An international perspective on illness identity in adults with congenital heart disease: Associations with patient characteristics, National Culture and well-being.
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Van Laere Elise, Luyckx Koen, Van Bulck Liesbet, Kovacs Adrienne H, Goossens Eva, Ladak Laila Akbar, Leye Mohamed, Van De Bruaene Alexander, Leong Ming Chern, Kaneva Anna, Manso Paulo Henrique, Araujo John Jairo, Sasikumar Navaneetha, Gabriel Harald, Yadeta Dejuma, Yang Hsiao-Ling, Enomoto Junko, Areias Maria Emilia, Kosmidi Diamantis, Coats Louise, Valente Anne Marie, Moon Ju Ryoung, Ladouceur Magalie, Thomet Corina, Jackson Jamie L, Sandberg Camilla, Johansson Bengt, Callus Edward, Kim Yuli Y, Lykkeberg Birgitte, Alday Luis, Bredy Charlène, Saidi Arwa, Reyes Fernando Baraona, Menahem Samuel, de Hosson Michèle, Hlebowicz Joanna, Christersson Christina, Zaidi Ali N, Andresen Brith, Ambassa Jean-Claude, Mandalenakis Zacharias, Constantine Andrew, Amedro Pascal, van Melle Joost P, Cedars Ari, Ortiz Lucia, Demir Fatma, Khairy Paul, Windram Jonathan, Bouchardy Judith, Caruana Maryanne, Jameson Susan M, Mahadevan Vaikom S, McGrath Lidija B, Mwita Julius Chacha, Moons Philip, APPROACH-IS II consortium on behalf of the International Society for Adult Congenital Heart Disease (ISACHD)
Аннотация
METHODS: This study utilized data from the APPROACH-IS-II project which included 8415 patients from 32 countries (collected between 2019 and 2022). Patients completed questionnaires on patient characteristics (i.e., age, sex, marital status, employment, education, ethnicity, NYHA class, and CHD complexity), illness identity, and patient-reported outcomes (i.e., depressive symptoms, anxiety, quality of life, self-perceived [mental and physical] health). National culture was included using Hofstede's cultural dimensions. Data were analyzed using multivariable generalized linear mixed models.
RESULTS: Inter-country variation was observed in the illness identity dimensions. Patient characteristics (i.e., sex, age, marital status, employment, education, NYHA class, and CHD complexity) and national culture were related to differences in how patients related their CHD to their identity. Acceptance and enrichment were related to better well-being, quality of life, and self-perceived health, while engulfment and rejection were associated with worse patient-reported outcomes.
CONCLUSIONS: Personal and contextual factors were associated with differences in the illness identity dimensions. Moreover, the present study substantiated the unique value of illness identity dimensions in explaining individual differences in well-being, quality of life, and self-perceived health in this population.