Original study
Social adaptation of young adults with congenital heart disease

https://doi.org/10.1016/0167-5273(92)90104-BGet rights and content

Abstract

The social status of 71 young adults (30 females, 41 males, aged 22.9 ± 1.9 yr) with congenital heart disease was compared with that of 211 (106 females, 105 males, mean age 23.2 ± 1.4 yr) randomly selected controls. The clinical examinations included clinical study with ultrasonic visualization, electrocardiography, X-ray and measurement of exercise capacity.

In the study group 87% had completed school at the secondary level and another 21% at high school level, while the corresponding figures in the control group were 98% and 51%. About half of both groups continued to vocational training and a fifth to a higher level. Those without any vocational education made up 32% of the study group (95% confidence interval 21–43%) and 11% of the controls (95% confidence interval 7–15%). State benefits were the main source of income for 13% of the study group as compared to 2% among the controls. The employment status of the actual labour force showed no significant difference between the groups. Among patients with congenital heart disease there were significantly more of those who had developed a dependent life style, living with their parents without a marital or quasi-marital relationship. A cyanotic type of severe heart defect is one of the factors predisposing to poor success at school and a dependent lifestyle.

Congenital heart disease, even when treated, is a significant factor which influences adult life. The results call for more practical support to assist psychosocial maturation, especially in patients with residual defects.

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    Better employment status was also observed in patients with mild versus severe defects (76% vs. 57%) in a study by Kamphuis et al. [31]. This observation is also partly explained by the greater social dependency of young adults with CHD [32], by discrimination against job applicants with CHD and by lower motivation in patients with CHD [30]. Even without a control population, it is obvious that the employment rate in our study is much lower than in the general population, as the unemployment rate in the area in the same year was about 10.4% [33].

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