Perceived health competence predicts anxiety and depressive symptoms after a three-year follow-up among adolescents and adults with congenital heart disease

Abstract

Background: Congenital heart disease places survivors at increased risk for cardiovascular complications as they age and requires long-term medical management. Perceived health competence, or how capable one feels in managing one’s health, is linked to emotional adjustment in various disease populations, but has not been investigated among congenital heart disease survivors. Aim: The purpose of this study was to examine the relationship of perceived health competence at baseline (T1) as a predictor of anxiety and depressive symptoms three years later (T2). Methods: Congenital heart disease survivors ( n=125; MT1age=27; 58.6% female; severity of cardiac lesion: 25% simple, 44% moderate, 31% complex) were recruited from a pediatric and an adult hospital as part of a larger study. Participants completed the Perceived Health Competence Scale and the Youth or Adult Self-Report at T1 for anxiety and affective/depressive symptoms. At T2, participants completed the Hospital Anxiety and Depression Scale. New York Heart Association functional class, a measure of functional impairment, was abstracted from medical charts at T2. Results: Lower T1 perceived health competence was significantly associated with greater emotional distress at T1 (depression r=−0.47; anxiety: r=−0.45), as well as greater T2 functional impairment ( r=−0.41). T1 perceived health competence also predicted T2 anxiety and depressive symptoms, which remained significant when including T1 anxiety and depressive symptoms and T2 functional impairment. Conclusion: Congenital heart disease survivors who feel more competent in managing their health may be less likely to experience future anxiety and depressive symptoms. Perceived health competence may be a worthwhile target for psychosocial intervention to promote emotional wellbeing among congenital heart disease survivors and ensure the best outcomes.

The Influence of Illness Perception and Coping on Anxiety in Adults With Congenital Heart Disease

“…We observed that nearly 32% of participants reported mild, moderate, or severe anxiety symptoms (HADS-A ≥8). This result is similar or lower than the prevalence of anxiety symptoms found in 2 recent North American studies (35% 22 and 42% 23 ). Nevertheless, the average severity of anxiety symptoms we observed (6 ± 4) is similar to what these 2 studies (6 ± 4 22 , 7 ± 4 23 ) reported, as well as an international study (6 ± 4 24 ).…”

Nursing research in congenital heart disease has grown up

“…Indeed, individuals who feel more competent in managing their health may be less likely to experience future anxiety and depressive symptoms. 11 These results are in keeping with the findings of a study that was previously published in the Journal, indicating that general self-efficacy predicted anxiety and depression with an explained variance of 5.9% and 13.6%, respectively. 6 In another study, Chang and colleagues scrutinised the relationship between the cyanotic status of CHD and internalising problems, such as anxiety and depression.…”

“…Leslie and co-workers investigated the relationship between perceived health competence and future anxiety and depression in adults with CHD. 11 Perceived health competence refers to how capable one feels in managing one's own health. 11 This construct is closely linked to selfefficacy.…”

“…In the current issue of the Journal, three articles are published that focus on studying persons with congenital or genetic heart disease. [11][12][13] These three studies have in common that they address symptoms of anxiety and depression. Indeed, anxiety and depression are frequent in CHD and more prevalent than in the general population.…”

“…11 Perceived health competence refers to how capable one feels in managing one's own health. 11 This construct is closely linked to selfefficacy. These authors found that perceived health competence predicts anxiety and depression over time.…”