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Psychological Factors Associated with a Better Quality of Life Following Head-Up Tilt Testing

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Abstract

Quality of life (QoL) is reduced in patients with recurrent vasovagal (VVS) or unexplained syncope (US). Little is known concerning the natural evolution of QoL following diagnosis. Psychological factors contributing to QoL improvement, such as psychological distress and self-efficacy remain to be explored. The objective of this study is to examine whether QoL changes 2 months and 6 months following head-up tilt (HUT) testing as well as to determine whether psychological factors are predictive of changes in QoL. Seventy-three patients undergoing HUT for recurrent syncope were interviewed 1 month before as well as 2 months and 6 months following HUT, using semi-structured interviews and questionnaires. Pre-HUT QoL was significantly worse than at the 2-month (p = 0.000) and 6-month follow-ups (p = 0.000). Psychological distress at baseline was associated with worse QoL 2 months post-HUT (Beta = .280; p = .024), independently of socio-demographic and clinical factors. Improved self-efficacy at follow-up predicted improvements in QoL (Beta = −.186; p = .023). Two and 6 months post-HUT, QoL is mproved in patients with recurrent syncope. Better QoL is predicted by low psychological distress and a heightened sense of self-efficacy following HUT. Strategies for enhancing self-efficacy and reducing psychological distress could be an efficient way to promote QoL in patients suffering from recurrent syncope.

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Abbreviations

ANOVA:

Analysis of variance

DSM-IV:

Diagnostic and statistical manual-revision 4

HRQoL:

Health-related quality of life

HUT:

Head-up tilt testing

LNS:

Life time number of syncope

PRIME-MD:

Primary care evaluation of mental disorders

PSI:

Psychiatric symptom index

QoL:

Quality of life

US:

Unexplained syncope

VVS:

Vasovagal syncope

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Acknowledgements

This research was supported by a grant awarded to Dr. D’Antono by the Canadian Institutes of Health Research. We also thank the Fonds de la recherche en santé du Québec for salary support of Dr. D’Antono. Finally, we wish to acknowledge the collaboration of Dr. Gendreau at the Centre Hospitalier Ambulatoire de la Région de Laval for his implication in this project.

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Authors and Affiliations

  1. Research Center, Montreal Heart Institute, 5000 Belanger Street, Montreal, Quebec, H1T 1C8, Canada

    Karine Lévesque, Gilles Dupuis, Bernard Thibault, Peter G. Guerra, France Bédard & Bianca D’Antono

  2. Department of Psychology, Université du Québec à Montréal, P.O. Box 8888, succursale Centre-Ville, Montreal, Quebec, H3C 3P8, Canada

    Karine Lévesque, Gilles Dupuis & France Bédard

  3. Department of Cardiology, Sacré-Cœur Hospital of Montreal, 5400, boul. Gouin Ouest, Montreal, Quebec, H4J 1C5, Canada

    Teresa Kus

  4. Department of Pharmacology, Université de Montreal, C.P.6128, Succursale Centre-ville, Montreal, Quebec, H3C 3J7, Canada

    Teresa Kus

  5. Centre Entrac Montréal, 4801 rue Molson, Montréal, Québec, H1Y 0A2, Canada

    Karine St-Jean

  6. Department of Medicine, Montreal Heart Institute and Université de Montréal, 5000 Belanger Street, Montreal, Quebec, H1T 1C8, Canada

    Bernard Thibault & Peter G. Guerra

  7. Department of Psychiatry, Université de Montréal, P.O. Box 6128, succursale Centre-ville, Montreal, Quebec, H3C 3J7, Canada

    Bianca D’Antono

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  1. Karine Lévesque
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  2. Teresa Kus
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  3. Karine St-Jean
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Correspondence to Bianca D’Antono.

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Lévesque, K., Kus, T., St-Jean, K. et al. Psychological Factors Associated with a Better Quality of Life Following Head-Up Tilt Testing. Applied Research Quality Life 5, 185–201 (2010). https://doi.org/10.1007/s11482-010-9104-8

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