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The association between somatization and health care utilization in patients with non-cardiac chest pain
Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0001-9140-8922
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0002-4259-3671
Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
2015 (English)In: Abstracts, Oxford University Press, 2015, Vol. 36, 283-283 p., P1665Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Background: Chest pain is one of the most common reasons for care-seeking, but often patients are diagnosed as non-cardiac (NCCP). NCCP patients suffer from cardiac anxiety, defined as fear of cardiac-related stimuli and sensations, which is strongly associated with increased healthcare utilization. Research indicates that somatization, defined as report of somatic symptoms that have no pathophysiological cause, is a relatively common cause in chest pain patients. The prevalence of somatization in NCCP patients and its association with cardiac anxiety and healthcare utilization needs further investigation.

Purpose: To describe the prevalence of somatization and its association with cardiac anxiety and healthcare utilization in NCCP patients.

Methods: Data in this cross sectional study was collected from 552 patients diagnosed with NCCP in four Swedish hospitals within one month from discharge. Patients had a mean age of 64±17 years, and 51% were women. Somatization was measured with the Patient Health Questionnaire-15 and cardiac anxiety with the Cardiac Anxiety Questionnaire. Healthcare utilization, i.e. number of healthcare contacts the year before study inclusion was self-reported by the patients. To determine the association between somatization, cardiac anxiety and healthcare utilization, a logistic hierarchical regression analysis was used with cardiac anxiety inserted in the first block, somatization in the second block, and a variable where these two were multiplied in the third block.

Results: In total, 283 (51%) patients reported at least moderate levels of somatization and 229 (42%) patients reported cardiac anxiety. Of the total, 89 (16%) had only somatization; 88 (16%) had only cardiac anxiety; and 194 (35%) had both somatization and cardiac anxiety. Somatization was strongly related to cardiac anxiety (r=.54, p<.010). About 26% of the patients reported 2-3 healthcare contacts and 14% reported more than 3 healthcare contacts due to chest pain. Both somatization (r=.37, p<.010) and cardiac anxiety (r=.46, p<.010) were significantly related to number of healthcare contacts. The logistic hierarchical regression showed that cardiac anxiety (OR=1.09, CI=1.07-1.11, p< .001) and somatization (OR=1.08, CI=1.03-1.13, p< .001) were associated with increased healthcare utilization. The multiplicative interaction term between these variables was not significant (OR=1.09, CI=0.996-1.00, p .901).

Conclusions: Somatization was frequently reported by NCCP patients and associated with cardiac anxiety and increased healthcare contacts. Somatization may therefore be important to target with interventions.

Place, publisher, year, edition, pages
Oxford University Press, 2015. Vol. 36, 283-283 p., P1665
Series
European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645 ; suppl_1
National Category
Other Medical Sciences
Identifiers
URN: urn:nbn:se:liu:diva-142712DOI: 10.1093/eurheartj/ehv399OAI: oai:DiVA.org:liu-142712DiVA: diva2:1153887
Conference
ESC Congress London, UK, 29 Aug-02 Sep 2015
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2017-12-04Bibliographically approved

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Mourad, GhassanStrömberg, AnnaJaarsma, Tiny

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