Lykkeberg, BirgitteBirgitteLykkebergChristensen, Anne VinggaardAnne VinggaardChristensenBerg, Selina KikkenborgSelina KikkenborgBergLarsen, Signe HolmSigne HolmLarsenVan Bulck, LiesbetLiesbetVan BulckGoossens, EvaEvaGoossensKovacs, Adrienne HAdrienne HKovacsLuyckx, KoenKoenLuyckxLadak, Laila AkbarLaila AkbarLadakLeye, MohamedMohamedLeyeVan De Bruaene, AlexanderAlexanderVan De BruaeneLeong, Ming ChernMing ChernLeongKaneva, AnnaAnnaKanevaAmaral, FernandoFernandoAmaralAraujo, John JairoJohn JairoAraujoSasikumar, NavaneethaNavaneethaSasikumarGabriel, HaraldHaraldGabrielGoshu, Dejuma YadetaDejuma YadetaGoshuWang, Jou-KouJou-KouWangEnomoto, JunkoJunkoEnomotoAreias, Maria EmíliaMaria EmíliaAreiasKosmidis, DiamantisDiamantisKosmidisCoats, LouiseLouiseCoatsValente, Anne MarieAnne MarieValenteMoon, Ju RyoungJu RyoungMoonLadouceur, MagalieMagalieLadouceurThomet, CorinaCorinaThometJackson, Jamie LJamie LJacksonSandberg, CamillaCamillaSandbergCallus, EdwardEdwardCallusKim, Yuli YYuli YKimAlday, LuisLuisAldayBredy, CharleneCharleneBredySaidi, ArwaArwaSaidiReyes, Fernando BaraonaFernando BaraonaReyesMenahem, SamuelSamuelMenahemde Hosson, MichèleMichèlede HossonHlebowicz, JoannaJoannaHlebowiczChristersson, ChristinaChristinaChristerssonZaidi, AliAliZaidiJohansson, BengtBengtJohanssonAndresen, BrithBrithAndresenAmbassa, Jean-ClaudeJean-ClaudeAmbassaMandalenakis, ZachariasZachariasMandalenakisConstantine, AndrewAndrewConstantineAmedro, PascalPascalAmedroVan Melle, Joost PJoost PVan MelleCedars, AriAriCedarsOrtiz, LuciaLuciaOrtizDemir, FatmaFatmaDemirKhairy, PaulPaulKhairyWindram, JonathanJonathanWindramBouchardy, JudithJudithBouchardyCaruana, MaryanneMaryanneCaruanaJameson, Susan MSusan MJamesonMahadevan, Vaikom SVaikom SMahadevanMcGrath, Lidija BLidija BMcGrathMwita, Julius ChachaJulius ChachaMwitaMoons, PhilipPhilipMoons2025-12-312025-12-312026-02-01https://scholars.lib.ntu.edu.tw/handle/123456789/734929Person-centred care (PCC) is widely recommended by the World Health Organisation and other leading healthcare organisations. Although individuals with congenital heart disease (CHD) require lifelong follow-up, it remains unclear whether healthcare systems worldwide provide PCC to this population. This study investigated one key component of PCC, autonomy support, using patient-reported experiences in a global sample of adults with CHD.The study was part of the international cross-sectional APPROACH-IS-II. Data were obtained from 8367 adults with congenital heart disease across 53 centres in 32 countries. Perceived autonomy support was measured using a modified version of the Health Care Climate Questionnaire. A general linear mixed model was used to analyse the data.Autonomy support scores ranged from 27.9 (SD ± 9.4) to 37.7 (SD ± 6.3) on a six - 42 point scale. A significant clinical difference in perceived autonomy was observed, with calculated effect sizes using Cohen's D exceeding eight in several countries. Higher autonomy scores were associated with having a high school diploma and older age. Patient characteristics accounted for 1.4 % of the variance, while geographical location explained 7.5 %. A large proportion of the variance remained unexplained.This study highlights significant global differences in perceived autonomy support from healthcare providers among adults with CHD. Education and age were associated with higher levels of perceived autonomy support. The experience of PCC is challenged by diverse expectations of individuals and families, healthcare providers' beliefs and values, institutional policies, and broader sociocultural contexts.enACHD careAutonomy supportCongenital heart diseasePREMsPatient-Centred carePerson-Centred care[SDGs]SDG3journal article10.1016/j.ijcard.2025.13395841067646