1
|
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 Montreal 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.
Collapse
Affiliation(s)
- Cylia Houchi
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - 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
| | | | - Geneviève A Mageau
- Department of Psychology, Faculty of Arts and Science, 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, 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, Montreal, Québec, Canada
| | - Marie-Pierre Dubé
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Marie-A Chaix
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - François-Pierre Mongeon
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Annie Dore
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Blandine Mondésert
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Reda Ibrahim
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, 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.
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
4
|
Patient-Reported Outcomes in Adults With Congenital Heart Disease Following Hospitalization (from APPROACH-IS). Am J Cardiol 2021; 145:135-142. [PMID: 33460605 DOI: 10.1016/j.amjcard.2020.12.088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/14/2020] [Accepted: 12/29/2020] [Indexed: 01/07/2023]
Abstract
In this international study, we (1) compared patient-reported outcomes (PROs) in adults with congenital heart disease (CHD) who had versus had not been hospitalized during the previous 12 month, (2) contrasted PROs in patients who had been hospitalized for cardiac surgery versus nonsurgical reasons, (3) assessed the magnitude of differences between the groups (i.e., effect sizes), and (4) explored differential effect sizes between countries. APPROACH-IS was a cross-sectional, observational study that enrolled 4,028 patients from 15 countries (median age 32 years; 53% females). Self-report questionnaires were administered to measure PROs: health status; anxiety and depression; and quality of life. Overall, 668 patients (17%) had been hospitalized in the previous 12 months. These patients reported poorer outcomes on all PROs, with the exception of anxiety. Patients who underwent cardiac surgery demonstrated a better quality of life compared with those who were hospitalized for nonsurgical reasons. For significant differences, the effect sizes were small, whereas they were negligible in nonsignificant comparisons. Substantial intercountry differences were observed. For various PROs, moderate to large effect sizes were found comparing different countries. In conclusion, adults with CHD who had undergone hospitalization in the previous year had poorer PROs than those who were medically stable. Researchers ought to account for the timing of recruitment when conducting PRO research as hospitalization can impact results.
Collapse
|