Perceptions of Disease-Related Stress: A Key to Better Understanding Patient-Reported Outcomes Among Survivors of Congenital Heart Disease.
Perceptions of Disease-Related Stress: A Key to Better Understanding Patient-Reported Outcomes Among Survivors of Congenital Heart Disease.
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DOI：
10.1097/jcn.0000000000000371
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Vannatta K
中科院分区：
文献类型：
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作者：
Jackson JL;Gerardo GM;Daniels CJ;Vannatta K
背景：先天性心脏病（CHD）幸存者的疾病相关压力源已被定性描述，但未量化，也未检查与重要患者报告结局（PROs.Objective：本研究的目的是（1）根据年龄、功能状态和性别确定CHD幸存者经历的疾病相关压力的类型和程度，（2）检查压力和PROs的年龄、功能状态和性别差异，（3）确定感知压力对PROs.Methods变异性的独特贡献。参与者评估了他们发现CHD压力的各个方面的程度，并完成了与健康相关的生活质量和情绪困扰的PRO。通过方差分析和χ 2分析确定了预测因素之间的压力感知差异。感知压力预测PRO的相对贡献进行了检查，使用逐步线性regression.Results：两个项目出现了压力几乎一半的样本，包括对未来的健康和疤痕或其他迹象的医疗程序的关注。青少年报告的感知压力比新兴或年轻的成年人，甚至轻微的功能限制的幸存者报告更高的感知压力比那些没有任何症状。压力的感知显着贡献的变化，在PRO以上，超越其他预测因素，是唯一的变量来解释独特的方差在emotional distress.Conclusions：即使是轻微的功能障碍可能有显着的有害后果，通过增加对PRO的压力的看法。压力可以通过认知行为疗法来改变。
Background:Disease-related stressors for survivors of congenital heart disease (CHD) have been qualitatively described but not quantified nor examined in relationship to important patient-reported outcomes (PROs).Objective:The aims of this study are to (1) identify the types and degree of disease-related stress experienced by CHD survivors based on age, functional status, and sex,(2) examine differences in stress and PROs by age, functional status, and sex, and (3) determine the unique contribution of perceived stress to variability in PROs.Methods:A cross-sectional study of 173 adolescents and emerging and young adults who were recruited from both pediatric and adult CHD clinics was conducted. Participants rated the degree to which they found various aspects of CHD stressful and completed PROs of health-related quality of life and emotional distress. Differences in perceptions of stress across predictors were determined using analyses of variance and χ 2 analyses. The relative contribution of perceived stress predicting PROs was examined using stepwise linear regression.Results:Two items emerged as being stressful for almost half of the sample, including concerns about future health and having scars or other signs of medical procedures. Adolescents reported less perceived stress than emerging or young adults, and survivors with even mild functional limitations reported higher perceived stress than did those without any symptoms. Perceptions of stress significantly contributed to variability in PROs above and beyond other predictors and was the only variable to explain unique variance in emotional distress.Conclusions:Having even mild functional impairment may have significant deleterious consequences on PROs via increased perceptions of stress. Stress may be modifiable using cognitive behavioral therapy.