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Houchi C, Marcil MJ, Nadarajah K, Mageau GA, Khairy P, Marin MF, Cossette M, Dubé MP, Chaix MA, Mongeon FP, Dore A, Mondésert B, Ibrahim R, Brouillette J. The Relationship Between Perceived Parenting Practices and Anxiety in Adults With Congenital Heart Disease. Can J Cardiol 2024:S0828-282X(24)00343-X. [PMID: 38705272 DOI: 10.1016/j.cjca.2024.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/31/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Patients with congenital heart disease (CHD) and their parents face challenges throughout their lives that can lead to anxiety lasting into adulthood. We aim to assess the association between perceived parenting practices and anxiety beyond paediatric medical-surgical histories in adults with CHD. METHODS A cross-sectional study of adults with CHD was conducted at the Montréal Heart Institute (MHI). Perception of parental practices during childhood was retrospectively assessed with the use of validated self-report questionnaires, and anxiety in adulthood was assessed with the use of the Hospital Anxiety and Depression Scale. Sociodemographic and medical information were collected from a questionnaire and medical records. Hierarchic multiple linear regression was conducted. RESULTS Of the 223 participants, the mean age was 46 ± 14 years and 59% were female. Perceived parenting practices explained more variance (11%) in the anxiety score than paediatric medical-surgical history (2%). In our final model, anxiety was significantly associated with age, parental history of anxiety, and positive parenting practices, but not with overprotection. CONCLUSIONS Parenting practices are associated with anxiety in adults with CHD beyond paediatric medical-surgical history and sociodemographic. Positive parenting practices may be protective against anxiety in adulthood. Longitudinal studies are needed to determine causality.
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Affiliation(s)
- Cylia Houchi
- Research Center, Montréal Heart Institute, Montréal, Québec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Marie-Joëlle Marcil
- Research Center, Montréal Heart Institute, Montréal, Québec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | | | - Geneviève A Mageau
- Department of Psychology, Faculty of Arts and Science, Université de Montréal, Montréal, Québec, Canada
| | - Paul Khairy
- Research Center, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Marie-France Marin
- Department of Psychology, Faculty of Social Sciences and Humanities, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Mariève Cossette
- Montréal Health Innovations Coordinating Centre, a division of the Montréal Heart Institute, Montréal, Québec, Canada
| | - Marie-Pierre Dubé
- Research Center, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Marie-A Chaix
- Research Center, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - François-Pierre Mongeon
- Research Center, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Annie Dore
- Research Center, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Blandine Mondésert
- Research Center, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Reda Ibrahim
- Research Center, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Judith Brouillette
- Research Center, Montréal Heart Institute, Montréal, Québec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
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Lee PT, Tan JL, Yan L, Foo JS, Koh CH, Gandhi M. Comparison of Functional Health Status and Health Related Quality of Life Between Adult Patients With Fontan Procedure and Noncongenital Heart Diseases. Curr Probl Cardiol 2023; 48:101975. [PMID: 37473950 DOI: 10.1016/j.cpcardiol.2023.101975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023]
Abstract
To compare functional health status and Health Related Quality of Life (HRQoL) between Fontan and non-congenital heart disease (CHD) patients in an Asian population. Functional health status and HRQoL (New York Heart Association (NYHA) functional class, Duke Activity Status Index (DASI), HeartQol and EQ-5D-5L) were measured. A total of 65 patients (twenty Fontan patients, mean age 28 ± 5; and 45 age-matched non-CHD patients, mean age 33 ± 5) were recruited. After adjustment for age, gender and ethnicity, there were no significant differences in functional health status and HRQoL between groups. In an Asian population, Fontan patients have similar functional health status and Health Related Quality of Life compared to non-CHD patients.
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Affiliation(s)
- Phong Teck Lee
- Department of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore.
| | - Ju Le Tan
- Department of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore
| | - Limin Yan
- Department of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore
| | - Jie Sheng Foo
- Department of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore
| | - Choong Hou Koh
- Department of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore
| | - Mihir Gandhi
- Department of Biostatistics, Singapore Clinical Research Institute, Singapore; Centre for Qualitative Medicine and Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Tampere Center for Child, Adolescent, and Maternal Health Research: Global Health Group, Tampere University, Tampere, Finland
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Marcil MJ, Houchi C, Nadarajah K, Khairy P, Mageau GA, Marin MF, Cossette M, Dubé MP, Chaix MA, Mongeon FP, Dore A, Mondésert B, Ibrahim R, Brouillette J. The Influence of Illness Perception and Coping on Anxiety in Adults With Congenital Heart Disease. JACC. ADVANCES 2023; 2:100425. [PMID: 38939437 PMCID: PMC11198082 DOI: 10.1016/j.jacadv.2023.100425] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/29/2023] [Accepted: 05/17/2023] [Indexed: 06/29/2024]
Abstract
Background Up to one-half of adults with congenital heart disease (CHD) experience psychological distress, including anxiety. Objectives This paper sought to: 1) assess the contribution of illness perception in explaining anxiety symptoms beyond sociodemographic and medical variables in adults with CHD; and 2) investigate the potential mediating effect of coping style. Methods CHD adult patients were recruited at Montreal Heart Institute between June 2019 and April 2021 for this cross-sectional study. Participants responded to self-reported questionnaires (Hospital Anxiety and Depression Scale, Brief Illness Perception Questionnaire, and Brief COPE). Medical characteristics (CHD complexity, NYHA functional class, and cardiac devices) were collected from medical records. We conducted hierarchical multiple linear regression and mediation analyses. Results Of the 223 participants (mean age 46 ± 14 years, 59% women), 15% had clinically significant anxiety symptoms. Medical and sociodemographic variables explained 15% of the variation in anxiety symptoms. Adding illness perception explained an additional 18% of the variation in anxiety. This R2 change was significant (F[1,188] = 49.06, P < 0.0001). Illness perception explained more variance (18%) than medical and sociodemographic variables combined. A more threatening perception of illness was associated with greater anxiety symptoms (β = 0.45, P < 0.0001). Furthermore, illness perception was associated with coping, which was linked to reduced anxiety symptoms. Coping response style accounted for 20% of the total effect of illness perception on anxiety. Conclusions Illness perception and coping are associated with anxiety in adults with CHD. Future initiatives should assess whether targeting these potentially modifiable factors effectively prevents or mitigates anxious symptoms in adults with CHD.
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Affiliation(s)
- Marie-Joëlle Marcil
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Cylia Houchi
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | | | - Paul Khairy
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Geneviève A. Mageau
- Department of Psychology, Faculty of Arts and Science, Université de Montréal, Montréal, Québec, Canada
| | - Marie-France Marin
- Department of Psychology, Faculty of Social Sciences and Humanities, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Mariève Cossette
- Montreal Health Innovations Coordinating Centre, A Division of the Montreal Heart Institute, Montréal, Québec, Canada
| | - Marie-Pierre Dubé
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Marie-A. Chaix
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - François-Pierre Mongeon
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Annie Dore
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Blandine Mondésert
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Reda Ibrahim
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Judith Brouillette
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
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Van Bulck L, Moons P. Unraveling Anxiety in Adults With Congenital Heart Disease: Untrodden Paths. JACC. ADVANCES 2023; 2:100450. [PMID: 38939439 PMCID: PMC11198601 DOI: 10.1016/j.jacadv.2023.100450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Affiliation(s)
- Liesbet Van Bulck
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
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Bergsten U, Dehlin M, Klingberg E, Landgren AJ, Jacobsson LTH. Gender differences in illness perceptions and disease management in patients with gout, results from a questionnaire study in Western Sweden. BMC Musculoskelet Disord 2023; 24:300. [PMID: 37061681 PMCID: PMC10105391 DOI: 10.1186/s12891-023-06416-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/10/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Aims were to examine gender differences in patients with gout with regard to a) self-reported gout severity, b) illness perceptions (IP), c) impact on daily activities and Quality of Life (QoL), d) advice from healthcare professionals, e) having changed dietary- or alcohol habits. METHODS Adult patients with gout identified in primary and secondary care in Sweden between 2015 and 2017 (n = 1589) were sent a questionnaire about demographics, gout disease severity, IP (using the Brief Illness Perception Questionnaire, (B-IPQ)) and disease management. T-tests, Chi square tests, ANalysis Of VAriance (ANOVA) and linear regression models were used for gender comparisons. RESULTS Eight hundred sixty-eight patients responded to the questionnaire. Women, n = 177 (20%), experienced more severe gout symptoms (p = 0.011), albeit similar frequencies of flares compared to men. Women experienced modest but significantly worse IP with regard to consequences, identity, concerns and emotional response (p < 0.05) as well as daily activities such as sleeping (p < 0.001) and walking (p = 0.042) and QoL (p = 0.004). Despite this and a higher frequency of obesity in women (38 vs 21%, P < 0.001) and alcohol consumption in men (p < 0.001), obese women had received significantly less advice regarding weight reduction (47 vs 65%, p = 0.041) compared to obese men. On the other hand, women reported having acted on dietary advice to a larger degree. CONCLUSIONS Despite only modestly worse gout severity and perception, women appear to have been given less information regarding self-management than men. These gender differences should be given attention and addressed in clinical care.
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Affiliation(s)
- Ulrika Bergsten
- Region Halland, Research and development department, Halmstad, Sweden
| | - Mats Dehlin
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden.
| | - Eva Klingberg
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
| | - Anton J Landgren
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
- Region Västra Götaland, Research and Development Primary Health Care, Södra Bohuslän, Gothenburg, Sweden
| | - Lennart T H Jacobsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
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Moons P, Van Bulck L, Daelman B, Luyckx K. Mental health in adult congenital heart disease. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2023. [DOI: 10.1016/j.ijcchd.2023.100455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Psychosocial Risk Factors for Health-Related Quality of Life in Adult Congenital Heart Disease. J Cardiovasc Nurs 2023; 38:70-83. [PMID: 36508238 DOI: 10.1097/jcn.0000000000000897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is variability in the impact of adult congenital heart disease (ACHD) on health-related quality of life (HRQoL). A greater insight into the impact of ACHD may be gained from investigating HRQoL in various diagnostic groups and considering the importance of psychosocial risk factors for poor HRQoL. OBJECTIVE We compared the HRQoL of people with ACHD with normative data from the general population and among 4 diagnostic groups and identified risk factors for poor HRQoL in ACHD from a comprehensive set of sociodemographic, clinical, and psychosocial factors. METHODS We conducted a cross-sectional study with 303 participants from 4 diagnostic groups Simple, Tetralogy of Fallot, Transposition of the Great Arteries, Single Ventricle who completed measures of illness perceptions, coping, social support, mood, and generic and disease-specific HRQoL. Data were analyzed using 1-sample t tests, analysis of variance, and hierarchical multiple regressions. RESULTS There was diminished psychosocial HRQoL in the Simple group compared with the general population. Consistently significant risk factors for poor HRQoL included younger age, a perception of more severe symptoms due to ACHD, depression, and anxiety. Clinical factors were poor predictors of HRQoL. CONCLUSIONS The findings highlight the need to develop intervention studies aiming to improve HRQoL in people with ACHD and the routine assessment of illness perceptions and mood problems during key periods in people's lives. This will help address patient misconceptions that could be tackled by clinicians or specialist nurses during routine outpatient appointments and identify people in need of psychological support.
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Geuens S, Leyen K, Raymaekers K, Prikken S, Willen J, Goemans N, De Waele L, Lemiere J, Luyckx K. Illness Perceptions and Illness Identity in Adolescents and Emerging Adults With Neuromuscular Disorders. Clin Child Psychol Psychiatry 2022:13591045221125631. [PMID: 36112900 DOI: 10.1177/13591045221125631] [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: 11/16/2022]
Abstract
BACKGROUND Neuromuscular disorders (NMD) are intrusive medical conditions with implications for psychosocial development. OBJECTIVES This paper explores illness perceptions and illness identity dimensions of youth with NMD. First, we compare illness identity outcomes and illness perceptions of NMD patients with a comparison group of adolescents with type 1 diabetes mellitus (DM). Second, we report about the relationships between NMD-related variables and illness perceptions and illness identity. METHODS Scores on the Brief Illness Perception Questionnaire and the Illness Identity Questionnaire were compared between a group of NMD patients (N = 59; 12-22 years) and an age- and gender-matched group of DM patients (N = 118). NMD-related variables included time since diagnosis, prognosis, wheelchair use, and physical limitations. RESULTS Youth with NMD scored significantly higher on two of the four illness identity dimensions than youth with DM. NMD patients reported significantly less positive illness perceptions, experienced more physical symptoms, and had a lower score on understanding of their illness. Within the NMD group, wheelchair-users have a better understanding of their disease than those who are not wheelchair-bound. CONCLUSIONS The present study is the first to investigate illness identity and illness perceptions in NMD. More research is needed to provide insight in the identity formation process of the growing group of adolescents with NMDs.
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Affiliation(s)
- Sam Geuens
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, 26657KU Leuven, Leuven, Belgium
| | - Kathelijne Leyen
- School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium
| | - Koen Raymaekers
- School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium.,60182FWO Vlaanderen (Research Foundation Flanders), Leuven, Belgium
| | - Sofie Prikken
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium.,60182FWO Vlaanderen (Research Foundation Flanders), Leuven, Belgium
| | - Joanna Willen
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium
| | - Nathalie Goemans
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, 26657KU Leuven, Leuven, Belgium
| | - Liesbeth De Waele
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, 26657KU Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- Child Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Koen Luyckx
- School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium.,UNIBS, 60182University of the Free State, Bloemfontein, South Africa
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Quality of life and emotional vulnerability in a national cohort of adolescents living with Fontan circulation. Cardiol Young 2022; 32:874-882. [PMID: 34387177 DOI: 10.1017/s1047951121003188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION To investigate quality of life and mental health after Fontan completion, we aimed to characterise outcomes in a representative group of adolescent patients. The study was part of the pre-transition clinical work-up in adolescents with Fontan-type palliation of univentricular CHD. The programme covers the entire paediatric Fontan patient population in Norway. METHODS Our cross-sectional study included 42 adolescents with Fontan circulation aged 15-18. We recruited a control group of 29 healthy peers. Quality of life was measured by the Pediatric Quality of Life Inventory Questionnaire, while mental health was assessed with the Strength and Difficulties Questionnaire. RESULTS Fontan patients scored lower than healthy controls on the Pediatric Quality of Life Inventory total (p = 0.004), the physical (p < 0.001) and social (p = 0.001) functioning subscale, and the Strength and Difficulties Questionnaire subscale of emotional symptoms (p = 0.035). Compared to two of the healthy teens (7%), seven patients (16%) in the Fontan group scored as having impaired mental health (p = 0.224). The female/male ratio for individuals with impaired health was 7:2 (p = 0.003). CONCLUSIONS Compared to healthy controls, adolescents after Fontan-type palliation in Norway have good health-related quality of life and mental health, despite having slightly lower score than healthy individuals, mainly in physical domains and school functioning. Compared to healthy controls and healthy teenagers, these adolescents have somewhat more emotional problems, and compared to male patients, female patients more often have impaired mental health.
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Lu CW, Wang JK, Yang HL, Kovacs AH, Luyckx K, Ruperti-Repilado FJ, Van De Bruaene A, Enomoto J, Sluman MA, Jackson JL, Khairy P, Cook SC, Chidambarathanu S, Alday L, Oechslin E, Eriksen K, Dellborg M, Berghammer M, Johansson B, Mackie AS, Menahem S, Caruana M, Veldtman G, Soufi A, Fernandes SM, White K, Callus E, Kutty S, Apers S, Moons P. Heart Failure and Patient-Reported Outcomes in Adults With Congenital Heart Disease from 15 Countries. J Am Heart Assoc 2022; 11:e024993. [PMID: 35470715 PMCID: PMC9238599 DOI: 10.1161/jaha.121.024993] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Heart failure (HF) is the leading cause of mortality and associated with significant morbidity in adults with congenital heart disease. We sought to assess the association between HF and patient‐report outcomes in adults with congenital heart disease. Methods and Results As part of the APPROACH‐IS (Assessment of Patterns of Patient‐Reported Outcomes in Adults with Congenital Heart disease—International Study), we collected data on HF status and patient‐reported outcomes in 3959 patients from 15 countries across 5 continents. Patient‐report outcomes were: perceived health status (12‐item Short Form Health Survey), quality of life (Linear Analogue Scale and Satisfaction with Life Scale), sense of coherence‐13, psychological distress (Hospital Anxiety and Depression Scale), and illness perception (Brief Illness Perception Questionnaire). In this sample, 137 (3.5%) had HF at the time of investigation, 298 (7.5%) had a history of HF, and 3524 (89.0%) had no current or past episode of HF. Patients with current or past HF were older and had a higher prevalence of complex congenital heart disease, arrhythmias, implantable cardioverter‐defibrillators, other clinical comorbidities, and mood disorders than those who never had HF. Patients with HF had worse physical functioning, mental functioning, quality of life, satisfaction with life, sense of coherence, depressive symptoms, and illness perception scores. Magnitudes of differences were large for physical functioning and illness perception and moderate for mental functioning, quality of life, and depressive symptoms. Conclusions HF in adults with congenital heart disease is associated with poorer patient‐reported outcomes, with large effect sizes for physical functioning and illness perception. Registration URL: https://clinicaltrials.gov; Unique identifier: NCT02150603.
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Affiliation(s)
- Chun-Wei Lu
- Department of Pediatrics National Taiwan University Hospital Taipei Taiwan
| | - Jou-Kou Wang
- Department of Pediatrics National Taiwan University Hospital Taipei Taiwan
| | - Hsiao-Ling Yang
- School of Nursing College of Medicine National Taiwan University Taipei Taiwan.,Department of Nursing National Taiwan University Hospital Taipei Taiwan
| | - Adrienne H Kovacs
- Toronto Adult Congenital Heart Disease ProgramPeter Munk Cardiac CenterUniversity Health NetworkUniversity of Toronto Toronto Canada.,Knight Cardiovascular InstituteOregon Health & Science University Portland OR
| | - Koen Luyckx
- KU Leuven School Psychology and Development in Context KU Leuven Leuven Belgium.,UNIBSUniversity of the Free State Bloemfontein South Africa
| | - Francisco Javier Ruperti-Repilado
- Center for Congenital Heart Disease Department of Cardiology Inselspital - Bern University HospitalUniversity of Bern Bern Switzerland
| | - Alexander Van De Bruaene
- Division of Congenital and Structural Cardiology University Hospitals Leuven Leuven Belgium.,KU Leuven Department of Cardiovascular Sciences KU Leuven Leuven Belgium
| | | | - Maayke A Sluman
- Coronel Institute of Occupational HealthAmsterdam UMCUniversity of Amsterdam Amsterdam The Netherlands.,Department of Cardiology Jeroen Bosch Hospital's Hertogenbosch The Netherlands
| | - Jamie L Jackson
- Center for Biobehavioral Health Nationwide Children's Hospital Columbus OH
| | - Paul Khairy
- Adult Congenital Heart CenterMontreal Heart InstituteUniversité de Montréal Montreal Canada
| | - Stephen C Cook
- Indiana University Health Adult Congenital Heart Disease Program Indianapolis IN
| | - Shanthi Chidambarathanu
- Pediatric Cardiology Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation) Chennai India
| | - Luis Alday
- Division of Cardiology Hospital de Niños Córdoba Argentina
| | - Erwin Oechslin
- Toronto Adult Congenital Heart Disease ProgramPeter Munk Cardiac CenterUniversity Health NetworkUniversity of Toronto Toronto Canada
| | - Katrine Eriksen
- Adult Congenital Heart Disease Center Oslo University Hospital - Rikshospitalet Oslo Norway
| | - Mikael Dellborg
- Adult Congenital Heart Unit Sahlgrenska University Hospital/Östra Gothenburg Sweden.,Institute of Medicine The Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden.,Centre for Person-Centred Care (GPCC) University of Gothenburg Gothenburg Sweden
| | - Malin Berghammer
- Department of Health Sciences University West Trollhättan Sweden.,Department of Paediatrics Queen Silvia Children's HospitalSahlgrenska University Hospital Gothenburg Sweden
| | - Bengt Johansson
- Department of Public Health and Clinical Medicine Umeå University Umeå Sweden
| | - Andrew S Mackie
- Division of Cardiology Stollery Children's HospitalUniversity of Alberta Edmonton Canada
| | - Samuel Menahem
- Monash HeartMonash Medical CentreMonash University Melbourne Australia
| | - Maryanne Caruana
- Department of Cardiology Mater Dei Hospital Birkirkara Bypass Malta
| | - Gruschen Veldtman
- Adult Congenital Heart Disease CenterCincinnati Children's Hospital Medical Center Cincinnati OH
| | - Alexandra Soufi
- Department of Cardiac Rehabilitation Médipôle Lyon-Villeurbanne Lyon France
| | - Susan M Fernandes
- Adult Congenital Heart Program at StanfordLucile Packard Children's Hospital and Stanford Health Care Palo Alto CA
| | - Kamila White
- Adult Congenital Heart Disease CenterWashington University and Barnes Jewish Heart & Vascular CenterUniversity of Missouri Saint Louis MO
| | - Edward Callus
- Clinical Psychology Service IRCCS Policlinico San Donato Milan Italy.,Department of Biomedical Sciences for Health University of Milan Milan Italy
| | - Shelby Kutty
- Adult Congenital Heart Disease Center University of NebraskaMedical Center/Children's Hospital and Medical Center Omaha NE.,Taussig Heart CenterJohns Hopkins School of Medicine Baltimore MD
| | - Silke Apers
- KU Leuven Department of Public Health and Primary Care KU Leuven Leuven Belgium
| | - Philip Moons
- Centre for Person-Centred Care (GPCC) University of Gothenburg Gothenburg Sweden.,KU Leuven Department of Public Health and Primary Care KU Leuven Leuven Belgium.,Institute of Health and Care Sciences University of Gothenburg Gothenburg Sweden.,Department of Paediatrics and Child Health University of Cape Town Cape Town South Africa
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Portal D, Hirsch R, Benderly M. Increased prevalence of cardiac and non-cardiac chronic morbidity among adults with congenital heart disease. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2022. [DOI: 10.1016/j.ijcchd.2021.100314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Jaschinski C, Knetsch V, Parzer P, Meyr J, Schroeder B, Fonseca E, Karck M, Kaess M, Loukanov T. Psychosocial Impact of Congenital Heart Diseases on Patients and Their Families: A Parent's Perspective. World J Pediatr Congenit Heart Surg 2021; 13:9-15. [PMID: 34860617 DOI: 10.1177/21501351211044127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Currently, over 90% of children with congenital heart disease (CHD) survive into adulthood. As a consequence the psychosocial impact on children and their families has become an important outcome measure. Therefore, the goal of this study was to assess the psychosocial impact from a parent's perspective and to identify possible predictors. METHODS We included all parents of children who underwent open-heart surgery in the years 2010 and 2011 at the Department of Cardiothoracic Surgery at University Hospital Heidelberg and invited them to complete standardized questionnaires. Psychosocial outcome was measured via parent self- and proxy reporting of family burden (Family Burden Questionnaire, FaBel), health-related quality of life (KidScreen-10), developmental problems (Five-to-Fifteen, FTF), and mental health problems (Strength and Difficulties Questionnaire, SDQ). RESULTS In total, 113 families returned the questionnaires completely (71.5%). The Aristotle Basic Complexity score and the STAT 2020 Score overall did not predict the psychosocial impact, whereas the number of surgical operations did significantly predict psychosocial impact across all domains in this study cohort. CONCLUSIONS These data suggest that the number of surgical operations might be a relevant predictor for the long-term psychosocial impact on families suffering from CHD and a potential connecting factor for specialized psychological support. When setting up screening instruments or support programs the entire family must be considered.
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Affiliation(s)
- Christoph Jaschinski
- 27178Department of Cardiothoracic Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Vivien Knetsch
- 27178Department of Cardiothoracic Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter Parzer
- Department of Child and Adolescent Psychiatry, Center of Psychosocial Medicine, 27178University Hospital Heidelberg, Heidelberg, Germany
| | - Juliane Meyr
- 27178Department of Cardiothoracic Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Brian Schroeder
- 27178Department of Cardiothoracic Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Elizabeth Fonseca
- 27178Department of Cardiothoracic Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Matthias Karck
- 27178Department of Cardiothoracic Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, Center of Psychosocial Medicine, 27178University Hospital Heidelberg, Heidelberg, Germany.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Tsvetomir Loukanov
- 27178Department of Cardiothoracic Surgery, University Hospital Heidelberg, Heidelberg, Germany
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Abstract
PURPOSE OF REVIEW Adults with congenital heart disease (CHD) may experience anxiety specifically related to their medical condition. This review introduces the concepts of health anxiety and heart-focused anxiety, summarizes what is currently known about heart-focused anxiety among adults with CHD and offers suggestions to help adult CHD providers address heart-focused anxiety in their patients. RECENT FINDINGS Although minimal research has been conducted specific to this outcome, health anxiety may occur at any point across the lifespan of individuals with CHD. A recent study found that children and adolescents with CHD reported greater health anxiety than community peers. Health anxiety was commonly reported among adults with CHD presenting for psychological assessment. It was linked with older age, trait anxiety, perceived parental overprotection and greater CHD complexity in one study. SUMMARY Adults with CHD face many potential health-related stressors, including cardiac symptoms, treatments and interventions throughout the lifespan (including surgeries and other invasive procedures), the impact of CHD on daily lives and longer-term health expectations. Providers should be aware that heart-focused anxiety among patients is understandable and perhaps common. Patient-centred education and psychological intervention should be integrated within a comprehensive approach to long-term disease management.
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Moon Y, Jung JW, Lee S. Sibling Relationships of Adolescents with Congenital Heart Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052698. [PMID: 33800133 PMCID: PMC7967429 DOI: 10.3390/ijerph18052698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/04/2021] [Indexed: 11/23/2022]
Abstract
Adolescents with congenital heart disease (CHD) continuously need family support because of their repeated follow ups, treatments, and complications. However, sibling relationships have not been well studied among adolescents with CHD. The purpose of the present study was to explore the relationships between adolescents with CHD and their siblings, and to examine these relationships according to birth order and age. Adolescents aged from 13 to 21 years who had been diagnosed with CHD and had siblings were included as participants. The Sibling Relationship Questionnaire (SRQ) was used. The SRQ consists of four factors: warmth/closeness, conflict, relative power/status, and rivalry. A univariate general linear model was conducted to identify the sibling relationship factors according to birth order and sibling ages. The score for relative power/status of participants who were the eldest sibling was higher than that of younger siblings. The score for rivalry increased as sibling age increased. Therefore, healthcare providers need to investigate sibling relationships and to explain the importance of self-identity and power balance between adolescents with CHD and their siblings to parents.
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Affiliation(s)
- Youngji Moon
- College of Nursing, The Catholic University of Korea, Seoul 03722, Korea;
| | - Jo Won Jung
- Division of Pediatric Cardiology, Department of Pediatrics, College of Medicine, Yonsei University, Seoul 03722, Korea;
| | - Sunhee Lee
- College of Nursing, The Catholic University of Korea, Seoul 03722, Korea;
- Correspondence: ; Tel.: +82-2-2258-7414
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Fernandes SM, Lui GK, Long J, Lin A, Rogers IS, Sillman C, Romfh A, Dade TC, Dong E, Haeffele C, Scribner C, Major M, McElhinney DB. Predicting 10-year mortality in adults with congenital heart disease. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2021. [DOI: 10.1016/j.ijcchd.2020.100057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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16
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Moons P, Luyckx K, Kovacs AH. Patient-reported outcomes in adults with congenital heart disease: What have we learned from APPROACH-IS? INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2021. [DOI: 10.1016/j.ijcchd.2020.100074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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17
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Abstract
BACKGROUND Progress in the management of complex congenital heart disease (CHD) led to an improvement in survival rates of adults with a Fontan-like circulation. The objective of this study was to assess the subjective health status and quality of life of this population. METHODS AND RESULTS Patients aged more than 18 years at the time of the study, who underwent a Fontan-like procedure. Subjective health status was assessed by the SF-36 questionnaire and a linear analog scale was used to score patients' self-perception of their quality of life; cardiac and demographic parameters were collected. RESULTS Among 65 eligible patients, 60 (23 females; mean ± SD age: 25.7 ± 7.2 years) answered the SF-36 questionnaire and 46 of these were interviewed to evaluate their perceived quality of life. Among them, 20 (33.3%) were working full-time and 21 (35%) experienced arrhythmias. The physical SF-36 scores were lower in patients than in the general population (p ≤ 0.05). The New York Hear Association (NYHA) class and occupation were correlated with SF-36 scores of physical activity (respectively, p = 0.0001 and p = 0.025). SF-36 scores of psychological status were associated with the number of drugs and occupation (respectively, p = 0.0001 and p = 0.02). The mean ± SD quality of life score measured using a linear analog scale was 7.02 ± 1.6 and was linked to education and occupation (p ≤ 0.05) but not with cardiac parameters. CONCLUSION Adult Fontan patients perceive an impaired physical health but report a good overall quality of life. Education and occupation impacts significantly on Fontan patients' quality of life.
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Casteigt B, Samuel M, Laplante L, Shohoudi A, Apers S, Kovacs AH, Luyckx K, Thomet C, Budts W, Enomoto J, Sluman MA, Lu CW, Jackson JL, Cook SC, Chidambarathanu S, Alday L, Eriksen K, Dellborg M, Berghammer M, Johansson B, Mackie AS, Menahem S, Caruana M, Veldtman G, Soufi A, Fernandes SM, White K, Callus E, Kutty S, Brouillette J, Moons P, Khairy P. Atrial arrhythmias and patient-reported outcomes in adults with congenital heart disease: An international study. Heart Rhythm 2020; 18:793-800. [PMID: 32961334 DOI: 10.1016/j.hrthm.2020.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/31/2020] [Accepted: 09/16/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Atrial arrhythmias (ie, intra-atrial reentrant tachycardia and atrial fibrillation) are a leading cause of morbidity and hospitalization in adults with congenital heart disease (CHD). Little is known about their effect on quality of life and other patient-reported outcomes (PROs) in adults with CHD. OBJECTIVE The purpose of this study was to assess the impact of atrial arrhythmias on PROs in adults with CHD and explore geographic variations. METHODS Associations between atrial arrhythmias and PROs were assessed in a cross-sectional study of adults with CHD from 15 countries spanning 5 continents. A propensity-based matching weight analysis was performed to compare quality of life, perceived health status, psychological distress, sense of coherence, and illness perception in patients with and those without atrial arrhythmias. RESULTS A total of 4028 adults with CHD were enrolled, 707 (17.6%) of whom had atrial arrhythmias. After applying matching weights, patients with and those without atrial arrhythmias were comparable with regard to age (mean 40.1 vs 40.2 years), demographic variables (52.5% vs 52.2% women), and complexity of CHD (15.9% simple, 44.8% moderate, and 39.2% complex in both groups). Patients with atrial arrhythmias had significantly worse PRO scores with respect to quality of life, perceived health status, psychological distress (ie, depression), and illness perception. A summary score that combines all PRO measures was significantly lower in patients with atrial arrhythmias (-3.3%; P = .0006). Differences in PROs were consistent across geographic regions. CONCLUSION Atrial arrhythmias in adults with CHD are associated with an adverse impact on a broad range of PROs consistently across various geographic regions.
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Affiliation(s)
| | - Michelle Samuel
- Montreal Heart Institute, Université de Montréal, Montreal, Canada
| | | | - Azadeh Shohoudi
- Montreal Heart Institute, Université de Montréal, Montreal, Canada
| | - Silke Apers
- KU Leuven Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Adrienne H Kovacs
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Koen Luyckx
- KU Leuven-University of Leuven, Psychology and Development in Context, Leuven, Belgium and UNIBS, University of the Free State, Bloemfontein, South Africa
| | - Corina Thomet
- Center for Congenital Heart Disease, Inselspital-Bern University Hospital, University of Bern, Bern, Switzerland
| | - Werner Budts
- Division of Congenital and Structural Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Junko Enomoto
- Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan
| | - Maayke A Sluman
- Department of Cardiology, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands and Coronel Institute for Occupational Health, Academic Medical Centre, Amsterdam, the Netherlands
| | - Chun-Wei Lu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Jamie L Jackson
- Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, Ohio
| | - Stephen C Cook
- Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, Michigan
| | | | - Luis Alday
- Division of Cardiology, Hospital de Niños, Córdoba, Argentina
| | - Katrine Eriksen
- Department of Cardiology, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Mikael Dellborg
- Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Malin Berghammer
- Centre for Person-Centred Care (GPCC), University of Gothenburg and Department of Health Sciences, University West, Trollhättan, Sweden
| | - Bengt Johansson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Andrew S Mackie
- Division of Cardiology, Stollery Children's Hospital, University of Alberta, Edmonton, Canada
| | - Samuel Menahem
- Monash Medical Centre, Monash University, Melbourne, Australia
| | - Maryanne Caruana
- Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Malta
| | - Gruschen Veldtman
- Adult Congenital Heart Disease Center, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Alexandra Soufi
- Department of Congenital Heart Disease, Louis Pradel Hospital, Lyon, France
| | - Susan M Fernandes
- Department of Pediatrics and Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Kamila White
- Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, and University of Missouri, Saint Louis, Missouri
| | - Edward Callus
- Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Shelby Kutty
- Adult Congenital Heart Disease Center, University of Nebraska Medical Center/Children's Hospital & Medical Center, Omaha, Nebraska
| | | | - Philip Moons
- KU Leuven-University of Leuven, Department of Public Health and Primary Care, Leuven, Belgium Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden, and Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Paul Khairy
- Montreal Heart Institute, Université de Montréal, Montreal, Canada.
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Abstract
Supplemental digital content is available in the text. Type D personality has been previously shown to increase the risk for mortality in patients with acquired heart disease.
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Health-related quality of life in adult CHD surgical patients in a low middle-income country: a mixed-methods study. Cardiol Young 2020; 30:1126-1137. [PMID: 32633708 DOI: 10.1017/s1047951120001663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES This mixed-methods study aimed to assess health-related quality of life in young adults with CHD following surgery in a low middle-income country, Pakistan. Despite the knowledge that geographic, cultural and socio-economic factors may shape the way health and illness is experienced and managed and consequently determine a person's health-related quality of life, few health-related quality of life studies are conducted in low middle-income countries. This deficit is pronounced in CHD, so there is little guidance for patient care. METHODS The study utilised concurrent, mixed methods. Adults with CHD (n = 59) completed health-related quality of life surveys (PedsQLTM 4.0 Generic Core Scale, PedsQLTM Cognitive Functioning Scale and PedsQLTM 3.0 Cardiac Module). Semi-structured interview data were collected from a nested sub-sample of 17 participants and analysed using qualitative content analysis, guided by the revised Wilson-Cleary model of health-related quality of life. RESULTS The lowest health-related quality of life domain was emotional with the mean score (71.61 ± 20.6), followed by physical (78.81 ± 21.18) and heart problem (79.41 ± 18.05). There was no statistical difference in general or cardiac-specific health-related quality of life between mild, moderate or complex CHD. Qualitative findings suggested low health-related quality of life arose from a reduced capacity to contribute to family life including family income and gender. A sense of reduced marriageability and fear of dependency were important socio-cultural considerations. CONCLUSIONS CHD surgical patients in this low-income country experience poor health-related quality of life, and contributing factors differ to those reported for high-income countries. Socio-cultural understandings should underpin assessment, management and care-partnering with young adults with CHD following surgical correction.
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Shiloh S, Levy S, Heruti I, Avitsur R. Health-related quality of life after injury: examining the roles of perceived daily-life stress and injury perceptions. Qual Life Res 2020; 29:3053-3063. [PMID: 32535863 DOI: 10.1007/s11136-020-02548-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The present study aimed to examine the effects of injury perceptions and perceived daily stress on health-related quality of life (HRQL) of individuals affected by a physical injury. METHODS Two hundred and forty injured individuals completed questionnaires assessing HRQL (Medical Outcome Health Survey short-form 36), perceived daily-life stress (Perceived Stress Scale), and injury perceptions (Brief-InjPQ). RESULTS The direct effects of stress on HRQL scores were not moderated by gender. Emotional representation of the injury significantly mediated the links between PSS and all HRQL subscales only among women, but not among men. However, the mediation of the HRQL total score by emotional representations was significant for both genders. In addition, treatment control perceptions of the injury mediated the link between PSS and self-assessed health among men but not women, and injury-self perceptions mediated the link between PSS and physical functioning among men but not women. CONCLUSION These findings underscore the importance of perceived daily stress, gender, and injury perceptions as key factors for explaining variance in HRQL following injury. In addition to their conceptual contributions, the findings have clinical implications for treating injured populations.
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Affiliation(s)
- Shoshana Shiloh
- The School of Psychological Sciences, The Gordon Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Sigal Levy
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, PO Box 8401, 68114, Tel Aviv, Israel
| | - Irit Heruti
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, PO Box 8401, 68114, Tel Aviv, Israel.,Department of Psychology, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - Ronit Avitsur
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, PO Box 8401, 68114, Tel Aviv, Israel.
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Zentner D, Celermajer DS, Gentles T, d’Udekem Y, Ayer J, Blue GM, Bridgman C, Burchill L, Cheung M, Cordina R, Culnane E, Davis A, du Plessis K, Eagleson K, Finucane K, Frank B, Greenway S, Grigg L, Hardikar W, Hornung T, Hynson J, Iyengar AJ, James P, Justo R, Kalman J, Kasparian N, Le B, Marshall K, Mathew J, McGiffin D, McGuire M, Monagle P, Moore B, Neilsen J, O’Connor B, O’Donnell C, Pflaumer A, Rice K, Sholler G, Skinner JR, Sood S, Ward J, Weintraub R, Wilson T, Wilson W, Winlaw D, Wood A. Management of People With a Fontan Circulation: a Cardiac Society of Australia and New Zealand Position statement. Heart Lung Circ 2020; 29:5-39. [DOI: 10.1016/j.hlc.2019.09.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 02/07/2023]
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Moons P, Luyckx K. Quality-of-life research in adult patients with congenital heart disease: current status and the way forward. Acta Paediatr 2019; 108:1765-1772. [PMID: 31136004 DOI: 10.1111/apa.14876] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/11/2019] [Accepted: 05/23/2019] [Indexed: 12/18/2022]
Abstract
Over the past four decades, the number of papers on quality of life (QoL) in congenital heart disease (CHD) has grown exponentially. However, firm conclusions have been hard to draw, because conceptual issues occurred and methodological differences prevented direct comparisons of studies. In general, QoL in CHD patients is good and it can be even better than in healthy peers when measured as life satisfaction. When QoL is measured as physical functioning, patients with complex CHD do worse than patients with moderate or mild defects or healthy individuals. APPROACH-IS was a large-scale international project that confirmed international variations in QoL, with Australian patients reporting the best QoL. Poor QoL was predicted by older age, being a job seeker, unemployed or disabled, never having married and those with worse functional status. Perceived illness and religion and spirituality were also significant predictors for QoL. On the other hand, country-specific characteristics and healthcare system factors did not play a significant role in explaining variances in QoL of patients with CHD around the globe. Future studies should rely on a sound conceptual basis, use longitudinal research designs, be conducted in international, multi-centre settings and evaluate interventions that promote patients' QoL.
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Affiliation(s)
- Philip Moons
- Department of Public Health and Primary Care KU Leuven Leuven Belgium
- Institute of Health and Care Sciences Gothenburg University Gothenburg Sweden
- Department of Paediatrics and Child Health University of Cape Town Cape Town South Africa
| | - Koen Luyckx
- School Psychology and Development in Context KU Leuven ‐ University of Leuven Leuven Belgium
- UNIBS, University of the Free State Bloemfontein South Africa
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Moons P. International research in cardiovascular nursing: Getting insight in the role of system factors. Eur J Cardiovasc Nurs 2019; 18:432-434. [PMID: 31023086 DOI: 10.1177/1474515119847031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Philip Moons
- 1 KU Leuven Department of Public Health and Primary Care, KU Leuven, Belgium.,2 Institute of Health and Care Sciences, University of Gothenburg, Sweden.,3 Department of Paediatrics and Child Health, University of Cape Town, South Africa
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Religion and spirituality as predictors of patient-reported outcomes in adults with congenital heart disease around the globe. Int J Cardiol 2019; 274:93-99. [DOI: 10.1016/j.ijcard.2018.07.103] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/15/2018] [Accepted: 07/20/2018] [Indexed: 01/08/2023]
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Holbein CE, Fogleman ND, Hommel K, Apers S, Rassart J, Moons P, Luyckx K, Sluman MA, Enomoto J, Johansson B, Yang HL, Dellborg M, Subramanyan R, Jackson JL, Budts W, Kovacs AH, Morrison S, Tomlin M, Gosney K, Soufi A, Eriksen K, Thomet C, Berghammer M, Alday L, Callus E, Fernandes SM, Caruana M, Menahem S, Cook SC, Rempel GR, White K, Khairy P, Kutty S, Veldtman G. A multinational observational investigation of illness perceptions and quality of life among patients with a Fontan circulation. CONGENIT HEART DIS 2018; 13:392-400. [PMID: 29457362 PMCID: PMC5993574 DOI: 10.1111/chd.12583] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 12/19/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE First, to compare QOL and illness perceptions between patients with a Fontan circulation and patients with anatomically simple defects (ie, atrial septal defects [ASD] or ventricular septal defects [VSD]). Second, to explore illness perceptions as a mediator of the association between congenital heart disease (CHD) diagnosis and QOL. DESIGN Cross-sectional observational study. SETTING Twenty-four cardiology centers from 15 countries across five continents. PATIENTS Four hundred thirty-five adult patients with congenital heart disease (177 Fontan and 258 ASD/VSD) ages 18-83 years. OUTCOME MEASURES QOL and illness perceptions were assessed by the Satisfaction With Life Scale and the Brief Illness Perceptions Questionnaire, respectively. RESULTS Patients with a Fontan circulation reported lower QOL (Wald Z = -3.59, p = <.001) and more negative perceptions of their CHD (Wald Z = -7.66, p < .001) compared with patients with ASD/VSD. After controlling for demographics, anxiety, depressive symptoms, and New York Heart Association functional class, path analyses revealed a significant mediation model, αβ = 0.15, p = .002, 95% CI = 0.06-0.25, such that CHD diagnosis was indirectly related to QOL through illness perceptions. CONCLUSIONS The Fontan sample's more negative perceptions of CHD were likely a reflection of life with a more complex defect. Illness perceptions appear to account for unique differences in QOL between groups of varying CHD complexity. Psychosocial screening and interventions may be important treatment components for patients with CHD, particularly those with Fontan circulations.
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Affiliation(s)
| | - Nicholas D. Fogleman
- Cincinnati Children's Hospital Medical Center, Cincinnati, USA
- University of Louisville, Louisville, USA
| | - Kevin Hommel
- Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | | | | | - Philip Moons
- KU Leuven, Leuven, Belgium
- University of Gothenburg, Gothenburg, Sweden
| | | | | | | | | | | | - Mikael Dellborg
- University of Gothenburg, Gothenburg, Sweden
- Adult Congenital Heart Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | - Werner Budts
- KU Leuven, Leuven, Belgium
- University Hospitals Leuven and Department of Cardiovascular Sciences, Leuven, Belgium
| | | | - Stacey Morrison
- Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Martha Tomlin
- Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Kathy Gosney
- Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | | | | | - Corina Thomet
- KU Leuven, Leuven, Belgium
- University Hospital Bern, University of Bern, Bern, Switzerland
| | - Malin Berghammer
- University of Gothenburg, Gothenburg, Sweden
- University West, Trollhättan, Sweden
| | | | | | | | | | | | | | | | - Kamila White
- Washington University and Barnes Jewish Heart & Vascular Center, University of Missouri, Saint Louis, USA
| | | | - Shelby Kutty
- Children's Hospital & Medical Center, Omaha, USA
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Moons P, Kovacs AH, Luyckx K, Thomet C, Budts W, Enomoto J, Sluman MA, Yang HL, Jackson JL, Khairy P, Cook SC, Subramanyan R, Alday L, Eriksen K, Dellborg M, Berghammer M, Johansson B, Mackie AS, Menahem S, Caruana M, Veldtman G, Soufi A, Fernandes SM, White K, Callus E, Kutty S, Van Bulck L, Apers S. Patient-reported outcomes in adults with congenital heart disease: Inter-country variation, standard of living and healthcare system factors. Int J Cardiol 2018; 251:34-41. [DOI: 10.1016/j.ijcard.2017.10.064] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/23/2017] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
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