Age moderates change in disease-related stress among congenital heart disease survivors: a 6-year follow-up.
Age moderates change in disease-related stress among congenital heart disease survivors: a 6-year follow-up.
复制标题
年龄调节先天性心脏病幸存者疾病相关压力的变化：6 年随访。
DOI：
10.1093/eurjcn/zvad045
复制
发表时间：
2024
影响因子：
2.9
通讯作者：
Jackson,JamieL
中科院分区：
文献类型：
--
作者：
Swenski,TaylorN;Fox,KristenR;Udaipuria,Shivika;Korth,ChristinaX;Daniels,CurtJ;Jackson,JamieL
目的随着先天性心脏病（CHD）幸存者年龄的增长，他们面临着心血管疾病发病风险的增加和日益复杂的疾病自我管理需求。鉴于压力与不良的身体和心理社会结果有关，因此研究疾病相关压力如何随时间推移在这一人群中发生变化至关重要。然而，迄今为止，这一结果很少受到研究关注。本研究旨在确定CHD幸存者中6年以上疾病相关压力变化的人口统计学和临床预测因素。（N= 252，法师= 25.6 ± 7.1，52.9%女性）完成了适应于CHD幸存者的应激反应问卷的前13项，评估研究入组（T1）和6年随访（T2）时的疾病相关压力源。将年龄、性别、家庭收入估计值和T1时的纽约心脏协会（NYHA）心功能分级输入混合线性模型，以确定其对疾病相关应激变化的影响。年龄较大（P< 0.001）、收入较低（P< 0.001）和存在功能限制（NYHA ≥ II）（P< 0.001）预示着疾病相关压力的增加更大。当控制NYHA、功能分级和收入时，发现了一个显著的时间与年龄的相互作用，即T1时青少年患者的疾病相关压力随时间增加[B= 4.20，P = 0.010，95%置信区间（1.01，7.40）]，但在年轻人中保持稳定。结论从青春期到成年期的过渡可能是一个时期的疾病相关的压力增加。医疗保健提供者应考虑在过渡教育期间对青少年进行疾病相关压力的筛查，并提供资源以增强复原力。
AimsAs congenital heart disease (CHD) survivors age, they are confronted with elevated risk of cardiovascular morbidity and increasingly complex disease self-management demands. Given that stress is associated with poor physical and psychosocial outcomes, it is crucial to examine how disease-related stress changes over time in this population. However, this outcome has received little research attention to date. This study aimed to identify demographic and clinical predictors of change in disease-related stress over 6 years among CHD survivors.Methods and resultsCongenital heart disease survivors (N= 252,Mage= 25.6 ± 7.1, 52.9% female) completed the first 13 items of the Responses to Stress Questionnaire, adapted for use among CHD survivors, to assess disease-related stressors at study entry (T1) and 6-year follow-up (T2). Age, gender, estimated family income, and New York Heart Association (NYHA) functional class atT1were entered into mixed linear models to determine their impact on change in disease-related stress. Older age (P< 0.001), lower income (P< 0.001), and presence of functional limitations (NYHA ≥ II) (P< 0.001) predicted greater increases in disease-related stress. When controlling for NYHA, functional class, and income, a significant time by age interaction was identified such that disease-related stress increased over time among those who were adolescents atT1[b= 4.20,P= 0.010, 95% confidence interval (1.01, 7.40)], but remained stable among young adults.ConclusionThe transition from adolescence to adulthood may be a period of increasing disease-related stress. Healthcare providers should consider screening adolescents for elevated disease-related stress during transition education and provide resources to bolster resilience.