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Assessment of the Psychological Situation in Adults with Congenital Heart Disease

Background: Due to advances in the diagnosis and treatment of congenital heart disease (CHD), the number of adults who are surviving with congenital heart disease (ACHD) is constantly growing. Until recently, the psychological effects of CHD had been widely neglected. Current research provides evide...

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Autores principales: Andonian, Caroline, Beckmann, Jürgen, Ewert, Peter, Freilinger, Sebastian, Kaemmerer, Harald, Oberhoffer-Fritz, Renate, Sack, Martin, Neidenbach, Rhoia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141297/
https://www.ncbi.nlm.nih.gov/pubmed/32182982
http://dx.doi.org/10.3390/jcm9030779
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author Andonian, Caroline
Beckmann, Jürgen
Ewert, Peter
Freilinger, Sebastian
Kaemmerer, Harald
Oberhoffer-Fritz, Renate
Sack, Martin
Neidenbach, Rhoia
author_facet Andonian, Caroline
Beckmann, Jürgen
Ewert, Peter
Freilinger, Sebastian
Kaemmerer, Harald
Oberhoffer-Fritz, Renate
Sack, Martin
Neidenbach, Rhoia
author_sort Andonian, Caroline
collection PubMed
description Background: Due to advances in the diagnosis and treatment of congenital heart disease (CHD), the number of adults who are surviving with congenital heart disease (ACHD) is constantly growing. Until recently, the psychological effects of CHD had been widely neglected. Current research provides evidence for an increased risk of emotional distress in ACHD. The concept of illness identity attempts to explain how patients experience and integrate their CHD into their identities. The present study investigated illness identity in relation to clinical parameters and psychological functioning. Psychometric properties of the German version of the Illness Identity Questionnaire (IIQD) were examined. Methods: Self-reported measures on illness identity and psychological functioning (HADS-D) were assessed in a representative sample of 229 ACHD (38 ± 12.5 (18−73) years; 45% female) at the German Heart Center Munich. Descriptive analyses and multiple regression models were conducted. Confirmatory factor analysis was performed to validate the IIQD. Results: The IIQD demonstrated good reliability. The originally-postulated four-factor structure could not be replicated. Anatomic disease complexity and functional status significantly influenced illness identity. Illness identity accounted for unique variances in depression and anxiety: Maladaptive illness identity states (i.e., , engulfment and rejection) were associated with higher emotional distress, whereas adaptive illness (i.e., , acceptance and enrichment) identity states were linked to lower emotional distress. Conclusions: Illness Identity emerged as a predictor of emotional distress in ACHD. Findings raise the possibility that interventions designed to target a patient’s illness identity may improve psychological well-being and cardiac outcomes in ACHD.
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spelling pubmed-71412972020-04-10 Assessment of the Psychological Situation in Adults with Congenital Heart Disease Andonian, Caroline Beckmann, Jürgen Ewert, Peter Freilinger, Sebastian Kaemmerer, Harald Oberhoffer-Fritz, Renate Sack, Martin Neidenbach, Rhoia J Clin Med Article Background: Due to advances in the diagnosis and treatment of congenital heart disease (CHD), the number of adults who are surviving with congenital heart disease (ACHD) is constantly growing. Until recently, the psychological effects of CHD had been widely neglected. Current research provides evidence for an increased risk of emotional distress in ACHD. The concept of illness identity attempts to explain how patients experience and integrate their CHD into their identities. The present study investigated illness identity in relation to clinical parameters and psychological functioning. Psychometric properties of the German version of the Illness Identity Questionnaire (IIQD) were examined. Methods: Self-reported measures on illness identity and psychological functioning (HADS-D) were assessed in a representative sample of 229 ACHD (38 ± 12.5 (18−73) years; 45% female) at the German Heart Center Munich. Descriptive analyses and multiple regression models were conducted. Confirmatory factor analysis was performed to validate the IIQD. Results: The IIQD demonstrated good reliability. The originally-postulated four-factor structure could not be replicated. Anatomic disease complexity and functional status significantly influenced illness identity. Illness identity accounted for unique variances in depression and anxiety: Maladaptive illness identity states (i.e., , engulfment and rejection) were associated with higher emotional distress, whereas adaptive illness (i.e., , acceptance and enrichment) identity states were linked to lower emotional distress. Conclusions: Illness Identity emerged as a predictor of emotional distress in ACHD. Findings raise the possibility that interventions designed to target a patient’s illness identity may improve psychological well-being and cardiac outcomes in ACHD. MDPI 2020-03-13 /pmc/articles/PMC7141297/ /pubmed/32182982 http://dx.doi.org/10.3390/jcm9030779 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Andonian, Caroline
Beckmann, Jürgen
Ewert, Peter
Freilinger, Sebastian
Kaemmerer, Harald
Oberhoffer-Fritz, Renate
Sack, Martin
Neidenbach, Rhoia
Assessment of the Psychological Situation in Adults with Congenital Heart Disease
title Assessment of the Psychological Situation in Adults with Congenital Heart Disease
title_full Assessment of the Psychological Situation in Adults with Congenital Heart Disease
title_fullStr Assessment of the Psychological Situation in Adults with Congenital Heart Disease
title_full_unstemmed Assessment of the Psychological Situation in Adults with Congenital Heart Disease
title_short Assessment of the Psychological Situation in Adults with Congenital Heart Disease
title_sort assessment of the psychological situation in adults with congenital heart disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141297/
https://www.ncbi.nlm.nih.gov/pubmed/32182982
http://dx.doi.org/10.3390/jcm9030779
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