Educational level and employment status in adults with congenital heart disease

Pfitzer, Constanze; Helm, P.; Rosenthal, Lisa-Maria; Walker, Christoph; Ferentzi, Hannah; Bauer, Ulrike; Berger, Felix; Schmitt, Katharina

doi:10.1017/s104795111700138x

Cited by 22 publications

(17 citation statements)

References 26 publications

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“…This is consistent with previous studies that have shown that compared to healthy peers, adults with CHD have lower employment rates . As expected, patients with CHD of great complexity were disproportionately susceptible to employment difficulties . Proposed explanations for this association include physical limitations that preclude regular employment as well as lower educational attainment due to increased school absences and/or neurocognitive deficits .…”

Section: Discussionsupporting

confidence: 91%

“…11,12 As expected, patients with CHD of great complexity were disproportionately susceptible to employment difficulties. 13,14 Proposed explanations for this association include physical limitations that preclude regular employment as well as lower educational attainment due to increased school absences and/or neurocognitive deficits. 15 Patients with complex CHD should be considered Transposition of the great arteries 25 (16) Bicuspid aortic valve disease 13 (9) Aortic coarctation 13 (9) Ventricular septal defect 10 (7) Double-outlet ventricle 10 (7) Partial anomalous pulmonary venous return 8…”

Section: Employment and Insurance Challenges Are Common In Americanmentioning

confidence: 99%

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Too little too late? Communication with patients with congenital heart disease about challenges of adult life

Deng

Gleason

Awh

et al. 2019

Congenital Heart Disease

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Objective To investigate the experiences and communication preferences of adult patients with congenital heart disease (CHD) in the domains of employment, insurance, and family planning. Design Patients ≥ 18 years of age completed a questionnaire about experiences and communication preferences regarding employment, health insurance, and family planning. Results Of 152 patients (median age = 33 years, 50% female, 35% with CHD of great complexity), one in four reported work‐related problems due to CHD and a quarter also recalled a previous gap in health insurance. Of females, 29% experienced an unplanned pregnancy. The median importance of discussion ratings (on a 0‐10 scale) were 3.5 (employment), 6.0 (insurance), and 8.0 (family planning). Few patients recalled discussions about employment (19%) or health insurance (20%). Over half recalled discussions about family planning, although males were less likely to have had these discussions than females (24% vs 86%, P < .001). Across the three domains, patients identified 16‐18 years as the most appropriate age to initiate discussion, although for patients who recalled discussions, they typically occurred between 20 and 25 years. Conclusions Adults with CHD commonly face employment, health insurance, and family planning challenges. However, discussions about these matters occur with less frequency than recommended and at older ages than patients would prefer. Communication about such issues should be incorporated into a comprehensive educational curriculum for adolescents during the process of transition to adult care.

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Section: Discussionsupporting

confidence: 91%

Section: Employment and Insurance Challenges Are Common In Americanmentioning

confidence: 99%

Too little too late? Communication with patients with congenital heart disease about challenges of adult life

Deng

Gleason

Awh

et al. 2019

Congenital Heart Disease

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“…8 Adults with CHD may also experience barriers to work participation related to age, sex, comorbidities, social support, and knowledge of the disease. 2,3,[8][9][10][11] Conversely, use of private health insurance, peers' awareness and understanding of CHD and its impact in the workplace, and employer accommodations for physical restrictions can facilitate increased employment for adults with CHD. 8,[10][11][12][13][14] Currently, our knowledge of employment among adults with CHD includes data from clinical registries, single-centre retrospective reviews, and cross-sectional surveys.…”

mentioning

confidence: 99%

Clinical and socio-economic predictors of work participation in adult CHD patients

et al. 2020

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Abstract Background: Adults with CHD have reduced work participation rates compared to adults without CHD. We aimed to quantify employment rate among adult CHD patients in a population-based registry and to describe factors and barriers associated with work participation. Methods: We retrospectively identified adults with employment information in the North Carolina Congenital Heart Defects Surveillance Network. Employment was defined as any paid work in a given year. Logistic regression was used to examine patients’ employment status during each year. Results: The registry included 1,208 adult CHD patients with a health care encounter between 2009 and 2013, of whom 1,078 had ≥1 year of data with known employment status. Overall, 401 patients (37%) were employed in their most recent registry year. On multivariable analysis, the odds of employment decreased with older age and were lower for Black as compared to White patients (odds ratio = 0.78; 95% confidence interval: 0.62, 0.98; p = 0.030), and single as compared to married patients (odds ratio = 0.50; 95% confidence interval: 0.39, 0.63; p < 0.001). Conclusion: In a registry where employment status was routinely captured, only 37% of adult CHD patients aged 18–64 years were employed, with older patients, Black patients, and single patients being less likely to be employed. Further work is needed to consider how enhancing cardiology follow-up for adults with CHD can integrate support for employment.

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“…The employment of adults with CHD (ACHD) has been investigated in many countries. Overall, the rate of patient employment is reported to be 50–80% for full‐time and part‐time workers, and the rate of unemployment ranges from a small percentage to more than 10% . ACHD generally have a lower employment rate than do individuals without CHD, although this varies by country.…”

mentioning

confidence: 99%

“…Overall, the rate of patient employment is reported to be 50-80% for full-time and part-time workers, and the rate of unemployment ranges from a small percentage to more than 10%. [1][2][3][4][5][6] ACHD generally have a lower employment rate than do individuals without CHD, although this varies by country. For example, according to a study in the UK, 7 the unemployment rate was reported to be 33% (excluding students and retired people), which suggests that these patients faced significantly greater difficulty in finding employment than others because the average unemployment rate was 8.3% in the area of investigation.…”

mentioning

confidence: 99%

Employment status and contributing factors among adults with congenital heart disease in Japan

Enomoto

Mizuno

Okajima

et al. 2020

Pediatrics International

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Background Working is an important concern in transitional care for adults with congenital heart disease (ACHD) because work connects people with society. Employment status is correlated with gender, but studies on patient employment by gender have rarely been conducted. This study therefore aimed to examine the employment status of ACHD by gender and to explore the factors influencing this status. Methods In this study, 193 Japanese ACHD (mean age: men—33.62 years, women—32.69 years; 89 men, no students included) completed a questionnaire including questions about employment status, an evaluation of hindrances to employment, the Linear Analog Scale to assess quality of life (QOL), and the Satisfaction with Life Scale (SWLS). Results In the study sample, 13 of 89 (14.6%) men and 13 of 104 (12.5%) women did not have a job. These rates were higher than the national standard rates in Japan (men: 5.0%, women: 2.9%). Of these patients, only one man and one woman listed their illness as a reason for their unemployment. The factors thought to explain unemployment were age for men and disease severity for women (P < 0.05 for both). Unemployed patients had significantly lower QOL and SWLS scores. Conclusions Most ACHD can join the workforce but a higher percentage of ACHD do not work and find it challenging to have a career compared with the general population. Moreover, because unemployed patients have low QOL and SWLS scores, obtaining work is crucial to enable these people to have mentally and emotionally stable and fulfilling lives.

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Educational level and employment status in adults with congenital heart disease

Abstract: More than half of the participants had high education levels and the majority were employed. The association between CHD and its severity and individuals' educational attainment should be investigated more closely in future studies.

Cited by 22 publications

References 26 publications

Too little too late? Communication with patients with congenital heart disease about challenges of adult life

Too little too late? Communication with patients with congenital heart disease about challenges of adult life

Clinical and socio-economic predictors of work participation in adult CHD patients

Employment status and contributing factors among adults with congenital heart disease in Japan

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