Illness perceptions in patients with heart failure and an implantable cardioverter defibrillator: Dimensional structure, validity, and correlates of the brief illness perception questionnaire in Dutch, French and German patients

- Little is known about illness perceptions in patients with heart failure.
- Analysis of the B-IPQ indicated two factors: consequences and control perceptions.
- The consequences factor is internally consistent and can be used as a separate subscale.
- Not medical but psychological factors are important correlates of heart failure perceptions.
- These findings were robust across Dutch, French and German patient subgroups.

BackgroundPatients' illness perceptions are associated with psychological wellbeing and can be measured with the Brief Illness Perception Questionnaire (B-IPQ). However, little is known about illness perceptions in patients with heart failure. We examined the dimensional structure, validity and clinical and psychological correlates of the B-IPQ in Dutch, French and German patients with heart failure and an implantable cardioverter defibrillator (ICD).MethodEuropean heart failure patients (n = 585) participating in the REMOTE-CIED study completed a set of questionnaires 1-2 weeks post ICD-implantation, including the B-IPQ. Information on clinical data was captured from patients' medical records.ResultsA two-factor structure (I = 'Consequences'; II = 'Control') represented 7 out of 8 B-IPQ items in the total sample and Dutch, German and French subgroups. The total B-IPQ had a Cronbach's α of 0.69, with the 'Consequences' subscale being more internally consistent (α = 0.80). Both the B-IPQ and its 'Consequences' subscale were significantly correlated with a number of psychological characteristics, but not with clinical characteristics. Multivariable logistic regression analysis indicated that threatening illness perceptions as measured with the total B-IPQ were associated with poor health status (OR = 2.66, 95%CI = 1.72-4.11), anxiety (OR = 1.79, 95%CI = 1.001-3.19), depression (OR = 2.81, 95%CI = 1.65-4.77), negative affectivity (OR = 1.93, 95%CI = 1.21-3.09) and poor ICD acceptance (OR = 2.68, 95%CI = 1.70-4.22).ConclusionThe B-IPQ demonstrated good psychometric properties in Dutch, French and German patients with heart failure. Psychological factors were the most important correlates of patients' perceptions of heart failure, emphasizing the importance of targeting maladaptive illness perceptions in this population, due to their impact on patients' wellbeing and quality of life.