PMID- 15789939
OWN - NLM
STAT- MEDLINE
DCOM- 20050421
LR  - 20191026
IS  - 0962-9343 (Print)
IS  - 0962-9343 (Linking)
VI  - 14
IP  - 1
DP  - 2005 Feb
TI  - Determinants of the quality of life of patients with congenital heart disease.
PG  - 35-43
AB  - OBJECTIVE: The improvement of the quality of life of chronically ill patients has 
      become an important goal in treatment. However, it is seldom taken into account 
      that many other factors, in addition to somatic factors, have an influence on the 
      quality of life of patients. Using patients with congenital heart defects as an 
      example, we examined the relative significance of biological factors, compared to 
      psychological and social factors, for the various quality of life dimensions. 
      RESEARCH DESIGN AND METHODS: One hundred and eleven patients (aged 33+/-12 years) 
      with different degrees of cardiac dysfunction were examined (NYHA 0: 2 I: 56, II: 
      38, III: 13, IV: 2). All patients for whom there was no contra-indication 
      underwent a treadmill ergometry in order to determine their level of 
      cardiopulmonary functioning (peak oxygen consumption: VO2max). All patients were 
      asked to fill out questionnaires concerning their quality of life (WHOQOL-Bref), 
      their cardiac complaints (Giessener Complaint Questionnaire GBB), their 
      personality traits (Giessen Test GTS), and the social support they experience 
      (Social Support Questionnaire SOZU-k22). The data were analyzed using a linear 
      structural equation model (SEM). RESULTS: In all aspects but the social domain, 
      the HRQL of CgHD patients was significantly diminished compared to the normal 
      population. The SEM proposed was valid, showing good indices of fit (chi2 = 1.18; 
      p = 0.55; AGFI = 0.92). The level of cardiopulmonary functioning was most 
      significant for the reporting of specific cardiac complaints (beta = -28) and for 
      the physical component of the general HRQL (beta = 32), although the former was 
      also influenced by a depressed disposition (beta = -0.20) and the extent of 
      social support experienced (beta = 0.18). The objective findings, however, had 
      virtually no individual significance for the psychological (beta = 0.09) and 
      social domains (beta = -0.02). These HRQL domains are primarily influenced by 
      depressive personality traits (beta= -26/-0.16) and the social support 
      experienced (beta = 0.51/0.51). CONCLUSIONS: The patient's organic dysfunction 
      primarily determines illness-specific complaints but has little relevance for the 
      psychological and social aspects of the HRQL. These aspects are predominantly 
      determined by the patient's depressive disposition and by the experienced social 
      support. A successful therapy should therefore take biological as well as 
      psycho-social determinants of the quality of life into account.
FAU - Rose, Matthias
AU  - Rose M
AD  - Department of Psychosomatic Medicine and Psychotherapy, Medical Clinic and 
      Policlinic, Charite-Humboldt University Berlin, Germany. rose@charite.de
FAU - Kohler, Kerstin
AU  - Kohler K
FAU - Kohler, Friedrich
AU  - Kohler F
FAU - Sawitzky, Barbara
AU  - Sawitzky B
FAU - Fliege, Herbert
AU  - Fliege H
FAU - Klapp, Burghard F
AU  - Klapp BF
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - Qual Life Res
JT  - Quality of life research : an international journal of quality of life aspects of 
      treatment, care and rehabilitation
JID - 9210257
SB  - IM
MH  - Adult
MH  - Germany
MH  - Heart Defects, Congenital/*physiopathology/psychology
MH  - Humans
MH  - Middle Aged
MH  - *Quality of Life
MH  - Social Support
MH  - Surveys and Questionnaires
EDAT- 2005/03/26 09:00
MHDA- 2005/04/22 09:00
CRDT- 2005/03/26 09:00
PHST- 2005/03/26 09:00 [pubmed]
PHST- 2005/04/22 09:00 [medline]
PHST- 2005/03/26 09:00 [entrez]
AID - 10.1007/s11136-004-0611-7 [doi]
PST - ppublish
SO  - Qual Life Res. 2005 Feb;14(1):35-43. doi: 10.1007/s11136-004-0611-7.