Abstract 16159: The Association of Psychosocial Factors to Self-Reported Functional Health Status in a Large Cohort of Young Adults With Repaired Transposition of the Great Arteries: A Multi-Institutional Congenital Heart Surgeons' Society Study
Objectives: Improved survival after congenital heart disease (CHD) surgery has led to increased interest in functional health status (FHS) as patients transition to adulthood. We sought to identify factors associated with self-reported FHS of young adults with repaired TGA.
Methods: Survivors followed into adulthood from a 1985-1989 CHSS inception cohort of neonates with TGA completed the SF-36 as a measure of current FHS (n=210; age 21-26 years). Patient characteristics, medical history, psychosocial factors, and previous adolescent FHS assessment by CHQ-CF87 were explored for association with SF-36 domains.
Results: Patients scored themselves the same or higher than published normative data in multiple SF-36 domains (table). Factors most commonly associated with lower domain scores were presence of cardiac symptoms, heart condition impacting physical activity/overall health/quality of life, unemployment, and lack of post secondary education. Less commonly associated factors were lower birth weight, higher total medication number, female gender, shorter procedure free interval, poor health knowledge, lower family income, younger age at SF-36, living with parents, and being married. Adolescent CHQ-CF87 scores associated with lower adult FHS included more bodily pain, lower self-esteem, more behavioral problems, social limitations, fewer family activities/higher stress due to health, and worse mental health. These factors accounted for 17 to 47% of the variation in FHS domain scores. Of note, FHS was minimally related to TGA morphology and repair type.
Conclusions: Most repaired TGA patients surviving into adulthood, regardless of cardiac morphology or repair type, can expect at least normal FHS. FHS was associated with current medical status, perceived impact of heart condition and psychosocial factors. Addressing the challenges of CHD patients entering adulthood requires consideration of psychosocial factors as well as clinical management.
- Adult congenital heart disease
- Congenital heart disease
- Congenital heart surgery
- Pediatric cardiology
- Quality of life
- © 2011 by American Heart Association, Inc.