Saef Joshua, Sodhi Sandeep, Tecson Kristen M, Al Rashida Vanessa, Mi Ko Jong, White Kamila S, Ludbrook Philip A, Cedars Ari M
Department of Cardiology, Washington University School of Medicine, St Louis, Missouri.
Baylor Heart and Vascular Institute, Baylor Scott & White Research Institute, Dallas, Texas.
Congenit Heart Dis. 2018 Nov;13(6):967-977. doi: 10.1111/chd.12668. Epub 2018 Sep 27.
Growth in the adults with congenital heart disease (ACHD) population represents a challenge to the health care infrastructure. As patients with chronic disease are increasingly held accountable for their own care, contributors to disease-specific health knowledge, which are known to correlate with patients' participation in care, merit investigation to design patient-focused interventions.
We conducted a single-site, cross-sectional study of ACHD patients. Investigators retrospectively gathered clinical data as well as psychometric and health status assessments completed at the time of enrollment.
We investigated the impact of clinical and psychological variables on Leuven Knowledge Questionnaire for Congenital Heart Diseases health knowledge composite scores (HKCS). Variables with significant associations were considered in a stepwise multivariable regression model to determine which combination of variables jointly explained variability in HKCS.
Overall HKCS was associated with the number of prior cardiac surgeries (r = 0.273; 95% CI: 0.050-0.467; P = .016), perceived stress (r = 0.260; 95% CI: 0.033-0.458; P = .024), SF-36 emotional well-being (r = -0.251; 95% CI: -0.451, -0.024; P = .030), history of noncardiac surgery (P = .037), cirrhosis (P = .048), and presence of implantable cardioverter-defibrillator (P = .028). On multivariable modeling, only the number of cardiac surgeries was found to correlate with HKCS.
While univariate correlations were found between HCKS and several other clinical and psychological variables, only number of prior cardiac surgeries independently correlated with disease-specific health knowledge in ACHD patients. These results suggest that clinical and psychological variables are not impediments to disease-specific health knowledge.
先天性心脏病成年患者(ACHD)群体的增长对医疗保健基础设施构成了挑战。随着慢性病患者越来越多地要对自己的护理负责,特定疾病健康知识的影响因素值得研究,因为已知这些因素与患者参与护理相关,以便设计以患者为中心的干预措施。
我们对ACHD患者进行了一项单中心横断面研究。研究人员回顾性收集了临床数据以及入组时完成的心理测量和健康状况评估。
我们研究了临床和心理变量对鲁汶先天性心脏病知识问卷健康知识综合评分(HKCS)的影响。在逐步多变量回归模型中考虑具有显著关联的变量,以确定哪些变量组合共同解释了HKCS的变异性。
总体HKCS与既往心脏手术次数(r = 0.273;95%CI:0.050 - 0.467;P = 0.016)、感知压力(r = 0.260;95%CI:0.033 - 0.458;P = 0.024)、SF - 36情感健康(r = -0.251;95%CI:-0.451,-0.024;P = 0.030)、非心脏手术史(P = 0.037)、肝硬化(P = 0.048)和植入式心脏复律除颤器的存在(P = 0.028)相关。在多变量建模中,仅发现心脏手术次数与HKCS相关。
虽然发现HCKS与其他几个临床和心理变量之间存在单变量相关性,但在ACHD患者中,只有既往心脏手术次数与特定疾病健康知识独立相关。这些结果表明,临床和心理变量并非特定疾病健康知识的障碍。