The purpose of this paper was to examine the relationship between type D personality and cardiovascular disease, and to suggest future research directions.

A literature search was conducted from the following nine databases: 1) MEDLINE, 2) CINAHL, 3) Pubmed Unrestricted, 4) PsycINFO, 5) KISS, 6) RICHIS, 7) RISS4U, and 8) Nanet. The combinations of the words, "type D personality", "personality", "heart", "cardiovascular", and "coronary" were used for keyword searches to find relevant articles. Twenty eight studies were identified.

Type D personality has been associated with increased morbidity and mortality in patients with established cardiovascular disease. Type D patients are also at increased risk for impaired quality of life, and seem to benefit less from medical and invasive treatment.

There is substantial evidence for a relationship between type D personality and clinical outcomes related to cardiovascular disease. Randomized clinical trials are needed to further evaluate the value of controlling type D personality to improve survival and reduce morbidity in patients with cardiovascular disease. Accumulating evidence from this analysis indicates the urgent need to adopt a personality approach in order to optimize the identification of patients at risk for stress related cardiac events.

The purpose of this study was to identify the factors that influence the functional status of patients with heart failure.

A descriptive, correlational study design was used. The participants in this study were 260 patients with heart failure who were admitted at Y University and U University in Seoul, Korea. Between September 2005 and December 2005 data was collected by an interview using a questionnaire and from medical records. The Functional status was measured with KASI. Physical factors (dyspnea, ankle edema, chest pain, fatigue, and sleep dysfunction), psychological factors (anxiety and depression), and situational factors (self-management compliance and family support) were examined.

In general, the functional status, anxiety, depression, self-management compliance, and family support was relatively not good. The level of fatigue was highest and the level of ankle edema was lowest for physical symptom experiences. In regression analysis, functional status was significantly influenced by dyspnea(23%), age(13%), monthly income(7%), fatigue(3%), ankle edema(2%), depression(1%), and length of stay in the hospital(1%). These factors explained 50% of the variables in the functional status.

These results suggest that psycho-physiological symptoms management should be a focus to improve the functional status in patients with heart failure.