Aim: To develop a model for assessing cognitive-behavioral dysfunction in patients with heart failure, through the analysis of data gathered from clinical interviews.
Sample: One hundred sixty-six consecutive inpatients with previous or current heart failure: 125 males and 41 females, mean age 59 +/- 9.3 yrs.
Method: Three professional psychologists independently analyzed the clinical reports of the interviews. The cognitive-behavioral dysfunction recorded was correlated to age and sex, history of heart failure and cardiac function indices (ejection fraction, NYHA Class).
Results: The concordance index among the three psychologists was 97%. Illness management was found to be more difficult for younger subjects (p = 0.03), in those with a longer history of heart failure (p = 0.04) and in those with advanced NYHA class (p = 0.008). An incorrect behavioral style, as defined by the variables "type A", "risk factors", and "vital exhaustion", was significantly correlated with the level of cardiac impairment (ejection fraction) (p = 0.04) and with inadequate illness management (p = 0.02).
Conclusions: Clinical interviews seem to be a simple and accurate tool for assessing cognitive behavioral dysfunction in patients with heart failure and for detecting the areas that require further investigation and more adequate psychological support. The key element that emerges with regard to both diagnosis and treatment is a dysadaptive behavioral style, as defined by the "type A" variables, "risk factors" and "vital exhaustion".