J Cardiovasc Nurs. 2023;38(1):60-69. doi: 10.1097/JCN.0000000000000941. Epub 2022 Aug 29.
Adults with congenital heart defects (CHDs) have an increased risk for cardiovascular complications, but few are in optimal cardiovascular health. Executive function deficits, which are elevated among CHD survivors, may contribute to engagement in behaviors that increase cardiovascular risk.
The aim of this study was to identify the association between executive function and the health risk behaviors of tobacco use, saturated fat intake, and insufficient physical activity among young adults with CHDs.
Young adults with CHDs completed the Behavior Rating Inventory of Executive Function-Adult Version, which yields composite and 9 individual domain scores (eg, inhibition, working memory). Participants also completed self-report measures of tobacco use, saturated fat intake, and physical activity. Linear and logistic regression models determined the association between executive function and risky health behaviors, adjusting for demographic factors, disease status, and emotional distress.
One in 10 young adults with CHDs reported clinically significant difficulties with global executive function. Difficulties with global executive function were associated with increased tobacco use ( P = .018) and greater saturated fat intake ( P = .015) but not insufficient physical activity ( P = .902). Difficulties with inhibition were specifically associated with increased tobacco use ( P = .003) and greater saturated fat intake ( P = .007), and problems with self-monitoring were associated with increased tobacco use ( P = .017).
Executive function difficulties are associated with self-reported engagement in health risk behaviors among young adults with CHDs. Health behavior interventions for adult CHD survivors may require additional modifications that consider executive function problems, particularly difficulties with inhibition.
患有先天性心脏病 (CHD) 的成年人患心血管并发症的风险增加,但很少有人处于最佳心血管健康状态。执行功能缺陷在 CHD 幸存者中升高,可能导致其参与增加心血管风险的行为。
本研究旨在确定执行功能与 CHD 年轻患者的吸烟、饱和脂肪摄入和体力活动不足等健康风险行为之间的关联。
CHD 年轻患者完成了行为评定量表的执行功能成人版,该量表产生综合和 9 个单独的领域分数(例如,抑制、工作记忆)。参与者还完成了吸烟、饱和脂肪摄入和体力活动的自我报告测量。线性和逻辑回归模型确定了执行功能与危险健康行为之间的关联,同时调整了人口统计学因素、疾病状况和情绪困扰。
十分之一的 CHD 年轻患者报告存在全球执行功能的临床显著困难。全球执行功能困难与增加的吸烟(P=0.018)和更多的饱和脂肪摄入(P=0.015)相关,但与体力活动不足无关(P=0.902)。抑制方面的困难与增加的吸烟(P=0.003)和更多的饱和脂肪摄入(P=0.007)相关,自我监控方面的问题与增加的吸烟(P=0.017)相关。
执行功能困难与 CHD 年轻患者自我报告的健康风险行为的参与有关。针对成年 CHD 幸存者的健康行为干预可能需要进行额外的修改,以考虑执行功能问题,特别是抑制方面的困难。