Quality of life, depressed mood, and self-esteem in adolescents with heart disease
Quality of life, depressed mood, and self-esteem in adolescents with heart disease
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DOI：
10.1097/psy.0b013e318051542c
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发表时间：
2007-05-01
影响因子：
3.3
通讯作者：
Lorber, Avraham
中科院分区：
文献类型：
--
作者：
Cohen, Miri;Mansoor, Daniela;Lorber, Avraham
目的：评价青少年心脏病患者的健康相关生活质量（HRQoL）、抑郁情绪和自尊，并与同龄健康青少年（对照组）进行比较。方法：90名12 ~ 18岁先天性或获得性心脏病青少年和87名对照组分别完成了HRQoL （taaql - chd）、美国流行病学研究中心抑郁量表和Rosenberg自尊问卷。收集了相关的医疗细节。病人和他们的父母被要求对他们认为的心脏病的严重程度进行评分。结果：患有严重心脏病的青少年比患有中度和轻度心脏病的青少年以及年龄匹配的健康对照者报告了更高水平的抑郁情绪和更低的自尊。患有严重心脏病的青少年的HRQoL也比患有中度和轻度疾病的青少年差。经多元回归分析，44%的HRQoL方差可由研究变量解释。疾病严重程度单独解释了11%的方差，但当与其他研究变量一起输入时，抑郁情绪、自尊和青少年对疾病严重程度的感知是HRQoL解释方差的唯一显著贡献者。因此，采用Sobel检验进行探索性中介分析，结果表明抑郁情绪和感知到的疾病严重程度介导了疾病严重程度与HRQoL的关系，而自尊不介导。结论：青少年重症心脏病患者HRQoL较低。心理社会因素对青少年的心理状态有显著影响，应予以重视和治疗。
Objective: To assess health-related quality of life (HRQoL), depressed mood, and self-esteem in adolescents with heart disease and compare them with age-matched healthy adolescents (control group). Methods: Ninety adolescents (aged 12 to 18 years with congenital or acquired heart disease) and 87 controls completed the HRQoL (TAAQOL-CHD), Center for Epidemiologic Studies Depression scale, and Rosenberg self-esteem questionnaires. Relevant medical details were collected. The patients and their parents were asked to rate their perceived severity of heart disease. Results: Adolescents with severe heart disease reported higher levels of depressed mood and lower self-esteem than did adolescents with moderate and mild heart disease and age-matched healthy controls. Adolescents with severe heart disease also reported worse HRQoL than those with moderate and mild disease. According to the multiple regression analysis, 44% of variance of HRQoL was explained by the study variables. Disease severity alone explained 11% of the variance, but when entered with the other study variables, depressed mood, self-esteem, and adolescents' perceived severity of disease were the only significant contributors to the explained variance of HRQoL. An exploratory mediation analysis, using the Sobel test, was therefore applied, and it showed that depressed mood and perceived disease severity, but not self-esteem, mediated the relationship between disease severity and HRQoL. Conclusions: Lower HRQoL was found in adolescents with severe heart disease. Psychosocial factors have a significant effect on the psychological state of adolescents, and they should be addressed and treated.