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Chow PC. Patient-Reported Outcomes and Resilience in Patients With Congenital Heart Disease. JACC. ADVANCES 2024; 3:100915. [PMID: 38939640 PMCID: PMC11198414 DOI: 10.1016/j.jacadv.2024.100915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Affiliation(s)
- Pak-Cheong Chow
- Cardiology Centre, Department of Paediatrics & Adolescent Medicine, Hong Kong Children’s Hospital, Kowloon Bay, Hong Kong SAR
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Steiner JM, Nassans K, Brumback L, Stout KK, Longenecker CT, Yi-Frazier JP, Curtis JR, Rosenberg AR. Key Psychosocial Health Outcomes and Association With Resilience Among Patients With Adult Congenital Heart Disease. JACC. ADVANCES 2024; 3:100917. [PMID: 38846320 PMCID: PMC11156219 DOI: 10.1016/j.jacadv.2024.100917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/12/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Adult congenital heart disease (ACHD) can negatively impact quality of life (QOL). Strengthening resilience may improve this and other psychosocial outcomes important for living a meaningful life. OBJECTIVES The purpose of this study was to describe resilience and key psychosocial health outcomes in ACHD and evaluate the associations between resilience and these outcomes. METHODS We conducted a prospective cohort study of outpatients with moderate or complex ACHD between May 2021 and June 2022. Participants completed surveys at baseline and 3 months, evaluating resilience (Connor-Davidson Resilience Scale-10), health-related QOL (EQ5D-3L, linear analog scale), health status (Euroqol visual analog scale), self-competence (Perceived Competence Scale), and psychological symptom burden (Hospital Anxiety and Depression Scale) and distress (Kessler-6). RESULTS The mean participant age (N = 138) was 41 ± 14 years, 51% were female, and 83% self-identified as non-Hispanic White. ACHD was moderate for 75%; 57% were physiologic class B. Mean baseline resilience score (Connor-Davidson Resilience Scale-10) was 29.20 ± 7.54. Participants had relatively good health-related QOL, health status, and self-competence, and low psychological symptom burden and distress. Higher baseline resilience was associated with better values of all outcomes at 3 months (eg, 1 point higher resilience was associated with 0.92 higher linear analog scale; 95% CI: 0.52-1.32) with or without adjustment for demographics. After further adjusting for the baseline psychosocial measure, only the association between resilience and QOL measures at 3 months remained statistically significant. CONCLUSIONS Resilience is positively associated with health-related QOL for outpatients with moderate or complex ACHD, though relationships are small in magnitude. Study findings can guide the application of resilience-building interventions to the ACHD population.
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Affiliation(s)
- Jill M. Steiner
- Division of Cardiology, Department of Medicine & Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA
| | - Katherine Nassans
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Lyndia Brumback
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Karen K. Stout
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Chris T. Longenecker
- Division of Cardiology and Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Joyce P. Yi-Frazier
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - J. Randall Curtis
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine & Cambia Palliative Care Center of Excellence, University of Washington, Harborview Medical Center, Seattle, Washington, USA
| | - Abby R. Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute & Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Verrall CE, Tran DL, Kasparian NA, Williams T, Oxenham V, Ayer J, Celermajer DS, Cordina RL. Cognitive Functioning and Psychosocial Outcomes in Adults with Complex Congenital Heart Disease: A Cross-sectional Pilot Study. Pediatr Cardiol 2024; 45:529-543. [PMID: 38261061 PMCID: PMC10891231 DOI: 10.1007/s00246-023-03376-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/05/2023] [Indexed: 01/24/2024]
Abstract
Adults with complex congenital heart disease (CHD) are at risk for cognitive dysfunction. However, associations between cognitive dysfunction and psychosocial outcomes are poorly defined. Between June and November 2022, we prospectively recruited 39 adults with complex CHD who completed a computerized cognitive assessment (Cogstate) and validated psychosocial scales measuring psychological distress, health-related quality of life (HRQOL), and resilience. Participants had a mean age of 36.4 ± 11.2 years. Over half (62%) were women, most (79%) had complex biventricular CHD, and 21% had Fontan physiology. Prevalence of cognitive dysfunction was greatest in the domains of attention (29%), working memory (25%), and psychomotor speed (21%). Adjusting for age and sex, Pearson partial correlations between Cogstate z-scores and self-reported cognitive problems were small. Participants who lived in the most disadvantaged areas and those with a below-average annual household income had lower global cognitive z-scores (p = 0.02 and p = 0.03, respectively). Two-thirds (64%) reported elevated symptoms of depression, anxiety, and/or stress. Small correlations were observed between psychological distress and cognitive performance. Greater resilience was associated with lower psychological distress (r ≥ -0.5, p < 0.001) and higher HRQOL (r = 0.33, p = 0.02). Our findings demonstrate that adults with complex CHD have a high risk of cognitive dysfunction, though may not recognize or report their cognitive challenges. Lower socioeconomic status may be an indicator for those at risk of poorer cognitive functioning. Psychological distress is common though may not be a strong correlate of performance-based cognitive functioning. Formal cognitive evaluation in this patient population is essential. Optimizing resilience may be a protective strategy to minimize psychological distress and bolster HRQOL.
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Affiliation(s)
- Charlotte E Verrall
- The University of Sydney School of Medicine, Sydney, NSW, Australia.
- Heart Centre for Children, The Children's Hospital at Westmead, Sydney, NSW, Australia.
- Clinical Research Group, Heart Research Institute, Sydney, NSW, Australia.
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
| | - Derek L Tran
- The University of Sydney School of Medicine, Sydney, NSW, Australia
- Clinical Research Group, Heart Research Institute, Sydney, NSW, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia
| | - Nadine A Kasparian
- Heart and Mind Wellbeing Center, Heart Institute and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Tracey Williams
- Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Vincent Oxenham
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
- Department of Neurology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Julian Ayer
- The University of Sydney School of Medicine, Sydney, NSW, Australia
- Heart Centre for Children, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - David S Celermajer
- The University of Sydney School of Medicine, Sydney, NSW, Australia
- Clinical Research Group, Heart Research Institute, Sydney, NSW, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Rachael L Cordina
- The University of Sydney School of Medicine, Sydney, NSW, Australia
- Clinical Research Group, Heart Research Institute, Sydney, NSW, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
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Cheng CH, Hsu CH, Sie JR, Tsay SL, Tung HH. The Relationship Between Resilience and Health-Related Quality of Life Among Heart Failure Patients in New York Heart Association Functional Classes II and III. J Nurs Res 2024; 32:e312. [PMID: 38271064 DOI: 10.1097/jnr.0000000000000594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Heart failure is an intense, unpredictable, and stressful chronic disease caused by the decline in cardiac pumping function. The influence of heart failure affects patients not only in terms of physical capabilities but also in terms of their emotional and social dimensions, with patients in different functional classes experiencing different levels of effect. Although resilience and health-related quality of life have been studied in populations with heart failure, the scholarly understanding of different functional classes is limited. PURPOSE This study was designed to investigate the relationship between resilience and health-related quality of life among patients with heart failure in different physical functional classes in Taiwan. METHODS A cross-sectional design was applied to study patients with heart failure in northern Taiwan. Two structured questionnaires, including the Resilience Scale for Adults and the 12-item Short Form Health Survey, were used to assess resilience and health-related quality of life. New York Heart Association functional class was used to determine physical function status, and canonical correlation analysis was used to determine the weight of each resilience and quality-of-life domain for the different functional classes. RESULTS The 100 participants had an average age of 65.52 years. Slightly over half (56%) were classified as Functional Class II. A group difference in health-related quality of life was observed. Personal strength (rs = .759) and social competence (rs = -.576) were found to influence the resilience and emotional role dimension of quality of life (rs = -.996) in the Functional Class II group. In addition, family cohesion (rs = -.922), dominant resilience, physical function (rs = .467), and bodily pain (rs = .465) were found to influence quality of life in the Functional Class III group. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The efficacy of measures taken to increase resilience to heart failure varied in patients in different functional classes. Functional Class II individuals were better able to manage the disease using their personal strength, whereas Functional Class III individuals relied more heavily on family support and assistance for this effort. Furthermore, participant feelings about quality of life also varied by functional class, with physical function and bodily pain taking on significantly more importance for Functional Class III individuals.
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Affiliation(s)
- Ching-Hui Cheng
- MSN, RN, Deputy Chief of Cardiac Nursing Department, Heart Center, Cheng-Hsin General Hospital, Taiwan, ROC
| | - Ching-Hwa Hsu
- PhD, RN, NP, Assistant Professor, School of Nursing, College of Medicine, Chang Gung University, Taiwan, ROC
| | - Jia-Rong Sie
- MSN, RN, NP, Doctoral Student, Department of Nursing, National Yang Ming Chiao Tung University, and Nurse Practitioner, Department of Emergency Medicine, National Taiwan University Hospital, Taiwan, ROC
| | - Shiow-Luan Tsay
- PhD, RN, APN, Professor, College of Nursing & Health Sciences, Da-Yeh University, Taiwan, ROC
| | - Heng-Hsin Tung
- PhD, RN, FNP, DNP, Distinguished Professor, Department of Nursing, National Yang Ming Chiao Tung University, and Adjunct Nursing Consultant, Tungs' Taichung MetroHarbor Hospital, Taiwan, ROC
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Glenn T, Cousino MK, Wernovsky G, Schuchardt EL. Resilient Hearts: Measuring Resiliency in Young People With Congenital Heart Disease. J Am Heart Assoc 2023; 12:e029847. [PMID: 37889178 PMCID: PMC10727399 DOI: 10.1161/jaha.123.029847] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023]
Abstract
Background Congenital heart disease (CHD) is a life-long disease with long-term consequences on physical and mental health. Patients with CHD face multifaceted physical and psychosocial challenges. Resilience is an important factor that can be protective and positively impact mental health. We studied resiliency and its associated factors in teenagers and young adults with and without CHD using a social media-delivered survey. Resilience was measured using the 25-item Connor-Davidson Resilience Scale, a validated metric with a historical mean of 80.4/100 in the general adult population. Methods and Results Individuals with and without CHD, aged 10 to 25 years, were prospectively recruited on social media to complete an online survey. The survey was completed from January to February 2022. Respondents provided information on their demographics and CHD details (where applicable) and completed the Connor-Davidson Resilience Scale. As a group, participants with CHD had higher resilience scores compared with same-aged healthy individuals (65.3±16.1 versus 55.4±13.8; P<0.001). For both cohorts, sex, race, and age were not associated with differences in resilience score. For individuals with CHD, lower resilience was associated with more hospital admissions, lack of exercise, presence of a mental health diagnosis, and no participation in support groups or disease-specific camps. Conclusions Young people with CHD had higher resilience than individuals without CHD in our sample. We identified several factors, both modifiable and nonmodifiable, that are associated with higher resilience. Awareness of resiliency and its contributors in the population with CHD may assist medical teams in improving patient physical and psychological well-being.
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Affiliation(s)
- Thomas Glenn
- Congenital Heart Center, Departments of Pediatrics and Cardiac SurgeryUniversity of MichiganAnn ArborMI
- Rady Children’s Hospital, Division of Cardiology, Department of PediatricsUniversity of California San Diego School of MedicineSan DiegoCA
| | - Melissa K. Cousino
- Congenital Heart Center, Departments of Pediatrics and Cardiac SurgeryUniversity of MichiganAnn ArborMI
| | - Gil Wernovsky
- Cardiac Critical Care and Pediatric CardiologyChildren’s National Hospital and George Washington University School of Medicine and Health SciencesWashingtonDC
| | - Eleanor L. Schuchardt
- Rady Children’s Hospital, Division of Cardiology, Department of PediatricsUniversity of California San Diego School of MedicineSan DiegoCA
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Steiner JM, Blakeney EAR, Baden AC, Freeman V, Yi-Frazier J, Curtis JR, Engelberg RA, Rosenberg AR. Definitions of resilience and resilience resource use as described by adults with congenital heart disease. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2023; 12:100447. [PMID: 37693226 PMCID: PMC10486316 DOI: 10.1016/j.ijcchd.2023.100447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Background Adult congenital heart disease (ACHD) is a lifelong illness that presents ongoing challenges to quality of life. Fostering personal resilience resources to sustain well-being can enhance patients' psychosocial health. Objective We aimed to describe patients' resilience experiences: how they understand, develop, and utilize resilience resources in managing ACHD. Methods We conducted a qualitative study of patients with ACHD. Participants were recruited using maximum variation sampling. Individual, semi-structured interviews were conducted June 2020 to August 2021. We queried approaches to managing ACHD-related stress and experiences with resilience and analyzed responses with thematic analysis. Results Participant (N = 25) median age was 32 years (range 22-44); 52% identified as female and 72% non-Hispanic white. Participants' anatomic ACHD was moderate (56%) or complex (44%); physiologically, 76% were functional class C or D. Participants described various resilience resources, which map to an established resilience framework: 1) internal resources: maintaining positivity, self-directed activity, and setting goals; 2) external resources: social support; 3) existential resources: purpose, gratitude, and cultivating health. Even among participants who reported feeling unfamiliar (8/25) with the term "resilience," all participants shared experiences reflecting resilience developed while living with ACHD. Conclusion ACHD-relevant resilience resources may help patients and clinicians navigate ACHD-related stress and promote psychosocial well-being.
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Affiliation(s)
- Jill M. Steiner
- Division of Cardiology, Department of Medicine & Cambia
Palliative Care Center of Excellence, University of Washington, 1959 NE Pacific St.,
Seattle, WA, 98195, USA
| | - Erin Abu-Rish Blakeney
- Department of Biobehavioral Nursing and Health Informatics,
School of Nursing, University of Washington, 1959 NE Pacific St., Seattle, WA,
98195, USA
| | - Andrea Corage Baden
- Division of General Internal Medicine, Department of
Medicine, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195,
USA
| | - Vea Freeman
- Division of Cardiology, Department of Medicine, University
of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA
| | - Joyce Yi-Frazier
- Division of Hematology/Oncology, Department of Pediatrics,
Palliative Care and Resilience Lab, Seattle Children’s Research Institute,
1920 Terry Ave, Seattle, WA, 98101, USA
| | - J. Randall Curtis
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine & Cambia Palliative Care Center of Excellence, University
of Washington, Harborview Medical Center, 325 9th A, Seattle, WA,
98104, USA
| | - Ruth A. Engelberg
- Department of Psychosocial Oncology and Palliative Care,
Dana-Farber Cancer Institute & Department of Pediatrics, Harvard Medical School,
450 Brookline Ave, Boston, MA, 02215, USA
| | - Abby R. Rosenberg
- Department of Psychosocial Oncology and Palliative Care,
Dana-Farber Cancer Institute & Department of Pediatrics, Harvard Medical School,
450 Brookline Ave, Boston, MA, 022155, USA
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Kotlińska-Lemieszek A, Fopka-Kowalczyk M, Krajnik M. Spirituality in people with advanced chronic obstructive pulmonary disease - challenge for more effective interventions, support, and healthcare education: Mini-review. Front Med (Lausanne) 2022; 9:954519. [PMID: 36561722 PMCID: PMC9763313 DOI: 10.3389/fmed.2022.954519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/31/2022] [Indexed: 12/12/2022] Open
Abstract
More recently there has been a growing interest in spirituality in medicine, especially in the field of palliative care, oncology, intensive care, and cardiology. However, according to literature, it seems to be a limited number of researches on how healthcare professionals should provide spiritual care (SC) for people with non-malignant lung diseases and what kind of education for them enables them to do it efficiently. This mini-review aims to provide an overview of current knowledge of an area of spirituality and SC for people with advanced chronic obstructive pulmonary disease, including spiritual well-being and religious/spiritual coping, their relations with the quality of life and symptom burden, exercise capacity and daily functioning, mental health, or medication adherence. It also analyses the use of interventions to meet patients' spiritual needs and patients' expectations regarding SC provided by professional careers. Based on the literature authors try to show the fields that should be improved and proposed future research directions.
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Affiliation(s)
- Aleksandra Kotlińska-Lemieszek
- Pharmacotherapy in Palliative Care Laboratory, Chair and Department of Palliative Medicine, Poznań University of Medical Sciences, Poznań, Poland,Outpatient Palliative Medicine Clinic, Heliodor Swięcicki University Hospital, Poznań, Poland,*Correspondence: Aleksandra Kotlińska-Lemieszek,
| | | | - Małgorzata Krajnik
- Department of Palliative Care, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
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Chami J, Strange G, Baker D, Cordina R, Grigg L, Celermajer DS, Nicholson C. Algorithmic complexity stratification for congenital heart disease patients. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2022. [DOI: 10.1016/j.ijcchd.2022.100430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Keir M, Borman M, Clegg R, Colbert J, Guron N, Harper L, Helmerson D, Patzer J, Reynolds S, Alvarez N. Caring for the Aging Patient With Adult Congenital Heart Disease: A Review of Cardiac and Noncardiac Comorbidities. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2022; 1:274-281. [PMID: 37969485 PMCID: PMC10642149 DOI: 10.1016/j.cjcpc.2022.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/12/2022] [Indexed: 11/17/2023]
Abstract
As the demographics of congenital heart disease (CHD) have shifted, there are now more adults living with CHD than children in North America. This presents unprecedented challenges as patients with CHD acquire noncardiac comorbidities and seek care for a variety of reasons, including noncardiac surgery and emergency department (ED) visits. CHD shifts from a one organ problem to a multisystem disease and requires a team of specialists to maintain high-quality longitudinal care. In this review, we summarize the challenges patients with CHD and their providers face as they age. We review the demographics of CHD and health care utilization. We examine the rates of noncardiac comorbidities and the current quality of care received by adult patients with CHD.
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Affiliation(s)
- Michelle Keir
- Southern Alberta Adult Congenital Heart Clinic, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Meredith Borman
- Section of Gastroenterology, Division of Internal Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Robin Clegg
- Southern Alberta Adult Congenital Heart Clinic, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jillian Colbert
- Southern Alberta Adult Congenital Heart Clinic, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Nita Guron
- Southern Alberta Adult Congenital Heart Clinic, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Lea Harper
- Section of Respirology, Division of Internal Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Doug Helmerson
- Section of Respirology, Division of Internal Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jessica Patzer
- Southern Alberta Adult Congenital Heart Clinic, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Stephen Reynolds
- Southern Alberta Adult Congenital Heart Clinic, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Nanette Alvarez
- Southern Alberta Adult Congenital Heart Clinic, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
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Curcio N, Turner ED, Leonard K, Bennett MM, Warren AM, Edgerton JR. The role of resilience and spirituality in recovery following cardiac surgery. Proc AMIA Symp 2022; 35:420-427. [DOI: 10.1080/08998280.2022.2043985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Nicholas Curcio
- Division of Trauma, Critical Care, and Acute Care Surgery, Baylor University Medical Center, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Emma D. Turner
- Division of Trauma, Critical Care, and Acute Care Surgery, Baylor University Medical Center, Dallas, Texas
| | - Kiara Leonard
- Division of Trauma, Critical Care, and Acute Care Surgery, Baylor University Medical Center, Dallas, Texas
| | | | - Ann Marie Warren
- Division of Trauma, Critical Care, and Acute Care Surgery, Baylor University Medical Center, Dallas, Texas
| | - James R. Edgerton
- Baylor Research Institute, Dallas, Texas
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, Missouri
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Jung SY, Choi JY. Sexual Health Issue in Adult Congenital Heart Disease to Improve the Quality of Life. Korean Circ J 2022; 52:243-245. [PMID: 35257535 PMCID: PMC8907991 DOI: 10.4070/kcj.2022.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/02/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Se Yong Jung
- Division of Pediatric Cardiology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Young Choi
- Division of Pediatric Cardiology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
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12
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Cocomello L, Dimagli A, Biglino G, Cornish R, Caputo M, Lawlor DA. Educational attainment in patients with congenital heart disease: a comprehensive systematic review and meta-analysis. BMC Cardiovasc Disord 2021; 21:549. [PMID: 34798837 PMCID: PMC8603574 DOI: 10.1186/s12872-021-02349-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/18/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Our aim was to comprehensively review published evidence on the association between having a congenital heart disease (CHD) compared with not, on educational attainment (i.e. not obtaining a university degree, completing secondary education, or completing any vocational training vs. obtaining/completing) in adults. METHOD Studies were eligible if they reported the rate, odds, or proportion of level of educational attainment in adults by whether or not they had a CHD. RESULT Out of 1537 articles screened, we identified 11 (N = 104,585 participants, 10,487 with CHD), 10 (N = 167,470 participants, 11,820 with CHD), and 8 (N = 150,813 participants, 9817 with CHD) studies reporting information on university education, secondary education, and vocational training, respectively in both CHD and non-CHD participants. Compared to their non-CHD peers, CHD patients were more likely not to obtain a university degree (OR = 1.38, 95% CI [1.16, 1.65]), complete secondary education (OR = 1.33, 95% CI [1.09, 1.61]) or vocational training (OR = 1.11, 95% CI [0.98, 1.26]). For all three outcomes there was evidence of between study heterogeneity, with geographical area contributing to this heterogeneity. CONCLUSION This systematic review identified all available published data on educational attainment in CHD patients. Despite broad inclusion criteria we identified relatively few studies that included a comparison group from the same population, and amongst those that did, few adjusted for key confounders. Pooled analyses suggest evidence of lower levels of educational attainment in patients with CHD when compared to non-CHD peers. The extent to which this may be explained by confounding factors, such as parental education, or mediated by treatments is not possible to discern from the current research literature.
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Affiliation(s)
- Lucia Cocomello
- MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
| | | | - Giovanni Biglino
- Bristol Medical School, Tyndall Avenue, Bristol, BS8 1UD, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Rosie Cornish
- MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Massimo Caputo
- Bristol Heart Institute, Terrell St, Bristol, BS2 8 ED, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol NIHR Biomedical Research Centre, Bristol, UK
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13
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When children with congenital heart disease become adults – Understanding psychosocial attainments and functioning in comparison to census population norms. PROGRESS IN PEDIATRIC CARDIOLOGY 2021. [DOI: 10.1016/j.ppedcard.2021.101421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Truong TH, Kim NT, Nguyen MNT, Do DL, Nguyen HT, Le TT, Le HA. Quality of life and health status of hospitalized adults with congenital heart disease in Vietnam: a cross-sectional study. BMC Cardiovasc Disord 2021; 21:229. [PMID: 33947343 PMCID: PMC8097946 DOI: 10.1186/s12872-021-02026-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/12/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Little is known about the quality of life (QOL) and health status of adults with congenital heart disease (CHD) in developing countries. Therefore, this study aimed to describe the QOL and health status of hospitalized adults with CHD in Vietnam and investigate the association between QOL and their biological-social characteristics. METHODS A cross-sectional study was conducted with 109 adults with CHD, hospitalized in the Vietnam National Heart Institute, between June and December 2019. Validated instruments to assess QOL and health status describing patient-reported outcomes were used, including the EuroQOL-5 Dimensions-5 Level, Satisfaction with Life Scale, and Hospital Anxiety and Depression Scale. RESULTS The mean scores on the EuroQOL-descriptive system (EQ-DS) and EuroQOL visual analogue scale (EQ-VAS) were 0.792 (SD = 0.122, 95% confidence interval [CI] 0.769-0.815) and 66.3 (SD = 12.5, 95% CI 63.9-68.7), respectively. A total of 9.2% (n = 9) patients experienced life dissatisfaction. The prevalence of anxiety and depression were 18.7% (n = 20) and 11% (n = 12), respectively. Scores of QOL in patients aged > 30 years were lower than in those aged ≤ 30 years. Stratified multivariate logistic regression revealed that poor QOL related to being unemployed/unstable employment (OR 4.43, 95% CI 1.71-11.47, p = 0.002), life dissatisfaction associated with unmarried status (OR 4.63, 95% CI 1.2-17.86, p = 0.026), anxiety regarding unemployment/unstable employment (OR 3.88, 95% CI 1.27-11.84, p = 0.017) and complex CHD/PAH (OR 4.84, 95% CI 1.33-17.54, p = 0.016), and depression regarding unemployment/unstable employment (OR 4.63, 95% CI 1.22-17.59, p = 0.003). CONCLUSIONS Reduced QOL and elevated psychological problems were common experiences among hospitalized adults with CHD in Vietnam. Biological-social characteristics such as unmarried status, unemployment/unstable employment, and complex CHD/PAH related to poor QOL, life dissatisfaction, anxiety, and depression.
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Affiliation(s)
- Thanh-Huong Truong
- Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000 Vietnam
- Department of Cardiology, Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, 100000 Vietnam
| | - Ngoc-Thanh Kim
- Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000 Vietnam
- Department of Cardiology, Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, 100000 Vietnam
| | - Mai-Ngoc Thi Nguyen
- Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000 Vietnam
- Department of Cardiology, Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, 100000 Vietnam
| | - Doan-Loi Do
- Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000 Vietnam
- Department of Cardiology, Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, 100000 Vietnam
| | - Hong Thi Nguyen
- Thanh Nhan Hospital, 42 Thanh Nhan Street, Hai Ba Trung District, Hanoi, 100000 Vietnam
| | - Thanh-Tung Le
- Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000 Vietnam
| | - Hong-An Le
- School of Medicine and Pharmacy, Vietnam National University, 144 Xuan Thuy Road, Cau Giay District, Hanoi, 100000 Vietnam
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Sobanski PZ, Krajnik M, Goodlin SJ. Palliative Care for People Living With Heart Disease-Does Sex Make a Difference? Front Cardiovasc Med 2021; 8:629752. [PMID: 33634172 PMCID: PMC7901984 DOI: 10.3389/fcvm.2021.629752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 01/14/2021] [Indexed: 12/26/2022] Open
Abstract
The distribution of individual heart disease differs among women and men and, parallel to this, among particular age groups. Women are usually affected by cardiovascular disease at an older age than men, and as the prevalence of comorbidities (like diabetes or chronic pain syndromes) grows with age, women suffer from a higher number of symptoms (such as pain and breathlessness) than men. Women live longer, and after a husband or partner's death, they suffer from a stronger sense of loneliness, are more dependent on institutionalized care and have more unaddressed needs than men. Heart failure (HF) is a common end-stage pathway of many cardiovascular diseases and causes substantial symptom burden and suffering despite optimal cardiologic treatment. Modern, personalized medicine makes every effort, including close cooperation between disciplines, to alleviate them as efficiently as possible. Palliative Care (PC) interventions include symptom management, psychosocial and spiritual support. In complex situations they are provided by a specialized multiprofessional team, but usually the application of PC principles by the healthcare team responsible for the person is sufficient. PC should be involved in usual care to improve the quality of life of patients and their relatives as soon as appropriate needs emerge. Even at less advanced stages of disease, PC is an additional layer of support added to disease modifying management, not only at the end-of-life. The relatively scarce data suggest sex-specific differences in symptom pathophysiology, distribution and the requisite management needed for their successful alleviation. This paper summarizes the sex-related differences in PC needs and in the wide range of interventions (from medical treatment to spiritual support) that can be considered to optimally address them.
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Affiliation(s)
- Piotr Z Sobanski
- Palliative Care Unit and Competence Center, Department of Internal Medicine, Spital Schwyz, Schwyz, Switzerland
| | - Malgorzata Krajnik
- Department of Palliative Care, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Sarah J Goodlin
- Geriatrics and Palliative Medicine, Veterans Affairs Portland Health Care System, Department of Medicine, Oregon Health and Sciences University, Patient-Centered Education and Research, Portland, OR, United States
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Jackson JL, Fox KR, Kovacs AH. Psychological Needs, Assessment, and Treatment in the Care of Adults with Congenital Heart Disease. Cardiol Clin 2020; 38:305-316. [PMID: 32622486 DOI: 10.1016/j.ccl.2020.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Although the majority of congenital heart disease survivors are thriving, many are at risk for declining emotional well-being as they age. Emotional distress is a risk factor for poorer health outcomes and must be addressed. Primary care and cardiology teams may be the first line of defense in identifying and providing referral resources for symptoms of depression, anxiety, and medical trauma. The current review provides information about commonly used self-report measures of emotional distress to identify symptoms that warrant referral and describes multiple options for addressing these symptoms.
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Affiliation(s)
- Jamie L Jackson
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, NEOB, 3rd Floor, Columbus, OH 43205, USA.
| | - Kristen R Fox
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, NEOB, 3rd Floor, Columbus, OH 43205, USA
| | - Adrienne H Kovacs
- Oregon Health and Science University, Knight Cardiovascular Institute, 3181 Southwest Sam Jackson Park Road, UHN-62, Portland, OR 97239, USA
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Noorani S, Roy B, Sahib AK, Cabrera-Mino C, Halnon NJ, Woo MA, Lewis AB, Pike NA, Kumar R. Caudate nuclei volume alterations and cognition and mood dysfunctions in adolescents with single ventricle heart disease. J Neurosci Res 2020; 98:1877-1888. [PMID: 32530059 DOI: 10.1002/jnr.24667] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 11/12/2022]
Abstract
Adolescents with single ventricle heart disease (SVHD) exhibit mood and cognitive deficits, which may result from injury to the basal ganglia structures, including the caudate nuclei. However, the integrity of the caudate in SVHD adolescents is unclear. Our aim was to examine the global and regional caudate volumes, and evaluate the relationships between caudate volumes and cognitive and mood scores in SVHD and healthy adolescents. We acquired two high-resolution T1-weighted images from 23 SVHD and 37 controls using a 3.0-Tesla MRI scanner, as well as assessed mood (Patient Health Questionnaire-9 [PHQ-9]; Beck Anxiety Inventory [BAI]) and cognition (Montreal Cognitive Assessment [MoCA]; Wide Range Assessment of Memory and Learning-2; General Memory Index [GMI]) functions. Both left and right caudate nuclei were outlined, which were then used to calculate and compare volumes between groups using ANCOVA (covariates: age, gender, and head-size), as well as perform 3D surface morphometry. Partial correlations (covariates: age, gender, and head-size) were used to examine associations between caudate volumes, cognition, and mood scores in SVHD and controls. SVHD subjects showed significantly higher PHQ-9 and BAI scores, indicating more depressive and anxiety symptoms, as well as reduced GMI scores, suggesting impaired cognition, compared to controls. SVHD patients showed significantly reduced caudate volumes (left, 3,198.8 ± 490.1 vs. 3,605.0 ± 480.4 mm3 , p < 0.004; right, 3,162.1 ± 475.4 vs. 3,504.8 ± 465.9 mm3 , p < 0.011) over controls, and changes were localized in the rostral, mid-dorsolateral, and caudal areas. Significant negative correlations emerged between caudate volumes with PHQ-9 and BAI scores and positive correlations with GMI and MoCA scores in SVHD and controls. SVHD adolescents show significantly reduced caudate volumes, especially in sites that have projections to regulate mood and cognition, which may result from developmental and/or hypoxia-/ischemia-induced processes.
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Affiliation(s)
- Sarah Noorani
- Department of Anesthesiology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, USA
| | - Bhaswati Roy
- Department of Anesthesiology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, USA
| | - Ashish K Sahib
- Department of Anesthesiology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Nancy J Halnon
- Division of Pediatric Cardiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Mary A Woo
- UCLA School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Alan B Lewis
- Division of Pediatric Cardiology, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Nancy A Pike
- UCLA School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Rajesh Kumar
- Department of Anesthesiology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, USA.,Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA.,Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA.,Brain Research Institute, University of California Los Angeles, Los Angeles, CA, USA
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Liu Z, Zhou X, Zhang W, Zhou L. Resilience and its correlates among first ischemic stroke survivors at acute stage of hospitalization from a tertiary hospital in China:a cross-sectional study. Aging Ment Health 2020; 24:828-836. [PMID: 30596461 DOI: 10.1080/13607863.2018.1550630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objectives: To measure the resilience of elderly patients with first ischemic stroke in mainland China and to identify variables that may be correlated with resilience at the acute stage of hospitalization.Methods: A cross-sectional survey was carried out in departments of neurology of two tertiary hospitals, where a convenience sample of one hundred and forty-seven elderly patients with first ischemic stroke voluntarily participated in our study. Resilience was assessed using the Chinese version of Connor-Davidson Resilience Scale with three dimensions (tenacity, strength, and optimism). The General Self-Efficacy Scale and Medical Coping Modes Questionnaire were applied to evaluate the respondents' general self-efficacy and coping style. Functional independency was also measured using the Functional Independency Measure.Results: The mean score of the 147 respondents' resilience was 62.51 ± 14.69. Together, general self-efficacy, resignation, confrontation, per capital monthly income, and being main source of family income explained 68.1% of the variance in resilience. General self-efficacy, resignation, and confrontation were the strongest explanatory factors. Specifically, 63.4% of the variance in tenacity was explained for general self-efficacy, resignation, being main source of family income, surgical history, and per capital monthly income. 63.2% of the variance in strength was ascribed to general self-efficacy, resignation, per capital monthly income and avoidance. 32.5% of the variance in optimism was attributed to general self-efficacy, religion, and resignation.Conclusion: General self-efficacy and coping style may be implied orientation in enhancing resilience of elderly patients with first ischemic stroke at acute hospitalization. Moreover, economic status may predict level of resilience.HighlightsResilience was measured in 147 older first-episode ischemic stroke survivors at acute hospitalization.General-efficacy was the strongest predictor of resilience.Resilience was significantly influenced by resignation.Coping strategy should be emphasized early after stroke.
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Affiliation(s)
- Zhihui Liu
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
| | - Xuan Zhou
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
| | - Wei Zhang
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
| | - Lanshu Zhou
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
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Wang QF, Rouse S, Hay M, Menahem S. Does Previous Cardiac Surgery Predict Impaired Quality of Life in Adults With Congenital Heart Disease? World J Pediatr Congenit Heart Surg 2020; 11:304-309. [PMID: 32293999 DOI: 10.1177/2150135120908185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Improved survival of children with congenital heart disease (CHD) into adult life has led to further study of their quality of life (QoL) and its determinants. The QoL including the symptoms of anxiety and depression of adults with CHD was analyzed to determine the relationship, if any, between prior cardiac surgery and QoL. METHODS Adults with CHD who were recruited from a single community-based cardiology practice completed self-reported questionnaires on their QoL, which included symptoms of anxiety and depression. Standard linear regression analysis was used to determine whether prior cardiac surgery predicted lower QoL scores. RESULTS One hundred forty-nine adult patients with CHD were sent QoL questionnaires. Completed questionnaires were received from 135 patients: 71 (53%) males and 64 (47%) females, with a mean age of 26.3 years (standard deviation: 7.8, min: 17, max: 49). Respondents were assigned to two groups: those who had (n = 89, 66%) or had not (n = 46, 34%) previously undergone one or more cardiac surgical interventions. Results from standard linear regression analyses revealed no predictive relationship between history of previous cardiac surgery, whether one or more operations, and QoL. CONCLUSIONS Among adult patients with CHD who completed QoL questionnaires, we observed no association between a patient's history of prior cardiac surgery and self-reported QoL measures. This welcome and important finding may be a reflection of the good functional capacity of both groups (postsurgical and nonsurgical) irrespective of the original CHD diagnosis and need for surgical intervention.
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Affiliation(s)
- Qi Feng Wang
- Royal Australian College of General Practitioners, West Leederville, Western Australia, Australia
| | - Sarah Rouse
- Department of Medical Education, University of Melbourne, Parkville, Victoria, Australia
| | - Margaret Hay
- Monash Institute for Health and Clinical Education, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Samuel Menahem
- School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
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Hashemi-Aliabadi S, Jalali A, Rahmati M, Salari N. Group reminiscence for hope and resilience in care-seekers who have attempted suicide. Ann Gen Psychiatry 2020; 19:4. [PMID: 31969928 PMCID: PMC6964065 DOI: 10.1186/s12991-020-0257-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rate of attempting suicide is growing due to the increasing social and economic problems and a variety of stresses taken by individuals in their lives. Helping people, boosting hope, and improving resilience to life hardships might be helpful in this area. This paper is an attempt to determine the effects of group reminiscence on hope and resilience in care-seekers who have attempted suicide. METHOD The study was carried out as a quasi-experimental interventional study. The participants were 57 care-seekers with a history of attempting suicide who met the inclusion criteria. The sampling was done through convenience sampling and the participants were grouped into control (n = 29) and experimental (n = 28) groups randomly. The experimental group received integrated reminiscence sessions (eight sessions; 60-90 min). Hope and resilience of the subjects were measured using Schneider's Hope Scale and Connor and Davidson's Resilience Scale. The scales were filled out by the subjects before, immediately after, and 4 weeks after the intervention. RESULTS The mean scores of hope in the experimental and control groups were 34.60 and 38.04, respectively, before the intervention. These figures immediately after the intervention were 44.07 and 35.96 in the experimental and control groups, respectively. 4 weeks after the intervention, the mean scores of hope in the experimental and control groups were 44.39 and 35.79, respectively, which is a statistically significant difference (p < 0.05). In terms of resilience, the mean scores in the experimental and control groups before the intervention were 48.17 and 57.51, respectively; and immediately after the intervention, these figures were 67.71 and 52.75, respectively. 4 weeks of the intervention, the mean scores of resilience were 59.17 and 52.24, respectively, which is a statistically significant difference (p < 0.05). CONCLUSION Group reminiscence has a positive effect on boosting hope and resilience in care-seekers who have attempted suicide.
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Affiliation(s)
- Somayeh Hashemi-Aliabadi
- 1Department of Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Jalali
- 2Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahmoud Rahmati
- 1Department of Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- 3Biostatistics Department, School of Nursing & Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Abu HO, McManus DD, Lessard DM, Kiefe CI, Goldberg RJ. Religious practices and changes in health-related quality of life after hospital discharge for an acute coronary syndrome. Health Qual Life Outcomes 2019; 17:149. [PMID: 31481073 PMCID: PMC6724337 DOI: 10.1186/s12955-019-1218-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 08/27/2019] [Indexed: 01/17/2023] Open
Abstract
Background Religious beliefs and practices influence coping mechanisms and quality of life in patients with various chronic illnesses. However, little is known about the influence of religious practices on changes in health-related quality of life (HRQOL) among hospital survivors of an acute coronary syndrome (ACS). The present study examined the association between several items assessing religiosity and clinically meaningful changes in HRQOL between 1 and 6 months after hospital discharge for an ACS. Methods We recruited patients hospitalized for an ACS at six medical centers in Central Massachusetts and Georgia (2011–2013). Participants reported making petition prayers for their health, awareness of intercessory prayers by others, and deriving strength/comfort from religion. Generic HRQOL was assessed with the SF-36®v2 physical and mental component summary scores. Disease-specific HRQOL was evaluated using the Seattle Angina Questionnaire Quality of Life subscale (SAQ-QOL). We separately examined the association between each measure of religiosity and the likelihood of experiencing clinically meaningful increase in disease-specific HRQOL (defined as increases by ≥10.0 points) and Generic HRQOL (defined as increases by ≥3.0 points) between 1- and 6-months post-hospital discharge. Results Participants (n = 1039) were, on average, 62 years old, 33% were women, and 86% were non-Hispanic White. Two-thirds reported praying for their health, 88% were aware of intercessions by others, and 85% derived strength/comfort from religion. Approximately 42, 40, and 26% of participants experienced clinically meaningful increases in their mental, physical, and disease-specific HRQOL respectively. After adjustment for sociodemographic, psychosocial, and clinical characteristics, petition (aOR:1.49; 95% CI: 1.09–2.04) and intercessory (aOR:1.72; 95% CI: 1.12–2.63) prayers for health were associated with clinically meaningful increases in disease-specific and physical HRQOL respectively. Conclusions Most ACS survivors in a contemporary, multiracial cohort acknowledged praying for their health, were aware of intercessory prayers made for their health and derived strength and comfort from religion. Patients who prayed for their health and those aware of intercessions made for their health experienced improvement in their generic physical and disease-specific HRQOL over time. Healthcare providers should recognize that patients may use prayer as a coping strategy for improving their well-being and recovery after a life-threatening illness. Electronic supplementary material The online version of this article (10.1186/s12955-019-1218-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hawa O Abu
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA.
| | - David D McManus
- Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA, 01605, USA
| | - Darleen M Lessard
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA
| | - Catarina I Kiefe
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA
| | - Robert J Goldberg
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA
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McGrath LB, Kovacs AH. Psychological resilience: Significance for pediatric and adult congenital cardiology. PROGRESS IN PEDIATRIC CARDIOLOGY 2019. [DOI: 10.1016/j.ppedcard.2019.101129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Liu Z, Zhou X, Zhang W, Zhou L. Factors associated with quality of life early after ischemic stroke: the role of resilience. Top Stroke Rehabil 2019; 26:335-341. [DOI: 10.1080/10749357.2019.1600285] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Zhihui Liu
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
| | - Xuan Zhou
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
| | - Wei Zhang
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
| | - Lanshu Zhou
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
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Can You Hear Me Now? Playing the Long Game in Cardiac Critical Care. Pediatr Crit Care Med 2019; 20:384-385. [PMID: 30950991 DOI: 10.1097/pcc.0000000000001844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The role of illness uncertainty in the relationship between disease knowledge and patient-reported outcomes among adolescents and adults with congenital heart disease. Heart Lung 2018; 48:325-330. [PMID: 30471879 DOI: 10.1016/j.hrtlng.2018.10.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Greater general disease knowledge predicts better patient-reported outcomes (PROs) among congenital heart disease (CHD) survivors, but higher illness uncertainty is associated with elevated emotional distress and poorer well-being among patients with chronic disease. OBJECTIVES This study explored the relationship of illness uncertainty and disease knowledge with emotional distress and health-related quality of life (HRQoL) among patients with CHD. METHODS Individuals with CHD (N = 169, ages 15-39) completed self-report measures of disease knowledge (general and risk-related), illness uncertainty, depressive and anxiety symptoms, and HRQoL. Pearson correlations and regressions analyses were utilized. RESULTS Greater risk-related knowledge was associated with greater anxiety (b = .41, p = .03, 95% CI = [.04, .77]) and poorer emotional HRQoL (b = -.53, p = .03, 95% CI = [-1.02, -.05]) when illness uncertainty was higher. CONCLUSION When individuals with CHD feel uncertain about their disease course and outcomes, knowledge about future cardiovascular risks may result in higher levels of distress.
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Abu HO, Ulbricht C, Ding E, Allison JJ, Salmoirago-Blotcher E, Goldberg RJ, Kiefe CI. Association of religiosity and spirituality with quality of life in patients with cardiovascular disease: a systematic review. Qual Life Res 2018; 27:2777-2797. [PMID: 29948601 PMCID: PMC6196107 DOI: 10.1007/s11136-018-1906-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE This review systematically identified and critically appraised the available literature that has examined the association between religiosity and/or spirituality (R/S) and quality of life (QOL) in patients with cardiovascular disease (CVD). METHODS We searched several electronic online databases (PubMed, SCOPUS, PsycINFO, and CINAHL) from database inception until October 2017. Included articles were peer-reviewed, published in English, and quantitatively examined the association between R/S and QOL. We assessed the methodological quality of each included study. RESULTS The 15 articles included were published between 2002 and 2017. Most studies were conducted in the US and enrolled patients with heart failure. Sixteen dimensions of R/S were assessed with a variety of instruments. QOL domains examined were global, health-related, and disease-specific QOL. Ten studies reported a significant positive association between R/S and QOL, with higher spiritual well-being, intrinsic religiousness, and frequency of church attendance positively related with mental and emotional well-being. Approximately half of the included studies reported negative or null associations. CONCLUSIONS Our findings suggest that higher levels of R/S may be related to better QOL among patients with CVD, with varying associations depending on the R/S dimension and QOL domain assessed. Future longitudinal studies in large patient samples with different CVDs and designs are needed to better understand how R/S may influence QOL. More uniformity in assessing R/S would enhance the comparability of results across studies. Understanding the influence of R/S on QOL would promote a holistic approach in managing patients with CVD.
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Affiliation(s)
- Hawa O Abu
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
| | - Christine Ulbricht
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Eric Ding
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Jeroan J Allison
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Elena Salmoirago-Blotcher
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, 02903, USA
- Department of Epidemiology, Brown School of Public Health, Providence, RI, 02903, USA
- Warren Alpert School of Medicine & School of Public Health, Brown University, Providence, RI, 02903, USA
| | - Robert J Goldberg
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Catarina I Kiefe
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
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Rometsch S, Greutmann M, Latal B, Bernaschina I, Knirsch W, Schaefer C, Oxenius A, Landolt MA. Predictors of quality of life in young adults with congenital heart disease. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2018; 5:161-168. [DOI: 10.1093/ehjqcco/qcy046] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 09/13/2018] [Accepted: 09/18/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Sarah Rometsch
- Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland
| | - Matthias Greutmann
- Department of Cardiology, University Hospital Zurich, Rämistrasse 100, Zurich, Switzerland
| | - Beatrice Latal
- Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland
| | - Ivana Bernaschina
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Binzmühlestrasse 14, Zurich, Switzerland
| | - Walter Knirsch
- Division of Pediatric Cardiology, Pediatric Heart Center, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland
| | - Christina Schaefer
- Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland
| | - Angela Oxenius
- Department of Cardiology, University Hospital Zurich, Rämistrasse 100, Zurich, Switzerland
- Division of Pediatric Cardiology, Pediatric Heart Center, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Binzmühlestrasse 14, Zurich, Switzerland
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Watson CG, Stopp C, Newburger JW, Rivkin MJ. Graph theory analysis of cortical thickness networks in adolescents with d-transposition of the great arteries. Brain Behav 2018; 8:e00834. [PMID: 29484251 PMCID: PMC5822582 DOI: 10.1002/brb3.834] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 08/07/2017] [Accepted: 08/16/2017] [Indexed: 01/01/2023] Open
Abstract
Objective Adolescents with d-transposition of the great arteries (d-TGA) who had the arterial switch operation in infancy have been found to have structural brain differences compared to healthy controls. We used cortical thickness measurements obtained from structural brain MRI to determine group differences in global brain organization using a graph theoretical approach. Methods Ninety-two d-TGA subjects and 49 controls were scanned using one of two identical 1.5-Tesla MRI systems. Mean cortical thickness was obtained from 34 regions per hemisphere using Freesurfer. A linear model was used for each brain region to adjust for subject age, sex, and scanning location. Structural connectivity for each group was inferred based on the presence of high inter-regional correlations of the linear model residuals, and binary connectivity matrices were created by thresholding over a range of correlation values for each group. Graph theory analysis was performed using packages in R. Permutation tests were performed to determine significance of between-group differences in global network measures. Results Within-group connectivity patterns were qualitatively different between groups. At lower network densities, controls had significantly more long-range connections. The location and number of hub regions differed between groups: controls had a greater number of hubs at most network densities. The control network had a significant rightward asymmetry compared to the d-TGA group at all network densities. Conclusions Using graph theory analysis of cortical thickness correlations, we found differences in brain structural network organization among d-TGA adolescents compared to controls. These may be related to the white matter and gray matter differences previously found in this cohort, and in turn may be related to the cognitive deficits this cohort presents.
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Affiliation(s)
- Christopher G. Watson
- Graduate Program for NeuroscienceBoston UniversityBostonMAUSA
- Department of NeurologyBoston Children's HospitalBostonMAUSA
| | - Christian Stopp
- Department of CardiologyBoston Children's HospitalBostonMAUSA
| | - Jane W. Newburger
- Department of CardiologyBoston Children's HospitalBostonMAUSA
- Department of PediatricsHarvard Medical SchoolBostonMAUSA
| | - Michael J. Rivkin
- Department of NeurologyBoston Children's HospitalBostonMAUSA
- Department of RadiologyBoston Children's HospitalBostonMAUSA
- Department of PsychiatryBoston Children's HospitalBostonMAUSA
- Department of NeurologyHarvard Medical SchoolBostonMAUSA
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Im YM, Yun TJ, Lee S. Health condition and familial factors associated with health-related quality of life in adolescents with congenital heart disease: a cross sectional study. Health Qual Life Outcomes 2018; 16:9. [PMID: 29321028 PMCID: PMC5763546 DOI: 10.1186/s12955-018-0841-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 01/04/2018] [Indexed: 11/12/2022] Open
Abstract
Background The focus of clinical care after the repair of congenital heart disease has shifted from saving life of the patient to the patient’s quality of life. The purpose of this study was to examine the health condition and familial factors associated with the health related quality of life of adolescents with congenital heart disease. Methods Ninety-eight adolescents aged 13–19 years were collected from a congenital heart clinic from July 22 to August 23, 2013. Perceptions of parental rearing behaviors, health related quality of life of adolescent with congenital heart disease, and general characteristics were measured. We used multiple linear regression analysis to explore factors that are associated with the health related quality of life of adolescents with congenital heart disease. Results New York heart association class (Adj R2 = .186, p = .000), presence of siblings (Adj R2 = .240, p = .010), and mother’s emotional warmth (Adj R2 = .265, p = .043) were significantly associated with the health related quality of life of adolescents with congenital heart disease. Conclusions Emotionally warm parental rearing behaviors and the presence of siblings were important familial factors that were positively associated with HRQOL in adolescents with CHD. Therefore, it is important for healthcare providers to develop a greater sensitivity to, and awareness of, the familial influences that may be impacting a subject’s HRQOL, as well as the exigencies of the CHD, itself.
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Affiliation(s)
- Yu-Mi Im
- Seoul Women's College of Nursing Seoul, 38, Ganhodae-ro, Seodaemun-gu, Seoul, 03617, South Korea
| | - Tae-Jin Yun
- Division of Pediatric Cardiac Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sunhee Lee
- College of Nursing, the Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea.
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Singh S, Kumar R, Roy B, Woo MA, Lewis A, Halnon N, Pike N. Regional brain gray matter changes in adolescents with single ventricle heart disease. Neurosci Lett 2017; 665:156-162. [PMID: 29222023 DOI: 10.1016/j.neulet.2017.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/20/2017] [Accepted: 12/04/2017] [Indexed: 11/25/2022]
Abstract
Adolescents with single ventricle heart disease (SVHD) show autonomic, mood, and cognitive deficits, indicating aberrations in brain areas that regulate these functions. However, the gray matter integrity in autonomic, mood, and cognitive control sites is unclear. We examined regional brain gray matter changes, using high-resolution T1-weighted images (3.0-T magnetic resonance scanner) with voxel based morphometry procedures, as well as mood and cognitive functions in SVHD (n=18; age, 15.7±1.1years; male, 10) and controls (n=31; age, 16.0±1.1years; male, 17). High-resolution T1-weighted images were realigned, gray matter tissue type partitioned, normalized to a common space, smoothed, and compared between groups (analysis of covariance; covariates, age and gender). The mood and cognitive scores were compared between groups using independent samples t-tests. SVHD subjects showed significantly altered mood and cognitive functions over controls. Significantly reduced gray matter emerged in multiple brain areas, including the thalamus, caudate nuclei, putamen, insula, prefrontal, post-central and precentral gyrus, occipital gyrus, para-hippocampal gyrus, temporal gyrus, and cerebellar sites in SVHD over controls. SVHD subjects show compromised gray matter integrity in autonomic, mood and cognitive control sites. The findings indicate that frequent deficits found in SVHD subjects have a brain structural basis in the condition.
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Affiliation(s)
- Sadhana Singh
- Department of Anesthesiology, University of California, Los Angeles, CA, USA
| | - Rajesh Kumar
- Department of Anesthesiology, University of California, Los Angeles, CA, USA; Department of Radiological Sciences, University of California, Los Angeles, CA, USA; Department of Bioengineering, University of California, Los Angeles, CA, USA; Brain Research Institute, University of California, Los Angeles, CA, USA.
| | - Bhaswati Roy
- UCLA School of Nursing, University of California, Los Angeles, CA, USA
| | - Mary A Woo
- UCLA School of Nursing, University of California, Los Angeles, CA, USA
| | - Alan Lewis
- Division of Pediatric Cardiology, Children's Hospital, Los Angeles, CA, USA
| | - Nancy Halnon
- Division of Pediatric Cardiology, University of California, Los Angeles, CA, USA
| | - Nancy Pike
- UCLA School of Nursing, University of California, Los Angeles, CA, USA.
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Abstract
BACKGROUND Following improved survival rates in children with CHD, their quality of life and its determinants have become increasingly important. As part of a multicentre study entitled "Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart Disease - International Study", this article reviews the relationships among quality of life, anxiety and depression, sense of coherence, and severity of disease in an Australian cohort of adults with CHD. Methods and results Adults with CHD were recruited from a single, community-based cardiology practice. All patients completed a self-reported questionnaire. A total of 135 patients, 71 males and 64 females, were recruited with a mean age of 26 years. The median quality of life in this cohort was 90; one-fifth of the patients experienced symptoms of anxiety. There was a significant negative correlation between quality of life and symptoms of anxiety and depression and a positive correlation between quality of life and sense of coherence. CONCLUSIONS The quality of life of this cohort was generally excellent; however, one-fifth of them experienced symptoms of anxiety. Those with less anxiety and depression symptoms appeared to have a better quality of life, as did those who reported a higher sense of coherence. Interestingly, there was no significant relationship between complexity of CHD and quality of life.
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Moon JR, Song J, Huh J, Kang IS, Park SW, Chang SA, Yang JH, Jun TG. The Relationship between Parental Rearing Behavior, Resilience, and Depressive Symptoms in Adolescents with Congenital Heart Disease. Front Cardiovasc Med 2017; 4:55. [PMID: 28944224 PMCID: PMC5596069 DOI: 10.3389/fcvm.2017.00055] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 08/16/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives Parental rearing behavior is one factor that influences the strength of resilience. In turn, resilience influences depression. However, it is unclear whether resilience has a mediating effect on the relationship between parental rearing and depression in adolescents with congenital heart disease (CHD). Therefore, the associations between parental rearing behavior and resilience and between rearing behavior and symptoms of depression were investigated with respect to age, gender and disease severity. Subjects and methods Patients completed a parental rearing behavior questionnaire, a resilience scale and the Children’s Depression Inventory during a routine clinic visit. Structural equation modeling with maximum likelihood estimation was used to analyze the data. Results The median age of the 180 patients included in the study was 17.8 years, and 64% were male. Lower resilience was found to be associated with overprotection, punishment, rejection, and control. There was a strong relationship between resilience and symptoms of depression. Resilience varied according to gender, age group, and disease severity. Conclusion Parental rearing behaviors such as emotional warmth, rejection, punishment, control, and overprotection have a significant influence on adolescent’s resilience. When developing intervention programs to increase resilience and reduce depression in adolescents with CHD, parenting attitudes, gender, age, and CHD severity should be considered.
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Affiliation(s)
- Ju Ryoung Moon
- Department of Nursing, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Seoul, Korea
| | - Jinyoung Song
- Department of Pediatrics, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - June Huh
- Department of Pediatrics, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - I-Seok Kang
- Department of Pediatrics, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Woo Park
- Division of Cardiology, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung-A Chang
- Division of Cardiology, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Hyuk Yang
- Department of Thoracic & Cardiovascular Surgery, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae-Gook Jun
- Department of Thoracic & Cardiovascular Surgery, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Adult CHD patients under clinical follow-up have a similar quality of life to the general population in Malta. Cardiol Young 2017; 27:1051-1059. [PMID: 27834165 DOI: 10.1017/s1047951116001980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The improved survival of patients born with CHD has led to increasing interest in research on quality of life of adult survivors. We report the findings of the first study in Malta carried out to investigate quality of life in adults with CHD under follow-up. METHODS A self-reporting questionnaire modelled on the basis of the European Health Interview Survey 2008, including questions on mental health and vitality, was administered to consecutive adult CHD outpatients, aged 16 years and over, between May, 2013 and May, 2014. Foreigners and patients with learning difficulties or cognitive impairment were excluded. Quality-of-life data were compared with that from 371 age- and sex-matched 2008 survey responders - general population cohort. The impact of congenital lesion complexity, hospitalisation in the preceding 12 months, arrhythmias, co-morbidities, and cardiac medication use on quality of life of the CHD cohort was also investigated. RESULTS There were a total of 120 patient responders (63 males; mean age 30.53, SD 12.77 years). Overall, there were no significant differences in mental health and vitality between patient and general population cohorts, although older patients had better mental health scores compared with age-matched controls. Within the adult CHD cohort, hospitalisation in the preceding 12 months was the only factor associated with a poorer quality of life. CONCLUSIONS Overall, CHD has no negative impact on mental health and vitality in Maltese adult patients under follow-up. Patients needing frequent hospitalisations might warrant closer attention by clinical psychologists.
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Kasmi L, Bonnet D, Montreuil M, Kalfa D, Geronikola N, Bellinger DC, Calderon J. Neuropsychological and Psychiatric Outcomes in Dextro-Transposition of the Great Arteries across the Lifespan: A State-of-the-Art Review. Front Pediatr 2017; 5:59. [PMID: 28393063 PMCID: PMC5364136 DOI: 10.3389/fped.2017.00059] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 03/10/2017] [Indexed: 11/17/2022] Open
Abstract
Advances in prenatal diagnosis, perioperative management, and postoperative care have dramatically increased the population of survivors of neonatal and infant heart surgery. The high survival rate of these patients into adulthood has exposed the alarming prevalence of long-term neuropsychological and psychiatric morbidities. Dextro-transposition of the great arteries (d-TGA) is one of the most extensively studied cyanotic congenital heart defect (CHD) with regard to neurodevelopmental outcomes. Landmark studies have described a common neurodevelopmental and behavioral phenotype associated with d-TGA. Children with d-TGA display impairments in key neurocognitive areas, including visual-spatial and fine motor abilities, executive functioning, processing speed, and social cognition. As they grow older, they may face additional challenges with a worsening of deficits in higher order cognitive skills, problems in psychosocial adjustment and a higher-than-expected rate of psychiatric disorders, such as attention-deficit hyperactivity disorder, depression, and anxiety. The aim of this review is to summarize the available recent data on neuropsychological and psychiatric outcomes in individuals with d-TGA after the arterial switch operation. We present findings within a life-span perspective, with a particular emphasis on the emerging literature on adolescent and young adult outcomes. Finally, we propose avenues for future research in the CHD adult neuropsychology field. Among these avenues, we explore the potential mechanisms by which pediatric neurodevelopmental impairments may have lifelong adverse effects as well as alternative interventions that could optimize outcomes.
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Affiliation(s)
- Leila Kasmi
- Laboratory of Psychopathology and Neuropsychology, Department of Psychology, University Paris 8, Paris Lumières - CNRS , Saint-Denis , France
| | - Damien Bonnet
- Referral Center for Complex Congenital Cardiac Malformations, Department of Congenital and Pediatric Cardiology, Necker Hospital, University Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Michèle Montreuil
- Laboratory of Psychopathology and Neuropsychology, Department of Psychology, University Paris 8, Paris Lumières - CNRS , Saint-Denis , France
| | - David Kalfa
- Division of Cardiac, Thoracic, and Vascular Surgery, Section of Pediatric Cardiac Surgery, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Irving Medical Center, Columbia University , New York, NY , USA
| | - Nikoletta Geronikola
- Laboratory of Psychopathology and Neuropsychology, Department of Psychology, University Paris 8, Paris Lumières - CNRS , Saint-Denis , France
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Johanna Calderon
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA
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Carvalho IG, Bertolli EDS, Paiva L, Rossi LA, Dantas RAS, Pompeo DA. Anxiety, depression, resilience and self-esteem in individuals with cardiovascular diseases. Rev Lat Am Enfermagem 2016; 24:e2836. [PMID: 27901221 PMCID: PMC5172617 DOI: 10.1590/1518-8345.1405.2836] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 09/15/2016] [Indexed: 11/30/2022] Open
Abstract
Objectives: to analyze the relationship between anxiety and depression symptoms, resilience
and self-esteem with sociodemographic and clinical characteristics; correlate
resilience and self-esteem with age and duration of the disease; check
associations between anxiety and depression with measures of resilience and
self-esteem among individuals with cardiovascular diseases. Method: correlational study conducted in a large university hospital in the interior of
the state of São Paulo, Brazil. The population was composed of adult inpatients
with cardiovascular diseases. A non-probabilistic consecutive sample was composed
of 120 patients. Variables of interest were assessed using the Hospital Anxiety
and Depression Scale, Resilience Scale, and Rosenberg Self-Esteem Scale. Results: anxiety and depression symptoms were present in 32.5% and 17.5% of the patients,
respectively, and were associated with the female sex (p = 0.002; p = 0.022).
Manifestations of depression were associated with the presence of comorbidities (p
= 0.020). More resilient patients did not present depression symptoms (p <
0.001) and anxious women were more resilient (p = 0.042). The highest scores
regarding self-esteem were present in patients with anxiety and depression. Men
presented higher resilience and lower self-esteem compared to women. Conclusion: patients with anxiety and depression were less resilient but presented higher
self-esteem.
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Affiliation(s)
| | | | - Luciana Paiva
- PhD, RN, Hospital das Clínicas, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil
| | - Lidia Aparecida Rossi
- PhD, Full Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Rosana Aparecida Spadoti Dantas
- PhD, Associate Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Daniele Alcalá Pompeo
- PhD, Adjunct Professor, Departamento de Enfermagem Especializada, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil
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Westhoff-Bleck M, Briest J, Fraccarollo D, Hilfiker-Kleiner D, Winter L, Maske U, Busch MA, Bleich S, Bauersachs J, Kahl KG. Mental disorders in adults with congenital heart disease: Unmet needs and impact on quality of life. J Affect Disord 2016; 204:180-6. [PMID: 27367306 DOI: 10.1016/j.jad.2016.06.047] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/13/2016] [Accepted: 06/14/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In adult congenital heart disease (ACHD), mental health status and quality of life become important issues due to improved life expectancy. Current literature provides conflicting data regarding mental health status in ACHD. Furthermore, none of the studies so far compared prevalence rates with a matched control group. METHODS The prevalence of mental disorders was assessed in 150 ACHD using a structured interview, and compared to 12-months estimates of the general German population. Quality of life (QoL) was measured with World Health Organization Quality of Life instrument. Furthermore, we related the diagnostic results of widely used screening instruments for depression (Beck Depression Inventory-2; BDI-2; Hospital Anxiety and Depression Scale; HADS) with clinical diagnoses, to receive optimal sensitivity and specificity values. RESULTS The prevalence of psychiatric disorders was significantly higher in ACHD than in the general population (48.0%; CI: 44.7-60.0 vs. 35.7%; CI: 33.5-37.9). Mood (30.7%; CI: 24.0-38.0 vs. 10.7%;CI:9.4-12.0) and anxiety disorders (28.0%; CI:22.0-36.7 vs. 16.8%; CI: 15.0-18.6) were the leading causes of psychiatric illness. Sixteen of 150 ACHD patients (10.7%) received specific treatment for psychiatric disorders before entering the study. Overall quality of life was independently and negatively associated with a diagnosis of major depression (p<0.001), alcohol dependency (p=0.004), nicotine dependency (p=0.036), and NYHA class (p=0.007). Accuracy of the HADS-D and BDI-2 as screening instruments was moderate (AUC 0.60-0.81), depending on the cut-off score used. CONCLUSIONS Psychiatric disorders, particularly mood and anxiety disorders are significantly more frequent in ACHD compared to the general population. However, these disorders are rarely diagnosed resulting in under treatment and loss of quality of life. Quality of life is independently associated with the existence of mood, anxiety and substance use disorders. When self-rating instruments (BDI-2, HADS) are used as screening instruments in ACHD care, lower cut-off values are recommended.
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Affiliation(s)
| | - Juliane Briest
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | | | | | - Lotta Winter
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Ulrike Maske
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Markus A Busch
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Germany
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany.
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Clark JMR, Marszalek JM, Bennett KK, Harry KM, Howarter AD, Eways KR, Reed KS. Comparison of factor structure models for the Beck Anxiety Inventory among cardiac rehabilitation patients. J Psychosom Res 2016; 89:91-7. [PMID: 27663116 DOI: 10.1016/j.jpsychores.2016.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 08/10/2016] [Accepted: 08/11/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Individuals with cardiovascular disease (CVD) experience greater rates of distress symptoms, such as anxiety and depressive symptoms, than the general population. These psychological outcomes have been linked to greater risk for negative outcomes following a cardiac event; however, research examining the relationship between specific components of anxiety and outcomes in CVD is limited. Further, prior research has not investigated the structure of anxiety symptoms in CVD. This study sought to compare previously established one, two, and four-factor models of the Beck Anxiety Inventory (BAI) in individuals enrolled in cardiac rehabilitation (CR). METHODS Our sample included 208 individuals with CVD recruited during enrollment in a phase II CR program. Participants completed the BAI at enrollment in CR (Time 1) and again 12weeks later at CR completion (Time 2, n=151). RESULTS Consistent with prior literature, 41% of our sample reported at least mild symptoms of anxiety (BAI>8), and the BAI proved to be a reliable measure within this sample (α=0.89). Confirmatory factor analysis (CFA) results indicated that a second-order model with four first order factors, consisting of cognitive, autonomic, neuromotor, and panic components, fit our data well. A multi-group CFA approach supported measurement invariance across time. CONCLUSION These results suggest that anxiety following CVD can be evaluated based on cognitive, autonomic, neuromotor, and panic components as well as the encompassing anxiety construct.
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Affiliation(s)
- Jillian M R Clark
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States; College of Health Professions, Medical University of South Carolina, Charleston, SC, United States.
| | - Jacob M Marszalek
- Division of Counseling and Educational Psychology, School of Education, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Kymberley K Bennett
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Kadie M Harry
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Alisha D Howarter
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Kalon R Eways
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Karla S Reed
- College of Health Professions, Medical University of South Carolina, Charleston, SC, United States
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38
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Pike NA, Woo MA, Poulsen MK, Evangelista W, Faire D, Halnon NJ, Lewis AB, Kumar R. Predictors of Memory Deficits in Adolescents and Young Adults with Congenital Heart Disease Compared to Healthy Controls. Front Pediatr 2016; 4:117. [PMID: 27843890 PMCID: PMC5086579 DOI: 10.3389/fped.2016.00117] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 10/11/2016] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Adolescents and young adults with congenital heart disease (CHD) show a range of memory deficits, which can dramatically impact their clinical outcomes and quality of life. However, few studies have identified predictors of these memory changes. The purpose of this investigation was to identify predictors of memory deficits in adolescents and young adults with CHD after surgical palliation compared to healthy controls. METHOD One hundred fifty-six adolescents and young adults (80 CHD and 76 controls; age 14-21 years) were recruited and administered an instrument to assess memory [Wide Range Assessment of Memory and Learning Second Edition - general memory index (GMI) score] and completed questionnaires that measure anxiety, depression, sleepiness, health status, and self-efficacy. Descriptive and non-parametric statistics were used to assess group differences, and logistic regression to identify predictors of memory deficits. RESULTS CHD subjects consisted of 58% males, median age 17 years, 43% Hispanic, and medians of 2 previous heart surgeries and 14 years since last surgery. Memory deficits (GMI ≤ 85) were identified in 50% CHD compared to 4% healthy controls (median GMI 85 vs. 104, p < 0.001). Of GMI subscale medians, CHD subjects had significantly worse memory performance vs. healthy controls (verbal 88 vs. 105, p < 0.001; attention 88 vs. 109, p < 0.001; working memory 86 vs. 108, p < 0.001). No significant differences appeared between groups for visual memory. Multiple clinical and psychosocial factors were identified which were statistically different on bivariate analyses between the subjects with and without memory deficits. By multivariate analysis, male gender, number of surgeries, anxiety, and self-efficacy emerged as independent predictors of memory deficits. CONCLUSION Adolescents and young adults with CHD, more than a decade since their last surgery, show significant verbal, attention, and working memory deficits over controls. To enhance patient memory/self-care, clinicians should explore ways to reduce anxiety, improve self-efficacy, and increase use of visual patient education material, especially in CHD males.
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Affiliation(s)
- Nancy A Pike
- School of Nursing, University of California Los Angeles , Los Angeles, CA , USA
| | - Mary A Woo
- School of Nursing, University of California Los Angeles , Los Angeles, CA , USA
| | - Marie K Poulsen
- Division of General Pediatrics, Children's Hospital Los Angeles , Los Angeles, CA , USA
| | - Wendy Evangelista
- School of Nursing, University of California Los Angeles , Los Angeles, CA , USA
| | - Dylan Faire
- School of Nursing, University of California Los Angeles , Los Angeles, CA , USA
| | - Nancy J Halnon
- Division of Pediatric Cardiology, University of California Los Angeles , Los Angeles, CA , USA
| | - Alan B Lewis
- Division of Pediatric Cardiology, Children's Hospital Los Angeles , Los Angeles, CA , USA
| | - Rajesh Kumar
- Department of Anesthesiology, University of California Los Angeles, Los Angeles, CA, USA; Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA; Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA; The Brain Research Institute, University of California Los Angeles, Los Angeles, CA, USA
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Karsenty C, Maury P, Blot-Souletie N, Ladouceur M, Leobon B, Senac V, Mondoly P, Elbaz M, Galinier M, Dulac Y, Carrié D, Acar P, Hascoet S. The medical history of adults with complex congenital heart disease affects their social development and professional activity. Arch Cardiovasc Dis 2015; 108:589-97. [DOI: 10.1016/j.acvd.2015.06.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 05/05/2015] [Accepted: 06/09/2015] [Indexed: 11/29/2022]
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A Novel TBX1 Loss-of-Function Mutation Associated with Congenital Heart Disease. Pediatr Cardiol 2015; 36:1400-10. [PMID: 25860641 DOI: 10.1007/s00246-015-1173-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 04/02/2015] [Indexed: 12/21/2022]
Abstract
Congenital heart disease (CHD) is the most prevalent type of birth defect in humans and is the leading non-infectious cause of infant death worldwide. There is a growing body of evidence demonstrating that genetic defects play an important role in the pathogenesis of CHD. However, CHD is a genetically heterogeneous disease and the genetic basis underpinning CHD in an overwhelming majority of patients remains unclear. In this study, the coding exons and splice junction sites of the TBX1 gene, which encodes a T-box homeodomain transcription factor essential for proper cardiovascular morphogenesis, were sequenced in 230 unrelated children with CHD. The available family members of the index patient carrying an identified mutation and 200 unrelated ethnically matched healthy individuals used as controls were subsequently genotyped for TBX1. The functional effect of the TBX1 mutation was predicted by online program MutationTaster and characterized by using a dual-luciferase reporter assay system. As a result, a novel heterozygous TBX1 mutation, p.Q277X, was identified in an index patient with double outlet right ventricle (DORV) and ventricular septal defect (VSD). Genetic analysis of the proband's available relatives showed that the mutation co-segregated with CHD transmitted in an autosomal dominant pattern with complete penetrance. The nonsense mutation, which was absent in 400 control chromosomes, altered the amino acid that was completely conserved evolutionarily across species and was predicted to be disease-causing by MutationTaster. Biochemical analysis revealed that Q277X-mutant TBX1 lost transcriptional activating function when compared with its wild-type counterpart. This study firstly associates TBX1 loss-of-function mutation with enhanced susceptibility to DORV and VSD in humans, which provides novel insight into the molecular mechanism underlying CHD and suggests potential implications for the development of new preventive and therapeutic strategies for CHD.
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Jackson JL, Hassen L, Gerardo GM, Vannatta K, Daniels CJ. Medical factors that predict quality of life for young adults with congenital heart disease: What matters most? Int J Cardiol 2015; 202:804-9. [PMID: 26476036 DOI: 10.1016/j.ijcard.2015.09.116] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/24/2015] [Accepted: 09/28/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Identify demographic and medical status indicators that account for variability in physical and emotional health-related quality of life (QoL) among young adults with congenital heart disease (CHD) as compared to traditional lesion severity categories. METHODS Cross-sectional study of 218 young adult survivors of CHD (mean=25.7, SD=7.1 years). Participants were recruited from pediatric and adult CHD clinics at a pediatric and an adult hospital. Stepwise linear regression examined the unique contribution of demographic (age; sex; estimated income) and medical status indicators (comorbid conditions; treatment modality; ventricular function/functional capacity) on QoL compared to traditional lesion severity categories (simple; moderate; complex). RESULTS Lesion severity category accounted for a small portion of the variance in physical QoL (3%), but was not associated with emotional QoL. Lesion severity did not significantly contribute to the variability in physical QoL once other variables were entered. Having an estimated income of ≤$30,000, taking more than one cardiac-related medication, and having a New York Heart Association (NYHA) functional class designation>I was associated with poorer physical QoL and explained 23% of the variability. NYHA class was the only variable that explained a unique proportion of variance (7%) in emotional QoL, and having a NYHA class designation>I was associated with greater risk for poorer emotional functioning. CONCLUSIONS Findings suggested that several indicators readily available to treatment teams may provide important information about the risk for poor patient-reported outcomes of physical and emotional QoL among CHD survivors.
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Affiliation(s)
- Jamie L Jackson
- Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatrics, The Ohio State University, Columbus, OH, United States.
| | - Lauren Hassen
- College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Gina M Gerardo
- Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, United States
| | - Kathryn Vannatta
- Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatrics, The Ohio State University, Columbus, OH, United States
| | - Curt J Daniels
- Columbus Ohio Adult Congenital Heart Disease Program, Heart Center, Nationwide Children's Hospital, Columbus, OH, United States; Departments of Internal Medicine and Pediatrics, The Ohio State University, Columbus, OH, United States
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Diller GP, Bräutigam A, Kempny A, Uebing A, Alonso-Gonzalez R, Swan L, Babu-Narayan SV, Baumgartner H, Dimopoulos K, Gatzoulis MA. Depression requiring anti-depressant drug therapy in adult congenital heart disease: prevalence, risk factors, and prognostic value. Eur Heart J 2015; 37:771-82. [PMID: 26314687 DOI: 10.1093/eurheartj/ehv386] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/21/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Depression is prevalent in adults with congenital heart disease (ACHD), but limited data on the frequency of anti-depressant drug (ADD) therapy and its impact on outcome are available. METHODS AND RESULTS We identified all ACHD patients treated with ADDs between 2000 and 2011 at our centre. Of 6162 patients under follow-up, 204 (3.3%) patients were on ADD therapy. The majority of patients were treated with selective serotonin-reuptake inhibitors (67.4%), while only 17.0% of patients received tricyclic anti-depressants. Twice as many female patients used ADDs compared with males (4.4 vs. 2.2%, P < 0.0001). The percentage of patients on ADDs increased with disease complexity (P < 0.0001) and patient age (P < 0.0001). Over a median follow-up of 11.1 years, 507 (8.2%) patients died. After propensity score matching, ADD use was found to be significantly associated with worse outcome in male ACHD patients [hazard ratio 1.44 (95% confidence interval 1.17-1.84)]. There was no evidence that this excess mortality was directly related to ADD therapy, QT-prolongation, or malignant arrhythmias. However, males taking ADDs were also more likely to miss scheduled follow-up appointments compared with untreated counterparts, while no such difference in clinic attendance was seen in females. CONCLUSIONS The use of ADD therapy in ACHD relates to gender, age, and disease complexity. Although, twice as many female patients were on ADDs, it were their male counterparts, who were at increased mortality risk on therapy. Furthermore, males on ADDs had worse adherence to scheduled appointments suggesting the need for special medical attention and possibly psychosocial intervention for this group of patients.
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Affiliation(s)
- Gerhard-Paul Diller
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, NIHR Cardiovascular and Respiratory Biomedical Research Unit, Royal Brompton Hospital, London, UK National Heart and Lung Institute, Imperial College London, London, UK Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Albert-Schweitzer-Str. 33, Muenster 48149, Germany
| | - Andrea Bräutigam
- Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Albert-Schweitzer-Str. 33, Muenster 48149, Germany
| | - Aleksander Kempny
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, NIHR Cardiovascular and Respiratory Biomedical Research Unit, Royal Brompton Hospital, London, UK National Heart and Lung Institute, Imperial College London, London, UK
| | - Anselm Uebing
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, NIHR Cardiovascular and Respiratory Biomedical Research Unit, Royal Brompton Hospital, London, UK National Heart and Lung Institute, Imperial College London, London, UK
| | - Rafael Alonso-Gonzalez
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, NIHR Cardiovascular and Respiratory Biomedical Research Unit, Royal Brompton Hospital, London, UK National Heart and Lung Institute, Imperial College London, London, UK
| | - Lorna Swan
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, NIHR Cardiovascular and Respiratory Biomedical Research Unit, Royal Brompton Hospital, London, UK National Heart and Lung Institute, Imperial College London, London, UK
| | - Sonya V Babu-Narayan
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, NIHR Cardiovascular and Respiratory Biomedical Research Unit, Royal Brompton Hospital, London, UK National Heart and Lung Institute, Imperial College London, London, UK
| | - Helmut Baumgartner
- Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Albert-Schweitzer-Str. 33, Muenster 48149, Germany
| | - Konstantinos Dimopoulos
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, NIHR Cardiovascular and Respiratory Biomedical Research Unit, Royal Brompton Hospital, London, UK National Heart and Lung Institute, Imperial College London, London, UK
| | - Michael A Gatzoulis
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, NIHR Cardiovascular and Respiratory Biomedical Research Unit, Royal Brompton Hospital, London, UK National Heart and Lung Institute, Imperial College London, London, UK
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Wang J, Mao JH, Ding KK, Xu WJ, Liu XY, Qiu XB, Li RG, Qu XK, Xu YJ, Huang RT, Xue S, Yang YQ. A novel NKX2.6 mutation associated with congenital ventricular septal defect. Pediatr Cardiol 2015; 36:646-56. [PMID: 25380965 DOI: 10.1007/s00246-014-1060-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 10/31/2014] [Indexed: 12/18/2022]
Abstract
Congenital heart disease (CHD) is the most common birth defect and is the most prevalent non-infectious cause of infant death. Aggregating evidence demonstrates that genetic defects are involved in the pathogenesis of CHD. However, CHD is genetically heterogeneous and the genetic determinants for CHD in an overwhelming majority of patients remain unknown. In this study, the coding regions and splice junctions of the NKX2.6 gene, which encodes a homeodomain transcription factor crucial for cardiovascular development, were sequenced in 210 unrelated CHD patients. As a result, a novel heterozygous NKX2.6 mutation, p.K152Q, was identified in an index patient with ventricular septal defect (VSD). Genetic analysis of the proband's available family members showed that the mutation cosegregated with VSD transmitted as an autosomal dominant trait with complete penetrance. The missense mutation was absent in 400 control chromosomes and the altered amino acid was completely conserved evolutionarily across species. Due to unknown transcriptional targets of NKX2.6, the functional characteristics of the identified mutation at transcriptional activity were analyzed by using NKX2.5 as a surrogate. Alignment between human NKX2.6 and NKX2.5 proteins displayed that K152Q-mutant NKX2.6 was equivalent to K158Q-mutant NKX2.5, and introduction of K158Q into NKX2.5 significantly reduced its transcriptional activating function when compared with its wild-type counterpart. This study firstly links NKX2.6 loss-of-function mutation with increased susceptibility to isolated VSD, providing novel insight into the molecular mechanism underpinning VSD and contributing to the development of new preventive and therapeutic strategies for this common form of CHD.
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Affiliation(s)
- Juan Wang
- Department of Cardiology, Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065, China,
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Trevino KM, McConnell TR. Religiosity and religious coping in patients with cardiovascular disease: change over time and associations with illness adjustment. JOURNAL OF RELIGION AND HEALTH 2014; 53:1907-1917. [PMID: 24908582 DOI: 10.1007/s10943-014-9897-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Little is known about the longitudinal relationship between religiosity/spirituality (R/S) and patient physical and mental health in patients with cardiovascular disease. Forty-three patients with a first-time myocardial infarction or coronary artery revascularization bypass surgery completed measures of religiosity, religious coping, quality of life (QOL), and weight prior to a cardiac rehabilitation program and 1 and 2 years later. R/S changed over time; the direction of the change varied by type of R/S. Increases in religiosity were associated with increases in weight and QOL; increases in religious coping were associated with decreases in weight and increases in QOL.
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Affiliation(s)
- K M Trevino
- Psychology Department, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA,
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Kim GB. Psychosocial adjustment and quality of life of adolescents and adults with congenital heart disease. KOREAN JOURNAL OF PEDIATRICS 2014; 57:257-63. [PMID: 25076970 PMCID: PMC4115066 DOI: 10.3345/kjp.2014.57.6.257] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 05/16/2014] [Indexed: 11/27/2022]
Abstract
The incidence of people living with congenital heart disease (CHD) has been increasing every year owing to remarkable advances in surgical and catheter intervention techniques and devices, and improved knowledge of critical care for patients with CHD. However, these patients continue to face physical, psychosocial, and environmental challenges, and a number of studies have shown higher rates of depression and anxiety disorders than the general population. To improve psychosocial functioning and quality of life for adults with CHD, health care providers are recommended to inform CHD patients of an accurate diagnosis, and overall treatment process, beginning in adolescence to facilitate a smooth transition from adolescence to adulthood. Active cooperation with psychiatrists, psychologists, social workers, chaplains, and family members is highly recommended to help CHD patients feel normal and optimistic and to promote good social interactions, close family relationships, and a strong sense of coherence.
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Affiliation(s)
- Gi Beom Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
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Wei D, Gong XH, Qiu G, Wang J, Yang YQ. Novel PITX2c loss-of-function mutations associated with complex congenital heart disease. Int J Mol Med 2014; 33:1201-8. [PMID: 24604414 DOI: 10.3892/ijmm.2014.1689] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 02/27/2014] [Indexed: 11/06/2022] Open
Abstract
Congenital heart disease (CHD) is the most common form of birth defect in humans and is the leading non-infectious cause of infant mortality. Emerging evidence strongly suggests that genetic risk factors play an important role in the pathogenesis of CHD. However, CHD is of pronounced genetic heterogeneity, and the genetic defects responsible for CHD in an overwhelming majority of patients remain unclear. In this study, the entire coding region and splice junction sites of the PITX2c gene, which encodes a paired-like homeodomain transcription factor crucial for proper cardiovascular morphogenesis, was sequenced in 170 unrelated neonates with CHD. The available relatives of the mutation carriers and 200 unrelated ethnically matched healthy individuals were genotyped. The disease-causing potential of the PITX2c sequence variations was predicted by MutationTaster and PolyPhen-2. The functional effect of the mutations was characterized using a luciferase reporter assay system. As a result, 2 novel heterozygous PITX2c mutations, p.R91Q and p.T129S, were identified in 2 unrelated newborns with transposition of the great arteries and ventricular septal defect, respectively. A genetic scan of the pedigrees revealed that each mutation co-segregated with CHD transmitted in an autosomal dominant pattern with complete penetrance. The mutations, which altered the amino acids completely conserved evolutionarily, were absent in 400 normal chromosomes and were predicted to be causative. Functional analysis revealed that the PITX2c mutations were both associated with significantly diminished transcriptional activity compared with their wild-type counterpart. This study demonstrates the association between PITX2c loss-of-function mutations and the transposition of the great arteries and ventricular septal defect in humans, providing further insight into the molecular mechanisms responsible for CHD.
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Affiliation(s)
- Dong Wei
- Department of Neonatology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, P.R. China
| | - Xiao-Hui Gong
- Department of Neonatology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, P.R. China
| | - Gang Qiu
- Department of Neonatology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, P.R. China
| | - Juan Wang
- Department of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, P.R. China
| | - Yi-Qing Yang
- Department of Cardiology, Cardiovascular Research Laboratory and Central Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, P.R. China
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