Clin Res Cardiol (2021). 10.1007/s00392-021-01933-9

Psychological well-being in adults with congenital heart disease: Testing the predictive value of illness identity
C. Andonian1, H. Kaemmerer1, S. Freilinger1, J. Beckmann2, M. Huber1, für die Studiengruppe: MERLIN
1Klinik für Kinderkardiologie und angeborene Herzfehler, Deutsches Herzzentrum München, München; 2Technische Universität München (TUM), München;

Background: Due to advances in medical care and treatment of congenital heart disease (CHD), the number of adults with congenital heart disease (ACHD) is constantly growing. Apparently, psychological functioning in ACHD is irrespective of their objective physical condition indicating symptoms experienced by patients to be more relevant. The present study examined illness identity as a mediator of the association between a self-rated health and emotional distress among ACHD.

Methods: The study used a cross-sectional design. A sample of 229 ACHD (38 ± 12.5 [18-73] years; 45% female) provided background data and completed three questionnaires on self-rated health (EQ-VAS), illness identity (IIQ), and emotional distress (HADS) at the German Heart Center Munich. Serial multiple mediator models were tested using PROCESS macro for SPSS.

Results: Perceived health had a direct and indirect effect on emotional distress which was mediated by illness identity (p<0.05). Compared to all other dimensions of illness identity, engulfment fully mediated the relationship between self-rated health and emotional distress, when adjusted for sociodemographic and clinical confounders. The model explained 42% of variance in total emotional distress (R2=0.416).  The extent of emotional distress did not differ as a function of CHD complexity.

Conclusions: Illness Identity emerged as a strong mediating factor between a patient’s self-rated health and psychological outcomes. More importance needs to be directed towards assessing a patient’s health perception and psychological state, independently of cardiac severity. Based on present findings, targeted psychocardiological interventions should include psychoeducational components and emotion-focused strategies.


https://dgk.org/kongress_programme/ht2021/P760.htm