title: Sense of coherence as a predictor of quality of life in adolescents with congenital heart defects: a register-based 1-year follow-up study.
abstract: OBJECTIVE
  Sense of coherence (SOC) is a resource for health and quality of life (QoL) in adults. The aim of this investigation was to prospectively evaluate the association between SOC and QoL in adolescents with congenital heart defects (CHDs).
  
  
  METHODS
  This is an observational study among 770 adolescents aged 14 to 17 years from a national CHD register. SOC was measured at baseline with the SOC-L9 questionnaire. QoL was measured at baseline and at a follow-up 12 months later. For this, we used the KINDL-R (revidierter KINDer Lebensqualitätsfragebogen) questionnaire to evaluate overall well-being and 6 subscales (physical well-being, psychological well-being, self-esteem, family-related well-being, friend-related well-being, and school-related well-being). The association between SOC and QoL both in terms of overall well-being and the KINDL-R subscales was evaluated in multilevel linear models. Fully adjusted models accounted for age, gender, behavioral factors, and medical and socioeconomic status.
  
  
  RESULTS
  Overall well-being, self-esteem, and school-related well-being were significantly higher at follow-up than at baseline. SOC (median: 50 [range: 16-63] points) was positively associated with overall well-being and all KINDL-R subscales at baseline. In overall well-being and the KINDL-R subscales (except in psychological well-being), significant negative interaction terms were observed for SOC at baseline and time to follow-up. However, the associations between SOC at baseline and overall well-being and all KINDL-R subscales at follow-up remained significant even in fully adjusted models.
  
  
  CONCLUSIONS
  SOC is an independent predictor of QoL in adolescents with CHD. In psychological well-being, this prediction remains stable, whereas in total well-being and all other QoL subdimensions, its strength as such wanes over the course of a year but does not entirely dissipate. Further studies should evaluate whether interventions designed to increase SOC in children with CHD would also improve their QoL.
authors.affiliation: From the *Clinical Epidemiology Section, Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; †Department of Epidemiology, Robert Koch Institute, Berlin, Germany; ‡Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany; §Centre for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium; ∥Competence Network for Congenital Heart Defects, National CHD Register, Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany; ¶Pediatric Haematology/Oncology, University of Münster, Münster, Germany.
authors.forename: Bruno
authors.initials: B
authors.lastname: Neuner
authors.forename: Markus A
authors.initials: MA
authors.lastname: Busch
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.forename: Philip
authors.initials: P
authors.lastname: Moons
authors.forename: Jürgen
authors.initials: J
authors.lastname: Wellmann
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bauer
authors.forename: Ulrike
authors.initials: U
authors.lastname: Nowak-Göttl
authors.forename: Hans-Werner
authors.initials: HW
authors.lastname: Hense
mesh_terms: D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000523:psychology*; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D012042:Registries; D060685:Sense of Coherence / Q000502:physiology*