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The impact of illness perceptions and disease severity on quality of life in congenital heart disease

Published online by Cambridge University Press:  20 January 2015

Claire E. O’Donovan ,
Liz Painter ,
Boris Lowe ,
Hayley Robinson  and
Elizabeth Broadbent
Claire E. O’Donovan
Affiliation:
Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
Liz Painter
Affiliation:
Department of Cardiology, Auckland District Health Board, Auckland, New Zealand
Boris Lowe
Affiliation:
Department of Cardiology, Auckland District Health Board, Auckland, New Zealand
Hayley Robinson
Affiliation:
Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
Elizabeth Broadbent*
Affiliation:
Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
*
Correspondence to: E. Broadbent, Department of Psychological Medicine, The University of Auckland, Private Bag 90219, Auckland, New Zealand. Tel: +649 373 7599; Fax: +649 373 7013; E-mail: [email protected]
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Abstract

Background

Despite an increasing prevalence of adults living with a CHD, little is known about the psychosocial impact of CHD. We sought to investigate the relative impact of disease severity and patients’ perceptions about their condition on depression, anxiety, and quality of life over a period of a year.

Methods

A total of 110 patients aged over 16 years completed an initial questionnaire containing measures for anxiety, depression, quality of life, and illness perceptions when they attended the Adult Congenital Heart Disease Clinic. Cardiologists rated the patients’ disease severity and illness course. A year later, patients were invited to complete the same measures. Regression analyses were performed to determine the relative impact of illness perceptions and disease severity on psychological outcomes a year later.

Results

At baseline, 23% of the study population had depressive symptoms and 30% had elevated trait anxiety. After controlling for associations with disease-related variables, illness perceptions explained 28% of the variance in depression, 40% anxiety, and 27% overall quality of life at baseline. Baseline illness perceptions bivariately predicted quality of life, cardiac anxiety, and depression 1 year later, and regression analyses controlling for other factors showed that they were significant predictors of outcomes 1 year later.

Conclusion

Symptoms of depression and anxiety are common among adults with CHD. Patients’ illness perceptions are related to psychological outcomes, especially cross-sectionally. Future research could investigate whether an intervention to discuss patients’ perceptions about their CHD can improve mental health and quality of life.

Keywords

Illness perceptionsdepressionanxietyquality of lifeCHD
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 1 , January 2016 , pp. 100 - 109
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Copyright
© Cambridge University Press 2015 

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References

1. Warnes, CA. The adult with congenital heart disease: born to be bad? J Am Coll Cardiol 2005; 46: 1–8.Google Scholar
2. Bromberg, JI, Beasley, PJ, D’Angelo, EJ, Landzberg, M, DeMaso, DR. Depression and anxiety in adults with congenital heart disease: a pilot study. Heart Lung 2003; 32: 105–110.Google Scholar
3. Horner, T, Liberthson, R, Jellinek, S. Psychosocial profile of adults with complex congenital heart disease. Mayo Clin Proc 2000; 75: 31–36.CrossRefGoogle ScholarPubMed
4. Kovacs, AH, Saidi, AS, Kuhl, EA, et al. Depression and anxiety in adult congenital heart disease: predictors and prevalence. Int J Cardiol 2009; 137: 158–164.CrossRefGoogle ScholarPubMed
5. Rose, M, Köhler, K, Köhler, F, Sawitzky, B, Fliege, H, Klapp, B. Determinants of the quality of life of patients with congenital heart disease. Qual Life Res 2005; 14: 35–43.CrossRefGoogle Scholar
6. van Rijen, EH, Utens, EM, Roos-Hesselink, JW, et al. Psychosocial functioning of the adult with congenital heart disease: a 20–33 years follow-up. Eur Heart J 2003; 24: 673–683.Google Scholar
7. Kamphuis, M, Ottenkamp, J, Vliegen, HW, et al. Health related quality of life and health status in adult survivors with previously operated complex congenital heart disease. Heart 2002; 87: 356–362.Google Scholar
8. Simko, LC, McGinnis, K. Quality of life experienced by adults with congenital heart disease. AACN Clin Issues 2003; 14: 42–53.Google Scholar
9. Jefferies, JL, Noonan, JA, Keller, BB, Wilson, JF, Griffith, C. Quality of life and social outcomes in adults with congenital heart disease living in rural areas of Kentucky. Am J Cardiol 2004; 94: 263–266.Google Scholar
10. Swan, L, Hillis, WS. Exercise prescription in adults with congenital heart disease: a long way to go. Heart 2000; 83: 685–687.Google Scholar
11. Vigl, M, Hager, A, Bauer, U, et al. Sexuality and subjective wellbeing in male patients with congenital heart disease. Heart 2009; 95: 1179–1183.Google Scholar
12. van Rijen, EH, Utens, EM, Roos-Hesselink, JW, et al. Medical predictors for psychopathology in adults with operated congenital heart disease. Eur Heart J 2004; 25: 1605–1613.Google Scholar
13. Brandhagen, DJ, Feldt, RH, Williams, DE. Long-term psychologic implications of congenital heart disease: a 25 year follow up. Mayo Clin Proc 1991; 66: 474–479.CrossRefGoogle ScholarPubMed
14. Leventhal, H, Meyer, D, Nerenz, D. The common sense representation of illness danger. In: Rachman S (eds). Contributions of Medical Psychology, vol. 2. Pergamon Press, New York, 1980: 7–30.Google Scholar
15. Petrie, KJ, Weinman, J, Sharpe, N, Buckley, J. Role of patients’ view of their illness in predicting return to work and functioning after myocardial infarction: longitudinal study. Brit Med J 1996; 312: 1191–1194.Google Scholar
16. Scharloo, M, Kaptein, AA, Weinman, J, et al. Illness perceptions, coping and functioning in patients with rheumatoid arthritis, chronic obstructive pulmonary disease and psoriasis. J Psychosom Res 1998; 44: 573–585.CrossRefGoogle ScholarPubMed
17. Treharne, GJ, Kitas, GD, Lyons, AC, Booth, DA. Well-being in rheumatoid arthritis: the effects of disease duration and psychosocial factors. J Health Psychol 2005; 10: 457–474.Google Scholar
18. Barnes, L, Moss-Morris, R, Kaufusi, M. Illness beliefs and adherence in diabetes mellitus: a comparison between Tongan and European patients. NZ Med J 2004; 117: 1188:U743.Google Scholar
19. Senior, V, Marteau, T, Weinman, J. Self-reported adherence to cholesterol-lowering medication in patients with familial hypercholesterolaemia: the role of illness perceptions. Cardiovasc Drug Ther 2004; 18: 475–481.Google Scholar
20. Stafford, L, Berk, M, Jackson, HJ. Are illness perceptions about coronary artery disease predictive of depression and quality of life outcomes? J Psychosom Res 2009; 66: 211–220.CrossRefGoogle ScholarPubMed
21. Schoormans, D, Mulder, BJ, van Melle, JP, et al. Illness perceptions of adults with congenital heart disease and their predictive value for quality of life two years later. Eur J Cardiovasc Nur 2014: 86–94.Google Scholar
22. Broadbent, E, Petrie, KJ, Main, J, Weinman, J. The brief illness perception questionnaire. J Psychosom Res 2006; 60: 631–637.Google Scholar
23. Spielberger, CD, Gorsuch, RL, Lushene, RE. Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press, Palo Alto, CA, 1970.Google Scholar
24. Spielberger, CD, Gorsuch, RL, Lushene, RE, Vagg, PR, Jacobs, GA. Manual for the State-Trait Anxiety Inventory. Mind Garden, 1983.Google Scholar
25. Eifert, GH, Thompson, RN, Zvolensky, MJ, et al. The cardiac anxiety questionnaire: development and preliminary validity. Behav Res Ther 2000; 38: 1039–1053.Google Scholar
26. Hoyer, J, Eifert, GH, Einsle, F, et al. Heart-focused anxiety before and after cardiac surgery. J Psychosom Res 2008; 64: 291–297.CrossRefGoogle ScholarPubMed
27. Andresen, EM, Malmgren, JA, Carter, WB, Patrick, DL. Screening for depression in well older adults: evaluation of a short form of the CES-D. Am J Prev Med 1994; 10: 77–84.CrossRefGoogle Scholar
28. Moons, P, Van Deyk, K, De Bleser, L, et al. Quality of life and health status in adults with congenital heart disease: a direct comparison with healthy counterparts. Eur J Cardiov Prev R 2006; 13: 407–413.Google Scholar
29. Kamphuis, M, Zwinderman, KH, Vogels, T, et al. A cardiac-specific health-related quality of life module for young adults with congenital heart disease: development and validation. Qual Life Res 2004; 13: 735–745.CrossRefGoogle ScholarPubMed
30. Hulsergen-Zwarts, M, Plokker, THWM, Brunninkhuis, LGH, et al. Illness perceptions of adults with congenital heart disease and their predictive value for quality of life two years later. Eur J Cardiovasc Nurs 2014; 13: 86–94.Google Scholar
31. Warnes, CA, Liberthson, R, Danielson, GK Jr, et al. Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol 2001; 37: 1170–1175.Google Scholar
32. Moons, P, Van Deyk, K, De Geest, S, Gewillig, M, Budts, W. Is the severity of congenital heart disease associated with the quality of life and perceived health of adult patients? Heart 2005; 91: 1193–1198.CrossRefGoogle ScholarPubMed
33. Quittner, AL, Goldbeck, L, Abbot, J, et al. Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries. Thorax 2014; 69: 1090–1097.Google Scholar
34. Dickens, C, McGowan, L, Percival, C, et al. Negative illness perceptions are associated with new-onset depression following myocardial infarction. Gen Hosp Psychiat 2008; 30: 414–420.CrossRefGoogle ScholarPubMed
35. Juergens, MC, Seekatz, B, Moosdorf, RG, Petrie, KJ, Rief, W. Illness beliefs before cardiac surgery predict disability, quality of life, and depression 3 months later. J Psychosom Res 2010; 68: 553–560.Google Scholar
36. Le Grande, MR, Elliott, PC, Worcester, MUC, et al. Identifying illness perception schemata and their association with depression and quality of life in cardiac patients. Psychol Health Med 2012; 17: 709–722.Google Scholar
37. Broadbent, E, Ellis, CJ, Thomas, J, Gamble, G, Petrie, KJ. Further development of an illness perception intervention for myocardial infarction patients: a randomized controlled trial. J Psychosom Res 2009; 67: 17–23.Google Scholar