Abstract
Quality of life (QOL) is a key outcome in patients with congenital heart disease (CHD) because CHD has become a chronic condition accompanied by lifelong impairments. Recently, published studies on QOL in adults with CHD have reported inconsistent findings. Patients’ QOL seems to depend on multiple factors and is not solely determined by their heart defect and various medical or demographic characteristics. For instance, evidence suggests that a strong sense of coherence might be an important pathway to improve QOL. However, studies on QOL and its determinants are characterized by important methodological differences and limitations, making it impossible to draw firm conclusions. To fill the gaps in the current evidence base, longitudinal and international research is needed. Furthermore, the research field on QOL in CHD should move on from observational studies to interventional research to guide health professionals in improving QOL.
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Wernovsky G. Improving neurologic and quality-of-life outcomes in children with congenital heart disease: past, present, and future. J Thorac Cardiovasc Surg. 2008;135:240–2.
Moons P, Bovijn L, Budts W, et al. Temporal trends in survival to adulthood among patients born with congenital heart disease from 1970 to 1992 in Belgium. Circulation. 2010;122:2264–72.
Marelli A. The future of ACHD Care Symposium: changing demographics of congenital heart disease. Prog Pediatr Cardiol. 2012;34:85–90.
Kovacs AH, Sears SF, Saidi AS. Biopsychosocial experiences of adults with congenital heart disease: review of the literature. Am Heart J. 2005;150:193–201.
Moons P, Budts W, De Geest S. Critique on the conceptualisation of quality of life: a review and evaluation of different conceptual approaches. Int J Nurs Stud. 2006;43:891–901.
Uzark K, King E, Spicer R, et al. The clinical utility of health-related quality of life assessment in pediatric cardiology outpatient practice. Congenit Heart Dis. 2013;8:211–8.
•• Fteropoulli T, Stygall J, Cullen S, et al. Quality of life of adult congenital heart disease patients: a systematic review of the literature. Cardiol Young. 2013;23:473–85. The authors reviewed 31 studies describing quality of life in adults with congenital heart disease. They concluded that physical quality of life seems to be compromised in this patient population, but more methodologically sound research is needed.
Gierat-Haponiuk K, Haponiuk I, Chojnicki M, et al. Exercise capacity and the quality of life late after surgical correction of congenital heart defects. Kardiol Pol. 2011;69:810–5.
Görler H, Ono M, Thies A, et al. Long-term morbidity and quality of life after surgical repair of transposition of the great arteries: atrial versus arterial switch operation. Interact Cardiovasc Thorac Surg. 2011;12:569–74.
Overgaard D, Schrader AM, Lisby KH, et al. Patient-reported outcomes in adult survivors with single-ventricle physiology. Cardiology. 2011;120:36–42.
Silva AM, Vaz C, Areias ME, et al. Quality of life of patients with congenital heart diseases. Cardiol Young. 2011;21:670–6.
Teixeira FM, Coelho RM, Proença C, et al. Quality of life experienced by adolescents and young adults with congenital heart disease. Pediatr Cardiol. 2011;32:1132–8.
Vigl M, Niggemeyer E, Hager A, et al. The importance of socio-demographic factors for the quality of life of adults with congenital heart disease. Qual Life Res. 2011;20:169–77.
Cotts T, Malviya S, Goldberg C. Quality of life and perceived health status in adults with congenitally corrected transposition of the great arteries. J Thorac Cardiovasc Surg. 2012;143:885–90.
Müller J, Hess J, Hager A. Daily physical activity in adults with congenital heart disease is positively correlated with exercise capacity but not with quality of life. Clin Res Cardiol. 2012;101:55–61.
Opić P, Utens EM, Moons P, et al. Psychosocial impact of implantable cardioverter defibrillators (ICD) in young adults with Tetralogy of Fallot. Clin Res Cardiol. 2012;101:509–19.
• Schoormans D, Mulder BJ, van Melle JP, et al. Patients with a congenital heart defect and type D personality feel functionally more impaired, report a poorer health status and quality of life, but use less healthcare. Eur J Cardiovasc Nurs. 2012;11:349–55. This is the first study examining Type D personality in patients with congenital heart disease. The authors found that these patients have a significantly lower quality of life than non-Type D patients emphasizing the importance of screening for psychosocial factors, such as personality.
Ruys TP, van der Bosch AE, Cuypers JA, et al. Long-term outcome and quality of life after arterial switch operation: a prospective study with a historical comparison. Congenit Heart Dis. 2013;8:203–10.
•• Luyckx K, Missotten L, Goossens E, Moons P. Individual and contextual determinants of quality of life in adolescents with congenital heart disease. J Adolesc Health. 2012;51:122–8. This longitudinal study aimed to identify potential determinants of quality of life in a large sample of adolescents with congenital heart disease, focusing on parental support, peer support, and sense of coherence. This study greatly contributed to our knowledge on temporal sequences and developmental pathways between individual and contextual determinants of quality of life in this patient population.
Antonovsky A. Health, stress, and coping: new perspectives on mental and physical well being. San Francisco: Jossey-Bass; 1979.
Seligman MEP, Csikszentmihalyi M. Positive psychology: an introduction. Am Psychol. 2000;55:5–14.
Antonovsky A. Unraveling the mystery of health: how people manage stress and stay well. San Francisco: Jossey-Bass; 1987.
Eriksson M, Lindström B. Antonovsky’s sense of coherence scale and the relation with health: a systematic review. J Epidemiol Community Health. 2006;60:376–81.
Eriksson M, Lindström B. Antonovsky’s sense of coherence scale and its relation with quality of life: a systematic review. J Epidemiol Community Health. 2007;61:938–44.
Moons P, Norekvål TM. Is sense of coherence a pathway for improving the quality of life of patients who grow up with chronic diseases? A hypothesis. Eur J Cardiovasc Nurs. 2006;5:16–20.
• Nio K. Sense of coherence in adolescents with congenital cardiac disease. Cardiol Young. 2010;20:538–46. This is the first study investigating sense of coherence in patients with congenital heart disease. The author concluded that adolescents with congenital heart disease scored higher for sense of coherence than healthy students.
•• Neuner B, Busch MA, Singer S, et al. Sense of coherence as a predictor of quality of life in adolescents with congenital heart defects: a register-based 1-year follow-up study. J Dev Behav Pediatr. 2011;32:316–27. This is the first study investigating the relationship between quality of life and sense of coherence in patients with congenital heart disease. The authors included a large group of adolescents and found that sense of coherence independently predicts their quality of life.
Apers S, Luyckx K, Rassart J, et al. Sense of coherence is a predictor of perceived health in adolescents with congenital heart disease: a cross-lagged prospective study. Int J Nurs Stud. 2013;50:776-85.
Wang Q, Hay M, Clarke D, Menahem S. The prevalence and predictors of anxiety and depression in adolescents with heart disease. J Pediatr. 2012;161:943–6.
Apers S, Moons P, Goossens E, et al. Sense of coherence and perceived physical health explain the better quality of life in adolescents with congenital heart disease. Eur J Cardiovasc Nurs. 2013. doi:10.1177/1474515113477955.
Wang Q, Hay M, Clarke D, Menahem S. Associations between knowledge of disease, depression and anxiety, social support, sense of coherence and optimism with health-related quality of life in an ambulatory sample of adolescents with heart disease. Cardiol Young. 2013. doi:10.1017/S1047951113000012.
Moons P. Why call it health-related quality of life when you mean perceived health status? Eur J Cardiovasc Nurs. 2004;3:275–7.
Smith KW, Avis NE, Assmann SF. Distinguishing between quality of life and health status in quality of life research: a meta-analysis. Qual Life Res. 1999;8:447–59.
Zullig KJ, Valois RF, Drane JW. Adolescent distinctions between quality of life and self-rated health in quality of life research. Health Qual Life Outcomes. 2005;3:64.
Taylor RM, Gibson F, Franck LS. The experience of living with a chronic illness during adolescence: a critical review of the literature. J Clin Nurs. 2008;17:3083–91.
Dahan-Oliel N, Majnemer A, Mazer B. Quality of life of adolescents and young adults born at high risk. Phys Occup Ther Pediatr. 2011;31:362–89.
Langeland E, Riise T, Hanestad BR, et al. The effect of salutogenic treatment principles on coping with mental health problems: a randomised controlled trial. Patient Educ Couns. 2006;62:212–9.
Rassart J, Luyckx K, Klimstra T, Moons P. The importance of studying personality in individuals with congenital heart disease. Eur J Cardiovasc Nurs. 2012;11:261–2.
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Silke Apers, Koen Luyckx, and Philip Moons declare that they have no conflict of interest.
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This article is part of the Topical Collection on Congenital Heart Disease
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Apers, S., Luyckx, K. & Moons, P. Quality of Life in Adult Congenital Heart Disease: What Do We Already Know and What Do We Still Need To Know?. Curr Cardiol Rep 15, 407 (2013). https://doi.org/10.1007/s11886-013-0407-x
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DOI: https://doi.org/10.1007/s11886-013-0407-x