Freiberger Annika, Andonian-Dierks Caroline, Beckmann Jürgen, Freilinger Sebastian, Ewert Peter, Henningsen Peter, Kaemmerer Harald, Kohls Niko, Richter Cristina, Huber Maximilian
Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, TUM University Hospital, Munich, Germany.
Department of Psychosomatic Medicine and Psychotherapy, School of Medicine, Technical University Munich, Munich, Germany.
Int J Behav Med. 2024 Nov 12. doi: 10.1007/s12529-024-10332-z.
Due to various reasons explored in previous studies, adults with congenital heart disease (ACHD) are at risk of developing post-traumatic stress symptoms (PTSS). The aim of this study is to explore multiple potential psychosocial protective factors in ACHD and to understand their role in different complexities of congenital heart disease (CHD) and PTSS.
This study was part of the "ABS-AHF" study, where 234 ACHD were recruited from November 2021 to August 2022 at a tertiary CHD care center. Data were collected on PTSS (PDS), resilience (RS-13), sense of coherence (SOC-L9), and social support (F-SozU K-14).
The mean scores were 70.55 + / - 12.31 [21-91] for resilience, 35.83 + / - 4.81 [15-60] for sense of coherence (SOC), and 4.30 + / - 0.79 [0.93-5] for social support. SOC (OR, .91; p = .024 [.84; 9.98]) and social support (OR, .48; p = .001 [.29; 7.96]) were shown to reduce the likelihood of PTSS. Low resilience (OR, 2.40, p = .0248 [1.18; 5.18]) seems to increase this likelihood.
Integrating parents and relatives early on seems to be an important protective resource. Parental support in childhood affects the development of SOC which is in line with social support related to lower PTSS. With regard to resilience and SOC, a brief and manageable screening option for personal resources is available to refer potentially vulnerable patients to specialized psychosocial care. Care offers should address coping styles and life with CHD. Offering multidisciplinary care, integrating the patient's social network, and education for patients to increase resilience and SOC might provide a way to enhance psychosocial outcomes, quality of life, and adherence in ACHD.
由于先前研究中探讨的各种原因，患有先天性心脏病的成年人（ACHD）有出现创伤后应激症状（PTSS）的风险。本研究的目的是探讨ACHD中多种潜在的心理社会保护因素，并了解它们在先天性心脏病（CHD）不同复杂性和PTSS中的作用。
本研究是“ABS-AHF”研究的一部分，2021年11月至2022年8月期间在一家三级CHD护理中心招募了234名ACHD患者。收集了关于PTSS（PDS）、心理韧性（RS-13）、连贯感（SOC-L9）和社会支持（F-SozU K-14）的数据。
心理韧性的平均得分为70.55±12.31[21-91]，连贯感（SOC）的平均得分为35.83±4.81[15-60]，社会支持的平均得分为4.30±0.79[0.93-5]。结果显示，SOC（比值比，0.91；p=0.024[0.84；0.998]）和社会支持（比值比，0.48；p=0.001[0.29；0.796]）可降低PTSS的发生可能性。低心理韧性（比值比，2.40，p=0.0248[1.18；5.18]）似乎会增加这种可能性。
尽早让父母和亲属参与似乎是一种重要的保护资源。童年时期父母的支持会影响SOC的发展，这与较低的PTSS相关的社会支持是一致的。关于心理韧性和SOC，有一个简短且易于管理的个人资源筛查选项，可将潜在脆弱的患者转介至专门的心理社会护理。护理措施应针对应对方式和CHD患者的生活。提供多学科护理，整合患者的社会网络，并对患者进行教育以提高心理韧性和SOC，可能是改善ACHD患者心理社会结局、生活质量和依从性的一种途径。
