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Anxiety, depressive and somatic symptoms in adults with congenital heart disease
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
Mid Sweden University, Faculty of Human Sciences, Department of Psychology.ORCID iD: 0000-0002-4116-5501
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Show others and affiliations
2013 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 74, no 1, 49-56 p.Article in journal (Refereed) Published
Abstract [en]

Objective

Despite the improvement in life-expectancy of adults with congenital heart disease, they may experience unique medical and social challenges that could impact on their psychological functioning. The aims of this study were to address the experience of anxiety, depressive and somatic symptoms among adults with congenital heart disease in comparison with that of non-heart diseased persons considering the role of various factors (e.g. socio-economic).

Methods

In cross-sectional case–control study, the participants consisted of 347 patients with congenital heart disease (18–64 years, 52.2% female) and 353 matched (by sex/age) non-heart diseased persons. The participants completed a questionnaire. The data were analyzed with bivariate and multivariate methods.

Results

In bivariate analyses, scores in anxiety and somatic symptoms were higher among patients than the healthy controls (both at p ≤ 0.001), whereas the groups did not differ in depressive symptoms. Following multiple-linear-regression-analyses, only the association between congenital heart disease and somatic symptoms was confirmed. Among the patients, perceived financial strain was significantly related to anxiety, depressive and somatic symptoms; lower perceived social support to anxiety and depression; and low annual income to somatic symptoms. Additionally, somatic symptoms were associated with anxiety and depressive symptoms, and vice versa. And no medical variables were related to anxiety, depressive and somatic symptoms.

Conclusions

Congenital heart disease was only independently associated with somatic symptoms. Financial strain, social support and co-existence of emotional distress with somatic symptoms should be considered in developing appropriate interventions to improve the well-being of patients with congenital heart disease. However, longitudinal research is warranted to clarify causality.

Place, publisher, year, edition, pages
2013. Vol. 74, no 1, 49-56 p.
Keyword [en]
Congenital heart disease; Grown-up; Mental health; Psychosomatic; Social functioning
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:miun:diva-17227DOI: 10.1016/j.jpsychores.2012.10.006ISI: 000313390100010Scopus ID: 2-s2.0-84871686549OAI: oai:DiVA.org:miun-17227DiVA: diva2:562291
Available from: 2013-01-18 Created: 2012-10-23 Last updated: 2015-07-01Bibliographically approved
In thesis
1. The Psychosocial Situation of Adults with Congenital Heart Disease in Iran
Open this publication in new window or tab >>The Psychosocial Situation of Adults with Congenital Heart Disease in Iran
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
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.

Place, publisher, year, edition, pages
Sundsvall: Faculty of Human Sciences, Mid Sweden University, 2013. 71 p.
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 168
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-20877 (URN)978-91-87557-14-9 (ISBN)
Public defence
2013-11-22, M 108, Holmgatan 10, Sundsvall, 11:52 (English)
Opponent
Supervisors
Available from: 2013-12-20 Created: 2013-12-20 Last updated: 2014-02-03Bibliographically approved

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