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Quality of life and life satisfaction among adults with and without 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.
Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap. Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden .
Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för psykologi.ORCID-id: 0000-0002-4116-5501
Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Vise andre og tillknytning
2015 (engelsk)Inngår i: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 22, nr 2, s. 169-179Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background Life-expectancy of adults with congenital heart disease (CHD) has improved world-wide, but there are limited data on these patients' experiences of quality of life (QoL), life satisfaction (LS), and their determinants (e.g. social support), particularly among patients from developing countries.

Design Cross-sectional case-control.

Methods A total of 347 CHD patients (18-64 years, 52.2% women) and 353 non-CHD participants, matched by sex/age, were recruited from two heart hospitals in Tehran, Iran. LS and QoL served as dependent variables, and demographic/socioeconomic status, mental-somatic symptoms, social support, and clinical factors (e.g. defect category) served as independent variables in multiple regression analyses once among all participants, and once only among CHD patients.

Results The CHD patients had significantly lower scores in LS and all domains of QoL than the control group. However, having CHD was independently negatively associated only with overall QoL, physical health, and life and health satisfaction. Additionally, multivariate analyses among the CHD patients revealed that female sex, younger age, being employed, less emotional distress, and higher social support were significantly associated with higher perceived QoL in most domains, while LS was associated with female sex, being employed, less emotional distress, and better social support. Neither QoL nor LS was associated with cardiac defect severity.

Conclusions The adults with CHD had poorer QoL and LS than their non-CHD peers in our developing country. Socio-demographics, emotional health, and social support were important 'determinants' of QoL and LS among the CHD patients. Longitudinal studies are warranted to establish causal links.

sted, utgiver, år, opplag, sider
2015. Vol. 22, nr 2, s. 169-179
Emneord [en]
Grown-up congenital heart disease; heart defect; mental health; psychosocial; social support
HSV kategori
Identifikatorer
URN: urn:nbn:se:miun:diva-20112DOI: 10.1177/2047487313514017ISI: 000348115400004Scopus ID: 2-s2.0-84920942176OAI: oai:DiVA.org:miun-20112DiVA, id: diva2:661325
Merknad

Publ online before print 18 nov 2013

Tilgjengelig fra: 2013-11-02 Laget: 2013-11-02 Sist oppdatert: 2017-12-06bibliografisk kontrollert
Inngår i avhandling
1. The Psychosocial Situation of Adults with Congenital Heart Disease in Iran
Åpne denne publikasjonen i ny fane eller vindu >>The Psychosocial Situation of Adults with Congenital Heart Disease in Iran
2013 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
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.

sted, utgiver, år, opplag, sider
Sundsvall: Faculty of Human Sciences, Mid Sweden University, 2013. s. 71
Serie
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 168
HSV kategori
Identifikatorer
urn:nbn:se:miun:diva-20877 (URN)978-91-87557-14-9 (ISBN)
Disputas
2013-11-22, M 108, Holmgatan 10, Sundsvall, 11:52 (engelsk)
Opponent
Veileder
Tilgjengelig fra: 2013-12-20 Laget: 2013-12-20 Sist oppdatert: 2014-02-03bibliografisk kontrollert

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