title: Looking beyond the biophysical realm to optimize health: results of a survey of psychological well-being in adults with congenital cardiac disease.
abstract: BACKGROUND
  The purpose was to examine the relationship between the complexity of structural heart disease and psychological well-being in adults with congenital cardiac disease.
  
  
  METHODS
  A total of 380 patients registered at the Adult Congenital Heart Clinic in Calgary, Alberta, Canada were surveyed. The patients were mailed a socio-demographic questionnaire and an instrument to measure psychological well-being. The instrument of psychological well-being measures six dimensions: positive relations with others, autonomy, environmental mastery, personal growth, purpose in life, and self-acceptance. Of the 380 patients surveyed, 85 of 205 patients with simple structural malformation responded, giving a response rate of 41%, and 78 of 175 patients with complex malformations, thus giving a response of 45%.
  
  
  RESULTS
  There was no statistically significant difference in the mean scores of each of the six dimensions of psychological well-being between those patients with simple and complex malformations. Two-way analysis of variance, and multivariate analysis of variance, found significant differences in mean scores for dimensions when other socio-demographic variables were included in the analysis. For example, significantly higher mean scores for the dimension of purpose in life was found in patients who obtained a higher level of education (p = 0.009), and in patients who were employed (p < 0.001). We present the socio-demographic variables that statistically impact the mean scores for the dimension of psychological well-being.
  
  
  CONCLUSIONS
  Psychological well-being is not affected by the complexity of the structural congenital cardiac disease. Certain socio-demographic variables that impact psychological well-being, nonetheless, must be considered when developing multidisciplinary programmes to care for young adults with congenitally malformed hearts.
authors.affiliation: Adult Congenital Heart Clinic, Calgary Health Region and University of Calgary, Calgary, Alberta, Canada. yvonne.balon@calgaryhealthregion.ca
authors.forename: Yvonne E
authors.initials: YE
authors.lastname: Balon
authors.forename: Karen L
authors.initials: KL
authors.lastname: Then
authors.forename: James A
authors.initials: JA
authors.lastname: Rankin
authors.forename: Tak
authors.initials: T
authors.lastname: Fung
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta; D001294:Attitude to Health; D005260:Female; D006304:Health Status; D006330:Heart Defects, Congenital / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D055815:Young Adult