title: Education and support needs of the older adult with congenital heart disease.
abstract: OBJECTIVE
  This article is a report of a study exploring health-related quality of life in adults with congenital heart disease and the extent to which it is associated with patients' illness beliefs and emotional health.
  
  
  BACKGROUND
  A reduction in mortality in patients with congenital heart disease has led to an increasingly older population that faces new challenges. Studies in a younger adult population have reported inconsistent findings regarding health-related quality of life. Factors such as, the complexity of the congenital heart defect, have not been found to be associated with quality of life. The association between illness beliefs and health-related quality of life has not previously been reported.
  
  
  METHODS
  A cross-sectional questionnaire study of adults with congenital heart disease attending an outpatient clinic in a specialist centre in the United Kingdom between October 2007 and May 2008.
  
  
  RESULTS
  The mean age of the study population was 37·2 years. Participants reported poorer physical functioning, role functioning and general health than a general population. High levels of anxiety were reported in 38% and high levels of depression in 17%. In multivariate analysis, higher levels of anxiety and depression were associated with poorer mental functioning and higher levels of depression with poorer physical quality of life.
  
  
  CONCLUSIONS
  We have reported that high levels of anxiety and depression in an older population of patients with congenital heart disease are associated with poorer quality of life. This highlights the need to routinely assess anxiety and depression in this patient group and to provide psychological support appropriately.
authors.affiliation: Royal Brompton & Harefield NHS Foundation Trust, London, UK. jillian.riley@imperial.ac.uk
authors.forename: Jillian P
authors.initials: JP
authors.lastname: Riley
authors.forename: Hajar
authors.initials: H
authors.lastname: Habibi
authors.forename: Winston
authors.initials: W
authors.lastname: Banya
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gatzoulis
authors.forename: Margaret
authors.initials: M
authors.lastname: Lau-Walker
authors.forename: Martin R
authors.initials: MR
authors.lastname: Cowie
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001007:Anxiety / Q000453:epidemiology; D001294:Attitude to Health; D002648:Child; D054626:Consumer Health Information; D003863:Depression / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D006331:Heart Diseases / Q000151:congenital* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010353:Patient Education as Topic; D011788:Quality of Life; D012944:Social Support; D017741:Survivors / Q000523:psychology*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult