title: [Social concern and independence in adults with congenital heart disease].
abstract: OBJECTIVE
  Recent advances in medical and surgical treatment have led to the survival of increasing numbers of adults with congenital heart disease (CHD). However, the social status of these patients remains unknown. This survey investigated the social prospects for adults with CHD, and the limiting factors for social independence.
  
  
  METHODS
  A written questionnaire on patient characteristics, education, employability, marital status and insurability was designed to define the characteristics of social independence in adults with CHD. Randomly selected adults with CHD were enrolled: 13 patients with cyanotic unrepaired CHD (4 males, 9 females, mean age: 29.8 +/- 10 years, range: 18-56 years) and 102 patients with other CHDs (48 males, 54 females, mean age: 29.5 +/- 10 years, range: 18-74 years).
  
  
  RESULTS
  University of California at Los Angeles functional class I-II was found in 94% of patients, medication in 46%, and hospitalization in 51%. Compared with the data from Japanese general population, study patients had a lower ratio of high school graduates (86% vs 94%), life insurability (51% vs 71%), marital status (31% vs 32%) and employability (82% vs 80%). Patients with unrepaired cyanotic CHD had significantly lower ratio than those with other CHDs (marital status 15%, p = 0.19; employability 40%, p = 0.0003; high school graduates 69%, p = 0.06; life insurability 18%, p = 0.02, respectively).
  
  
  CONCLUSIONS
  Factors affecting social independence in adults with CHD were severity of disease, continuing medication, lower level of education, lower self-esteem, and unknown natural history of CHD. To improve social independence in these patients, further development of medical and surgical therapy and more detailed knowledge of the patients, caretakers and society in this field are needed.
authors.affiliation: Department of Pediatrics, Chiba Cardiovascular Center, Tsurumai 575, Ichihara, Chiba 290-0512.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Niwa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Tateno
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tatebe
authors.forename: Kanako
authors.initials: K
authors.lastname: Fujita
authors.forename: Katsuo
authors.initials: K
authors.lastname: Sugita
authors.forename: Masaru
authors.initials: M
authors.lastname: Terai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Aotsuka
authors.forename: Osahiro
authors.initials: O
authors.lastname: Takahashi
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D004522:Educational Status; D004651:Employment; D005260:Female; D006330:Heart Defects, Congenital / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008393:Marriage; D008875:Middle Aged; D011788:Quality of Life; D012917:Social Adjustment