Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland.
Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland.
Eur Heart J Qual Care Clin Outcomes. 2019 Apr 1;5(2):161-168. doi: 10.1093/ehjqcco/qcy046.
The aim of this study was to identify medical and psychosocial risk factors for impaired health-related quality of life (HRQoL) and poor psychological adjustment (PA) in young adults with congenital heart disease (CHD).
A group of 188 patients (43% females, ages 18-30 years) with various types of CHD and 139 age-matched healthy controls (57% females) completed questionnaires assessing HRQoL, PA, social support, significant life events in the past year, education level, civil status, and employment status. Medical variables were retrieved from the patients' hospital records. Patients reported worse physical HRQoL than controls but similar mental HRQoL and PA. Female CHD patients showed worse physical and mental HRQoL and poorer PA than males. In CHD patients, a lower educational level and lower physical exercise capacity predicted lower physical HRQoL, but complexity of CHD was not related to HRQoL or PA. Less social support was associated with lower mental HRQoL and poorer PA in CHD patients.
Young adults with CHD have impaired physical HRQoL but normal mental HRQoL and PA. Lower physical exercise capacity, female sex, less social support, and lower educational level predict an unfavourable quality of life and PA. This subgroup of patients should be monitored more closely and provided with special psychosocial care to improve long-term outcome.
本研究旨在确定医学和社会心理风险因素,这些因素与患有先天性心脏病(CHD)的年轻成年人健康相关生活质量(HRQoL)受损和心理调整不良(PA)有关。
一组 188 名(43%为女性,年龄 18-30 岁)患有各种类型 CHD 的患者和 139 名年龄匹配的健康对照者(57%为女性)完成了评估 HRQoL、PA、社会支持、过去一年重大生活事件、教育程度、婚姻状况和就业状况的问卷。患者的医学变量从他们的医院记录中获取。与对照组相比,患者报告的身体 HRQoL 更差,但心理 HRQoL 和 PA 相似。女性 CHD 患者的身体和心理 HRQoL 以及 PA 均比男性差。在 CHD 患者中,较低的教育程度和较低的体力活动能力预测较低的身体 HRQoL,但 CHD 的复杂性与 HRQoL 或 PA 无关。社会支持较少与 CHD 患者的心理 HRQoL 较低和 PA 较差有关。
患有 CHD 的年轻成年人身体 HRQoL 受损,但心理 HRQoL 和 PA 正常。较低的体力活动能力、女性、较少的社会支持和较低的教育程度预测生活质量和 PA 不良。应更密切监测这一亚组患者,并提供特殊的社会心理护理,以改善长期预后。