legally established age limits valid?, NTR3918.

Personality and self-esteem in emerging adults with Type 1 diabetes

OBJECTIVE

The present study examined (1) mean-level differences in self-esteem and Big Five personality traits between individuals with and without diabetes; and (2) demographic, clinical, and psychological correlates of patients' self-esteem and Big Five.

RESEARCH DESIGN AND METHODS

A total of 478 emerging adults with Type 1 diabetes (18-35 years old) were selected from the Belgian Diabetes Registry and completed questionnaires on personality, self-esteem, and diabetes-related distress. The control group consisted of 341 healthy participants who were matched (1:1) on sex and age with the patient group.

RESULTS

First, mean-level differences between patients and controls differed according to patients' sex and illness duration. Women with diabetes reported lower self-esteem and were less extraverted and emotionally stable as compared to female controls. In contrast, men with diabetes reported higher self-esteem and were more agreeable but less emotionally stable as compared to male controls. Furthermore, whereas both patients with shorter and longer illness duration were less extraverted and emotionally stable as compared to controls, only patients with longer illness duration reported heightened agreeableness. Second, self-esteem and Big Five were found to relate to patients' sex and (to a lesser extent) age and illness duration. Finally, patients reporting elevated diabetes-related distress reported lower self-esteem, and were less agreeable and emotionally stable as compared to patients not reporting such distress.

CONCLUSIONS

Patients' personality and self-esteem might be important targets for future prevention and intervention efforts. The present findings can assist healthcare professionals in identifying those patients who might benefit the most from such programs.