Influencing Effects of Type D Personality on Symptom Experiences and Quality of Life in Patients with Percutaneous Coronary Intervention

Type D 성격 유형이 관상동맥중재술 환자의 증상 경험과 삶의 질에 미치는 영향

  • Received : 2016.07.17
  • Accepted : 2016.10.24
  • Published : 2016.10.31


Purpose: The aim of this study was to investigate the influencing effects of type D personality on symptom experiences and quality of life in percutaneous coronary intervention patients. Methods: A descriptive, cross-sectional study design was used. A total of 158 patients with percutaneous coronary intervention participated in this study, between July 1 and November 1, 2015. Data were analyzed by means, standard deviations, t-test, $x^2$ test, ANCOVA, and stepwise multiple regression analysis using SPSS 22.0 program. Results: About 53.8% of participants were classified as type D personality. The type D personality group reported statistically significantly higher symptom experience, lower cardiac function, and lower cardiovascular-specific quality of life compared to non-type D personality group. On stepwise multiple regression, the most significant factor of quality of life was symptom experiences (adjusted $R^2=.25$, p<.001), followed by type D personality (adjusted $R^2=.31$, p<.001). Conclusion: Personality trait assessment is recommended for patients with percutaneous coronary intervention to assess symptom experiences and quality of life. In addition, development of nursing intervention might be beneficial to manage symptom experience and quality of life in percutaneous coronary intervention patients with type D personality.


  1. Fernandez RS, Davidson P, Griffiths R, Juergens C, Salamonson Y. Development of a health-related lifestyle self-management intervention for patients with coronary heart disease. Heart & Lung. 2009;38(6):491-8.
  2. Statistics Korea. 2015 Annual report on the cause of death statistics [Internet]. Daejeon: Statistics Korea; 2015 [cited 2016 October 8]. Available from:
  3. Statistics Korea. Health insurance major surgery statistics [Internet]. Daejeon: Statistics Korea; 2016 [cited 2016 October 8] Available from:
  4. Smith SC, Allen J, Blair SN, Bonow RO, Brass LM, Fonarow GC, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update. Circulation. 2006;113:2363-72.
  5. Park JH, Bae SH. A systematic review of psychological distress as a risk factor for recurrent cardiac events in patients with coronary artery disease. Journal of Korean Academy of Nursing. 2011;41(5):704-14.
  6. Staniute M, Brozaitiene J, Burkauskas J, Kazukauskiene N, Mickuviene N, Bunevicius R. Type D personality, mental distress, social support and health-related quality of life in coronary artery disease patients with heart failure: a longitudinal observational study. Health and Quality of Life Outcomes. 2015;13:1.
  7. Pedersen SS, Lemos PA, van Vooren PR, Liu TK, Daemen J, Erdman RA, et al. Type D personality predicts death or myocardial infarction after bare metal stent or sirolimus-eluting stent implantation: a rapamycin-eluting stent evaluated at rotterdam cardiology hospital (RESEARCH) registry substudy. Journal of the American College of Cardiology. 2004;44(5):997-1001.
  8. Williams L, O'Connor RC, Grubb NR, O'Carroll RE. Type D personality and three-month psychosocial outcomes among patients post-myocardial infarction. Journal of Psychosomatic Research. 2012;72:722-6.
  9. Denollet J. Type D personality: a potential risk factor refined. Journal of Psychosomatic Research. 2000;49(4):255-66.
  10. Denollet J. DS14: standard assessment of negative affectivity, social inhibition, and type D personality. Psychosomatic Medicine. 2005;67(1):89-97.
  11. Wiliams L, O'Connor RC, Howard S, Hughes BM, Johnston DS, Hay JL, et al. Type-D personality mechanisms of effect: the role of health-related behavior and social support. Journal of Psychosomatic Research. 2008;64(1):63-6.
  12. Pederson SS, van Domburg RT, Theuns DA, Jordaens L, Erdmanm RA. Type D personality is associated with increased anxiety and depressive symptoms in patients with an implantable cardioverter defibrillator and their partner. Psychosomatic Medicine. 2004;66:714-9.
  13. Pedersen SS, Middel B. Increased vital exhaustion among type-D patients with ischemic heart disease. Journal of Psychosomatic Research. 2001;51(2):443-9.
  14. Choi KJ. A study on stress, coping strategy, and depression in the patients having percutaneous transluminal coronary angioplasty. [master's thesis]. Seoul: Yonsei University; 2001.
  15. Son YJ, Song EK. The life style and quality of life according to the pattern of type D personality in patients with hypertension. Korean Journal of Adult Nursing. 2007;19(4):644-55.
  16. Wong MS, Chair SY. Changes in health-related quality of life following percutaneous coronary intervention: a longitudinal study. International Journal of Nursing Studies. 2005;(44):1334-42.
  17. Hwang SJ. Symptom clusters and quality of life changes according to recovery periods of heart valve surgery patients. [dissertation]. Jeonju: Chonbuk University. 2015.
  18. Lim EH, Lee MS, Ko YH, Park YM, Joe SH, Kim YK, et al. Assessment of the type D personality construct in the Korean population: a validation study of the Korean DS14. Journal of Korean Medical Science. 2011;26(1):116-23.
  19. Armstrong TS. Symptoms experience: a concept analysis. Oncology Nursing Forum. 2003;30(4):601-6.
  20. Nieveen JL, Zimmerman LM, Barnason SA, Yates BC. Development and content validity testing of the cardiac symptom survey in patients after coronary artery bypass grafting. Heart & Lung. 2008;37(1):17-27.
  21. Lee EH, Moon SM, Tahk SJ, Kim SH. Quality of life in patients with chronic cardiovascular disease. Journal of Korean Academy of Adult Nursing. 2007;19:12-23.
  22. The Criteria Committee for the New York Heart Association. Nomenclature and criteria for diagnosis of disease of the heart and the great vessels (Ninth Edition). 1994;253-5. Boston: Little Brown and Company.
  23. Pedersen SS, Daemen J, van De SM, Sonnenschein K, Serruys PW, Erdman RA, et al. Type-D personality exerts a stable, adverse effect on vital exhaustion in PCI patients treated with paclitaxel-eluting stents. Journal of Psychosomatic Research. 2007;62(4):447-53.
  24. Pedersen SS, Denollet J, Ong A, Serruys PW, Erdman RA, van Domburg RT. Impaired health status in type D patients following PCI in the drug-eluting stent era. International Journal of Cardiology. 2007;114(3):358-65.
  25. Son HM. Quality of life and illness intrusiveness by type-D personality in the patients with coronary artery disease. Journal of Korean Academy of Fundamentals of Nursing. 2009;39(3):349-56.
  26. Isaksson RM, Holmgren L, Lundblad D, Brulin C, Eliasson M. Time trends in symptoms and prehospital delay time in women vs. men with myocardial infarction over a 15-year period. The Northern Sweden MONICA Study. European Journal Cardiovascular Nursing. 2008;7:152-58
  27. Park IS, Song RU, Ahn SH, So HY, Kim HL, Joo KO. Factors explaining quality of life in individuals with coronary artery disease. Journal Korean Academy of Nursing. 2008;38(6):866-73.
  28. Glymour MM. Alcohol and cardiovascular disease. British Medical Journal. 2014;349:g4334.
  29. Mols F, Denollet J. Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related health problems. Health and Quality of Life Outcomes. 2010;8:1-10.
  30. Denollet J, van Heck G. Psychological risk factors in heart disease: what type D personality is (not) about. Journal of Psychosomatic Research. 2001;51:465-8.

Cited by

  1. Somatic Symptoms and Quality of Life in Adults: Moderating Effect of Spiritual Well-being vol.21, pp.2, 2018,