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Gender differences in health conditions and socio-economic status of adults with congenital heart disease in a developing country
Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap. Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran . (folkhälsovetenskap)
Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för psykologi.ORCID-id: 0000-0002-4116-5501
Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap. Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden . (Folkhälsovetenskap)
Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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2013 (Engelska)Ingår i: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 23, nr 02, s. 209-218Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background Providing appropriate care for adults with congenital heart disease requires the evaluation of their current situation. There is limited research in Iran about these patients, particularly in relation to gender differences in the demographic/socio-economic and lifestyle factors, as well as disease parameters.

Materials and methods The sample consisted of 347 congenital heart disease patients in the age group of 18–64 years, including 181 women, assessed by an analytical cross-sectional study. The patients were recruited from the two major heart hospitals in Tehran. Data were collected using questionnaires.

Results The mean age of the patients was 33.24 years. Women were more often married and more often had offspring than men (p < 0.001). Educational level and annual income were similar between women and men. Unemployment was higher among women (p < 0.001), but financial strain was higher among men (p < 0.001). Smoking, alcohol, and water-pipe use was higher among men than among women (p < 0.001). Cardiac factors, for example number of cardiac defects, were similar among women and men, except that there were more hospitalisations owing to cardiac problems, for example arrhythmia, among men. Disease was diagnosed mostly at the hospital (57.4%). Most medical care was provided by cardiologists (65.1%). Only 50.1% of patients had knowledge about their type of cardiac defect.

Conclusion Gender differences exist in the socio-economic and lifestyle characteristics of adults with congenital heart disease, in some cases related to the disease severity. Our findings also point to the need for interventions to increase patients’ knowledge about, and use of, healthier lifestyle behaviours, irrespective of gender. Furthermore, providing appropriate jobs, vocational training, and career counselling may help patients to be more productive.

Ort, förlag, år, upplaga, sidor
2013. Vol. 23, nr 02, s. 209-218
Nyckelord [en]
Grown-up with congenital heart disease, lifestyle, socio-demographic status
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:miun:diva-16083DOI: 10.1017/S1047951112000625ISI: 000318623000007Scopus ID: 2-s2.0-84879804094OAI: oai:DiVA.org:miun-16083DiVA, id: diva2:515930
Tillgänglig från: 2012-04-16 Skapad: 2012-04-16 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
Ingår i avhandling
1. The Psychosocial Situation of Adults with Congenital Heart Disease in Iran
Öppna denna publikation i ny flik eller fönster >>The Psychosocial Situation of Adults with Congenital Heart Disease in Iran
2013 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Background and objectives:Adults with congenital heart disease (CHD) are a new group of patients with a prevalence of 4 per 1000. They have evolved as a result of significant improvements in medical management during the past decades. However, adults with CHD experience various medical and social challenges that may influence their psychosocial functioning. Providing appropriate medical, rehabilitation and social care for adults with CHD, and indeed improving their well-being require the evaluation of their current psychosocial situation. This thesis aims to increase the understanding of the mental health, somatic symptoms, social support, style of coping, quality of life and life satisfaction of adults with CHD and to examine the possible contributing factors in the context of a developing country; issues not addressed in the current literature.Methods:This thesis is based on four studies. Study I recruited 347 consecutive CHD patients (18-64 years) from two heart hospitals in Tehran, Iran. The study iscross-sectional and focused on sex differences in socio-economic status, lifestyle and medical characteristics of adults with CHD. Studies II, III and IV havea cross-sectional case-control design comparing the aforementioned CHD patients with 353 non-CHD participants, matched by sex and age. Outcome variables were anxiety, depressive and somatic symptoms (Study II), styles of coping (Study III), and life satisfaction/quality of life (Study IV). The data were analysed with bivariate and multivariate methods. Multivariate linear regression analyses were performed to scrutinize the association of demographic/socio-economic variables, social support, mental health, and medical variables with the aforementioned outcome variables among adults with CHD (Studies II, III, IV). Results:Study I showed that women with CHD were more often married and had children and were less often employed, but had healthier behaviour compared to men. Even though most of the patients received regular medical viiicare from different typesof medical professionals, half of them had no knowledge about the type of their cardiac defect. Study II showed that CHD patients experienced more anxiety and somatic symptoms than the healthy controls, whereas there were no differences in depressive symptoms. Perceived financial strain, lower social support and low annual income were positively associated with worse outcome in mental health and somatic symptoms. None of the medical variables were related to anxiety, depressive and somatic symptoms. Study III showed that the styles of coping of the CHD patients were comparable to those of the control group and CHD per se was not associated with a certain style of coping, except for palliative reaction pattern. Problem-focused styles of coping were associated with being never married, parenthood, higher level of anxiety and somatic symptoms, lower level of depressive symptoms and higher social support. Emotion-focused styles of coping were associated with annual income and higher level of anxiety. None of theadopted coping strategies were related to the heart disease variables. Study IV showed that adults with CHD had poorer quality of life and lower life satisfaction than the control group. However, CHD was associated only with decreased overall quality of life and its physical health domain, and life and health satisfaction. Among CHD patients, higher quality of life was associated with female sex, younger age, employment status, having less emotional distress and higher social support, while life satisfaction was associated with female sex, being employed, less emotional distress and higher social support. Conclusions:The results support the notion that psychosocial factors contribute to the well-being of adults with CHD.Socio-economic factors, emotional health and social support are significant determinants in nearly all outcomes of interest which need to be considered by health care providers and policy makers in their efforts to improve the health ofadults with CHD. However, longitudinal studies are warranted to establish causal linksand qualitative studies are recommended to deepen the understanding of coping and quality of life.

Ort, förlag, år, upplaga, sidor
Sundsvall: Faculty of Human Sciences, Mid Sweden University, 2013. s. 71
Serie
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 168
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:miun:diva-20877 (URN)978-91-87557-14-9 (ISBN)
Disputation
2013-11-22, M 108, Holmgatan 10, Sundsvall, 11:52 (Engelska)
Opponent
Handledare
Tillgänglig från: 2013-12-20 Skapad: 2013-12-20 Senast uppdaterad: 2014-02-03Bibliografiskt granskad

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