Steiner Jill M, Nassans Katherine, Brumback Lyndia, Stout Karen K, Longenecker Chris T, Yi-Frazier Joyce P, Curtis J Randall, Rosenberg Abby R
Division of Cardiology, Department of Medicine & Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA.
Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA.
JACC Adv. 2024 May;3(5). doi: 10.1016/j.jacadv.2024.100917. Epub 2024 Mar 28.
Adult congenital heart disease (ACHD) can negatively impact quality of life (QOL). Strengthening resilience may improve this and other psychosocial outcomes important for living a meaningful life.
The purpose of this study was to describe resilience and key psychosocial health outcomes in ACHD and evaluate the associations between resilience and these outcomes.
We conducted a prospective cohort study of outpatients with moderate or complex ACHD between May 2021 and June 2022. Participants completed surveys at baseline and 3 months, evaluating resilience (Connor-Davidson Resilience Scale-10), health-related QOL (EQ5D-3L, linear analog scale), health status (Euroqol visual analog scale), self-competence (Perceived Competence Scale), and psychological symptom burden (Hospital Anxiety and Depression Scale) and distress (Kessler-6).
The mean participant age (N = 138) was 41 ± 14 years, 51% were female, and 83% self-identified as non-Hispanic White. ACHD was moderate for 75%; 57% were physiologic class B. Mean baseline resilience score (Connor-Davidson Resilience Scale-10) was 29.20 ± 7.54. Participants had relatively good health-related QOL, health status, and self-competence, and low psychological symptom burden and distress. Higher baseline resilience was associated with better values of all outcomes at 3 months (eg, 1 point higher resilience was associated with 0.92 higher linear analog scale; 95% CI: 0.52-1.32) with or without adjustment for demographics. After further adjusting for the baseline psychosocial measure, only the association between resilience and QOL measures at 3 months remained statistically significant.
Resilience is positively associated with health-related QOL for outpatients with moderate or complex ACHD, though relationships are small in magnitude. Study findings can guide the application of resilience-building interventions to the ACHD population.
成人先天性心脏病（ACHD）会对生活质量（QOL）产生负面影响。增强心理韧性可能会改善这种情况以及其他对有意义生活至关重要的心理社会结果。
本研究的目的是描述ACHD患者的心理韧性和关键心理社会健康结果，并评估心理韧性与这些结果之间的关联。
我们在2021年5月至2022年6月期间对患有中度或复杂性ACHD的门诊患者进行了一项前瞻性队列研究。参与者在基线和3个月时完成了调查，评估心理韧性（Connor-Davidson心理韧性量表-10）、健康相关生活质量（EQ5D-3L、线性模拟量表）、健康状况（欧洲五维度健康量表视觉模拟量表）、自我能力（感知能力量表）以及心理症状负担（医院焦虑抑郁量表）和困扰（Kessler-6量表）。
参与者的平均年龄（N = 138）为41±14岁，51%为女性，83%自我认定为非西班牙裔白人。75%的ACHD为中度；57%为生理功能B级。基线时心理韧性平均得分（Connor-Davidson心理韧性量表-10）为29.20±7.54。参与者的健康相关生活质量、健康状况和自我能力相对较好，心理症状负担和困扰较低。较高的基线心理韧性与3个月时所有结果的更好值相关（例如，心理韧性得分每高1分，线性模拟量表得分高0.92；95%置信区间：0.52 - 1.32），无论是否对人口统计学因素进行调整。在进一步调整基线心理社会测量指标后，只有心理韧性与3个月时生活质量测量指标之间的关联仍具有统计学意义。
对于患有中度或复杂性ACHD的门诊患者，心理韧性与健康相关生活质量呈正相关，尽管这种关系的程度较小。研究结果可为针对ACHD人群的心理韧性建设干预措施的应用提供指导。
