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Quality of life in adults with congenital heart disease: biopsychosocial determinants and sex-related differences
  1. Chun-An Chen1,2,
  2. Shih-Cheng Liao3,7,
  3. Jou-Kou Wang1,
  4. Chung-I Chang4,
  5. Ing-Sh Chiu4,
  6. Yih-Sharng Chen4,
  7. Chun-Wei Lu1,5,
  8. Ming-Tai Lin1,
  9. Hsin-Hui Chiu1,
  10. Shuenn-Nan Chiu1,
  11. Yu-Chuan Hua6,
  12. Hung-Chi Lue1,6,
  13. Mei-Hwan Wu1
  1. 1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
  2. 2Heart Failure Center, National Taiwan University Hospital, Taipei, Taiwan
  3. 3Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
  4. 4Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
  5. 5Adult Congenital Heart Center, National Taiwan University Hospital, Taipei, Taiwan
  6. 6Cardiac Children's Foundation, Taiwan
  7. 7Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan
  1. Correspondence to Dr Mei-Hwan Wu, Division of Pediatric Cardiology, Department of Pediatrics, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan; wumh{at}ntu.edu.tw

Abstract

Objectives To assess the quality of life (QoL) in adults with congenital heart disease (ACHD) and to explore the sex-related differences and biopsychosocial determinants in an Asian cohort.

Design Prospective cross-sectional clinical study.

Setting One tertiary medical centre in Taiwan.

Patients and methods The QoL of ACHD (≥20 years) was investigated using the Taiwanese version of the QoL questionnaire designed by the WHO, which assesses four domains of QoL (physical, psychological, social and environmental). Personality, psychological distress and family support were assessed using the Maudsley Personality Inventory, Brief Symptom Rating Scale, and the Family APGAR score, respectively.

Results A total of 289 patients (age 33.2±10.6 years; 36% men) were studied. ACHD women had significantly lower QoL scores in the physical and psychological domains compared to the age-matched general population, whereas no differences were observed between ACHD men and the general population. Multivariate analysis showed that female gender was associated with poorer physical QoL; the sex difference in the psychological QoL was mediated by psychological distress. Interaction analysis showed that the effect of family support on the psychological domain of QoL may be different by sex. The determinants of QoL varied between different domains. Extroversion personality trait, psychological distress and family support were common determinants of most domains of QoL.

Conclusions In ACHD, female gender was associated with poor physical and psychological QoL. The common denominators for QoL were primarily personality trait, psychological distress and family support, but not disease severity.

  • Adults with congenital heart disease
  • sex discrepancy
  • quality of life
  • paediatric cardiology

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Footnotes

  • Funding This work was supported by a grant (CCFT0802) from the Cardiac Children's Foundation, Taiwan.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Institutional Review Board, National Taiwan University Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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