Analysis of the characteristics and illness comprehension bias among Chinese patients with psycho-cardiovascular disease: a multi-centre cross-sectional survey.

Abstract

Background: Psychological distress, such as depression and anxiety, impacts cardiovascular disease (CVD) prognosis and management. Illness comprehension is essential for effective treatment, but biases can lead to suboptimal outcomes. We explored psycho-cardiovascular disease (PCD) patient characteristics, with a specific focus on comprehension biases and treatment choices from patients' perspectives in China, to improve management strategies.

Methods: We enrolled 864 PCD patients in Chinese hospitals across 11 provinces. Tools included the seven-item General Anxiety Disorder scale, the nine-item Patient Health Questionnaire, and a self-designed PCD illness comprehensibility survey. We used χ² test, univariate, and multivariate logistic regression to examine patient characteristics.

Results: Of 834 enrolled PCD patients, over 90% experienced mild to moderate anxiety and depression, yet less than 10% received treatment. 52.90% of patients had high illness comprehension. Among the high comprehension group, there were fewer labourers (19.30% vs. 26.40%; P < 0.05), fewer older individuals (39.20% vs. 46.90%; P < 0.05), and those with lower household income (15.60% vs. 30.50%; P < 0.05). A greater proportion of those in the high comprehension group lacked insurance (17.50% vs. 10.00%; P < 0.05), and they were more highly educated (42.90% vs. 32.10% with a college education). Additionally, more patients in the high comprehension group frequently received psychological consultation (24.00% vs. 5.10%; P < 0.05) and therapy (7.70% vs. 2.30%; P < 0.05). These patient groups preferred tertiary hospitals (71.66% vs. 63.33%; P < 0.05) and psycho-cardiovascular clinics (40.14% vs. 25.90%; P < 0.05). In comparison, low comprehension patients prioritised cost (32.65% vs. 46.41%; P < 0.05) and favoured a transition to community hospitals (16.55% vs. 25.38%; P < 0.05).

Conclusions: More than 90% of PCD patients in Chinese CVD departments experience mild to moderate anxiety and depression with low treatment rates. Different illness comprehension levels are associated with variations in treatment willingness, considerations, health care preferences, medication choices, and illness knowledge acquisition methods.