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

Leslie CE, Schofield K, Vannatta K, Jackson JL.
Eur J Cardiovasc Nurs. 2020 Apr;19(4):283-290. doi: 10.1177/1474515119885858. Epub 2019 Nov 13.
PMID: 31722548
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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.