European Heart Journal vol:33 issue:suppl 1 pages:1064
European Society of Cardiology Congress 2012 location:Munich, Germany date:25-29 August 2012
Purpose: Life expectancy in patients with congenital heart disease (CHD) has increased substantially. In general, patients perceive their health as good, even in case of complex CHD. It is hypothesized that sense of coherence (SOC) plays a role in the perception of health. However, the interplay between SOC and perceived health has not been thoroughly scrutinized yet. Therefore, we examined the direction of relationships between SOC and domains of perceived health in adolescents with CHD.
Methods: In this longitudinal study, we assessed 429 adolescents with CHD at two points in time with a nine month interval. The median age was 16 years, and the sample comprised 53% boys. Subjects were recruited from the database of paediatric and congenital cardiology of our hospital, and were eligible if they had confirmed CHD; were 14-18 years of age at the start of the study; had a last cardiac consult ≤5 years ago; were able to read and write Dutch; and if valid contact details were available. Patients were excluded if they had cognitive and/or physical limitations inhibiting filling out the questionnaires; had prior heart transplantation; and if they did not consent. Participants were asked to complete the 13-item orientation to life questionnaire to measure SOC, and the generic and cardiac module of the PedsQL to measure generic and disease-specific perceived health. Cross-lagged path analysis using structural equation modelling was conducted, controlling for age, sex and disease complexity.
Results: SOC at time 1 negatively predicted all domains of generic perceived health (physical problems p<0.01; emotional problems p<0.001; social problems p<0.05; school problems p<0.001) and three out of five domains of disease-specific perceived health (symptoms p<0.05; physical appearance p<0.01; cognitive problems p<0.01) at time 2. Conversely, school problems (p<0.05), symptoms (p<0.05) and cognitive problems (p<0.05) at time 1 negatively predicted SOC at time 2.
Conclusions: Evidence was obtained for reciprocal pathways between SOC and the domains of perceived health, although the predominant direction of effects was from SOC to perceived health. Hence, SOC could be an important individual characteristic to focus on in intervention and prevention efforts. As such, improving SOC has the potential to enhance future perceived health of adolescents with CHD.