Quality of Life in Adults of Congenital Heart Disease

Background and Purposes: Due to the advancement of the pediatric cardiology, the number of the adult congenital heart disease (ACHD) patient has been stably grown. However, the complicated medical and psychosocial issues have affected the patients’ quality of life (QOL). The aim of this research is to investigate the adult congenital heart disease patients’ quality of life as well as other relevant influential factors.
Research method: This research applied the cross-sectional design to collect data, by means of purposive sampling approach at the Cardiology Department of a medical center in Taipei, from 10th November 2009 to 24th February 2010. Further, this research targeted on the ACHD patients aged between 18 and 65 and divided the sample into complicated and simple groups. 133 patients meet the requirement of the target and 121 valid samples were collected with a 91% of valid return rate. The content of the structured questionnaire includes the World Health Organization Quality of Life-BREF (WHOQOL-BREF) Taiwan version, the functional classification of the New York Heart Associations and demographic information form. Finally, the SPSS 13.0 for windows was used to conduct the descriptive and inferred statistics analysis.
Results:
1. The physical health domain received the highest score among four QOL for both groups. The social relationships domain received the lowest score for the complicated group while the psychological domain of the simple group received the lowest score. The scores of the social relationships and environment domains for the simple group were significantly higher than the scores of the complicated group. The physical health domain and the general health (G4) of the research subjects were significantly lower than those of the health people. However, the scores of the environment domain and the overall QOL (G1) were significantly higher than the scores of the healthy people. The overall score of the research targets were higher than the score of the heart disease patients and the hemodialysis patients.
2. For the complicated group, the scores of the physical health and psychological domains of the non believers in religion were significant higher than the scores of the religious believers. Those who were good/very good self-awareness of their health received much better physical health and psychological scores than those who were poor/very poorly self-awareness. Those who were happy/very happy about their lives received significant higher scores in all the four domains. The time for diagnosing the congenital heart disease was significantly negatively associated with the physical health domain. In other words, if the time for diagnosing the congenital heart disease was longer, the QOL of physical domain were worse. Moreover, the number of treatment was negatively associated with the QOL of the psychological domain. In other words, if the number of treatment required increases, the QOL of the psychological domain were decrease. For the simple group, the married couples/cohabitants received significant higher score in physical health domain than divorced/separated couples. Those who had a server illness card receive significant lower score in physical health domain than those who did not have. Those who were good/very good self-awareness of their health condition significantly received the highest score in physical health, psychological and environment domains. Those who were happy/very happy about their lives significantly received the highest scores in all of the four domains. The patients without other disease received higher score in psychology domain than the patients who had another disease. The patients who had the operation and catheterization received the lowest scores in both physical health and environment domains. The patients who did not take the cardiac medication received higher score in physical health domain comparing to those who took the medication. The amount of the cardiac medication being taken was significantly negatively associated with the physical health domain, which means the QOL of the physical health domain were decrease if the amount of the cardiac medication increases.
3. The predicted variables of that had the impact on the four QOL domains, the physical health domain included the self-awareness of health and life condition and the amount of the cardiac medication; the psychological domain included self-awareness of life condition, other medical history and self-awareness of health condition; the social relationships and environment domains included the self-awareness of life condition, disease groups, and the explained variances ranged from 24.1% to 44.2%.
Conclusion: The ACHD patients receive lower scores of quality of life in the physical domain and general health (G4), but receive scores similar to healthy people in other domains of QOL. Besides, they also have a better QOL comparing to the chronic heart disease and hemodialysis patients. In the future, more attention will be paid to the needs of the physical and psychological perspectives for ACHD. The finding of this research is benefical to understand the life quality of the heart disease patients meanwhile providing the references for the health care team workers in terms of the implementation of the holistic care management plan.