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Associations between knowledge of disease, depression and anxiety, social support, sense of coherence and optimism with health-related quality of life in an ambulatory sample of adolescents with heart disease*

Published online by Cambridge University Press:  12 February 2013

QiFeng Wang ,
Margaret Hay ,
David Clarke  and
Samuel Menahem
QiFeng Wang
Affiliation:
School of Psychology and Psychiatry, Monash University, Melbourne, Australia
Margaret Hay
Affiliation:
Health Psychology and Behavioural Medicine Unit, Monash University, Melbourne, Australia
David Clarke
Affiliation:
School of Psychology and Psychiatry, Monash University, Melbourne, Australia
Samuel Menahem*
Affiliation:
School of Psychology and Psychiatry, Monash University, Melbourne, Australia Department of Paediatrics, Monash University, Melbourne, Australia Monash Heart, Monash Medical Centre, Melbourne, Australia
*
Correspondence to: Proffesor S. Menahem, Monash Heart, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Vic 3168, Australia. Tel: +61-3-95946666; Fax: +61-3-95761352; E-mail: [email protected]
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Abstract

Introduction

Advances in overall management have led to an increasing number of adolescents with congenital heart disease reaching adulthood. This study aimed to evaluate the health-related quality of life in adolescents with heart disease, and examine its relationship with the adolescents’ knowledge and understanding of their congenital heart disease, its severity, and its relationship to the degree of anxiety and depression, feeling of optimism and sense of coherence experienced by the adolescents together with their social support.

Methods and results

Adolescents with heart disease were recruited from an ambulatory setting at a tertiary centre. Patients completed self-report questionnaires including the Paediatric Quality of Life Inventory 3.0-Cardiac Module, a questionnaire assessing the adolescents’ knowledge of their cardiac condition, the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Life Orientation Test-Revised, and Sense of Coherence-13, supplemented by clinical information provided by the attending cardiologists. A total of 114 patients aged 12–20 years were recruited over 15 months. In all, 98% of patients were in New York Heart Association class I. Their health-related quality of life was found to positively correlate with a low level of anxiety and depression (Pearson correlation, r = −0.57, p < 0.001), a good knowledge of their cardiac condition (r = 0.31, p < 0.01), feelings of optimism (r = 0.39, p < 0.001), adequate social support (r = 0.27, p < 0.01), and a strong sense of coherence (r = 0.24, p < 0.01).

Conclusions

Adolescents’ knowledge and understanding of their cardiac abnormality together with an improved sense of well-being had a positive influence on their health-related quality of life.

Keywords

Health-related quality of lifeknowledgeoptimismsense of coherencesocial supportadolescents with congenital heart diseaseanxiety and depression
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 1 , February 2014 , pp. 126 - 133
Copyright
Copyright © Cambridge University Press 2013 

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Footnotes

*

Presented in part: American College of Cardiology, April 2011 partly supported by the chair fund.

References

1. Bhat, AH, Sahn, DJ. Congenital heart disease never goes away, even when it has been ‘treated’: the adult with congenital heart disease. Curr Opin Pediatr 2004; 16: 500–507.CrossRefGoogle ScholarPubMed
2. 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
3. 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.CrossRefGoogle ScholarPubMed
4. Van den Bosch, AE, Roos-Hesselink, JW, Van Domburg, R, Bogers, AJ, Simoons, ML, Meijboom, FJ. Long-term outcome and quality of life in adult patients after the Fontan operation. Am J Cardiol 2004; 93: 1141–1145.Google Scholar
5. Claessens, P, Moons, P, Casterle, BD, Cannaerts, P, Budts, W, Gewillig, M. What does it mean to live with a congenital heart disease? A qualitative study on the lived experiences of adult patients. Eur J Cardiovasc Nurs 2005; 4: 3–10.CrossRefGoogle ScholarPubMed
6. Spijkerboer, AW, Utens, EM, Bogers, AJ, Verhulst, FC, Helbing, WA. Long-term behavioural and emotional problems in four cardiac diagnostic groups of children and adolescents after invasive treatment for congenital heart disease. Int J Cardiol 2008; 125: 66–73.CrossRefGoogle ScholarPubMed
7. Landolt, MA, Valsangiacomo Buechel, ER, Latal, B. Health-related quality of life in children and adolescents after open-heart surgery. J Pediatr 2008; 152: 349–355.CrossRefGoogle ScholarPubMed
8. Uzark, K, Jonesa, K, Burwinkleb, T, Varnic, JW. The pediatric quality of life inventory™ in children with heart disease. Prog Pediatr Cardiol 2003; 18: 141–149.CrossRefGoogle Scholar
9. Immer, FF, Althaus, SM, Berdat, PA, Saner, H, Carrel, TP. Quality of life and specific problems after cardiac surgery in adolescents and adults with congenital heart diseases. Eur J Cardiovasc Prev Rehab 2005; 12: 138–143.CrossRefGoogle ScholarPubMed
10. 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.Google Scholar
11. Culbert, EL, Ashburn, DA, Cullen-Dean, G, et al. Quality of life of children after repair of transposition of the great arteries. Circulation 2003; 108: 857–862.CrossRefGoogle ScholarPubMed
12. Utens, EM, Verhulst, FC, Erdman, RA, et al. Psychosocial functioning of young adults after surgical correction for congenital heart disease in childhood: a follow-up study. J Psychosomat Res 1994; 38: 745–758.CrossRefGoogle ScholarPubMed
13. Leventhal, H, Colman, S. Quality of life: a process view. Psychol Health 1997; 12: 753–767.CrossRefGoogle Scholar
14. Eiser, C, Patterson, D, Casas, R. Illness experience and children's concepts of health and illness. Child: care, health and development 1993; 10: 157–162.CrossRefGoogle Scholar
15. Veldtman, GR, Matley, SL, Kendall, L, et al. Illness understanding in children and adolescents with heart disease. Heart 2000; 84: 395–397.Google Scholar
16. Chessa, M, De Rosa, G, Pardeo, M, et al. Illness understanding in adults with congenital heart disease. Ital Heart J 2005; 6: 895–899.Google Scholar
17. Chang, EC, D'zurilla, TJ, Maydeu-Olivares, A. Assessing the dimensionality of optimism and pessimism using a multimeasure approach. Cognitive Therapy Res 1994; 18: 143–160.CrossRefGoogle Scholar
18. Antonovsky, A. The structure and properties of the Sense of Coherence Scale. Soc Sci Med 1993; 36: 725–733.Google Scholar
19. Rose, M, Kohler, K, Kohler, F, Sawitzky, B, Fliege, H, Klapp, BF. Determinants of the quality of life of patients with congenital heart disease. Qual Life Res 2005; 14: 35–43.CrossRefGoogle ScholarPubMed
20. Wolff, AC, Ratner, PA. Stress, social support, and sense of coherence. West J Nurs Res 1999; 21: 182–197.Google Scholar
21. Fok, SK, Chair, SY, Lopez, V. Sense of Coherence, coping and quality of life following a critical illness. J Advanced Nurs 2005; 49: 173–181.Google Scholar
22. Boscaglia, N, Clarke, DM. Sense of Coherence as a protective factor for demoralisation in women with a recent diagnosis of gynaecological cancer. Psycho-Oncology 2007; 16: 189–195.Google Scholar
23. Moons, P, Norekval, TM. Is sense of coherence a pathway for improving the quality of life of patients who grow up with chronic disease? A hypothesis. Euro J Cardiovascul Nurs 2006; 5: 16–20.CrossRefGoogle Scholar
24. Zimet, GD, Dahlem, NW, Zimet, SG, Farley, GK. The multidimensional scale of perceived social support. J Personal Assess 1988; 52: 30–41.Google Scholar
25. DeMaso, DR, Campis, LK, Wypij, D. The impact of maternal perceptions and medical severity on the adjustment of children with congenital heart disease. J Paediatr Psychol 1991; 16: 137–149.CrossRefGoogle ScholarPubMed
26. Zigmond, AS, Snaith, RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361–370.Google Scholar
27. Wang, Q, Hay, M, Clarke, D, Menahem, S. The prevalence and predictors of anxiety and depression in adolescents with heart disease. J Pediatr 2012; 161: 943–946.CrossRefGoogle ScholarPubMed
28. Wang, QF, Hay, M, Clarke, D, Menahem, S. Adolescents’ drawing of their cardiac abnormality. Cardiol Young 2011; 21: 556–561.Google Scholar
29. Tong, EM, Kools, S. Health care transitions for adolescents with congenital heart disease: patient and family perspectives. Nurs Clin North Am 2004; 39: 727–740.CrossRefGoogle ScholarPubMed
30. Murray, B, Fortinberry, A. Creating Optimism: A Proven Seven-step Program for Overcoming Depression. New York: McGraw Hill, New York, 2004.Google Scholar
31. Caldera, K, Ha, D, Menahem, S. The development of a CD-ROM: an aid to fetal cardiac diagnosis and counselling. Fetal Diagn Ther 2013; 33: 61–64.Google Scholar
32. Ha, D, Hay, M, Menahem, S. Development of a DVD to educate parents about their child's heart condition. Heart Lung Circ 2011; 20: S234–S235; (Abstract).Google Scholar