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Sense of coherence in adults with congenital heart disease in 15 countries: Patient characteristics, cultural dimensions and quality of life
KU Leuven - University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven (BEL); Centre for Person-Centred Care (GPCC), Gothenburg ; University of Gothenburg, Institute of Health and Care Sciences, Gothenburg; University of Cape Town, Department of Paediatrics and Child Health, (ZAF).
KU Leuven, Department of Public Health and Primary Care, KU Leuven (BEL).
University Health Network, University of Toronto, Peter Munk Cardiac Centre, Toronto (CAN); Oregon Health & Science University, Knight Cardiovascular Institute, Portland, USA (USA).
University of Bern, Center for Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, Bern (CHE).
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2021 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 20, no 1, p. 48-55Article in journal (Refereed) Published
Abstract [en]

Background: Previous studies have found that sense of coherence (SOC) is positively related to quality of life (QoL) in persons with chronic conditions. In congenital heart disease (CHD), the evidence is scant. Aims: We investigated (i) intercountry variation in SOC in a large international sample of adults with CHD; (ii) the relationship between demographic and clinical characteristics and SOC; (iii) the relationship between cultural dimensions of countries and SOC; and (iv) variation in relative importance of SOC in explaining QoL across the countries. Methods: APPROACH-IS was a cross-sectional, observational study, with 4028 patients from 15 countries enrolled. SOC was measured using the 13-item SOC scale (range 13–91) and QoL was assessed by a linear analog scale (range 0–100). Results: The mean SOC score was 65.5±13.2. Large intercountry variation was observed with the strongest SOC in Switzerland (68.8±11.1) and the lowest SOC in Japan (59.9±14.5). A lower SOC was associated with a younger age; lower educational level; with job seeking, being unemployed or disabled; unmarried, divorced or widowed; from a worse functional class; and simple CHD. Power distance index and individualism vs collectivism were cultural dimensions significantly related to SOC. SOC was positively associated with QoL in all participating countries and in the total sample, with an explained variance ranging from 5.8% in Argentina to 30.4% in Japan. Conclusion: In adults with CHD, SOC is positively associated with QoL. The implementation of SOC-enhancing interventions might improve QoL, but strategies would likely differ across countries given the substantial variation in explained variance. © The European Society of Cardiology 2020.

Place, publisher, year, edition, pages
2021. Vol. 20, no 1, p. 48-55
Keywords [en]
Heart defects, congenital, nursing, positive psychology, resilience, salutogenesis, sense of coherence, quality of life
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hv:diva-15736DOI: 10.1177/1474515120930496ISI: 000539855600001Scopus ID: 2-s2.0-85086328123OAI: oai:DiVA.org:hv-15736DiVA, id: diva2:1460333
Available from: 2020-08-24 Created: 2020-08-24 Last updated: 2022-01-19Bibliographically approved

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