title: Quality of life, health status, and depression: comparison between adolescents and adults after the Fontan procedure with healthy counterparts.
abstract: BACKGROUND
  Quality of life (QOL) in adolescents and adults who have undergone the Fontan procedure and are living with only 1 ventricle is presumed to be diminished.
  
  
  OBJECTIVE
  This study aimed to compare QOL, health status, and prevalence of depression in adolescents/adults after the Fontan procedure with healthy counterparts and to identify predictors of QOL in the Fontan group.
  
  
  METHODS
  Using a comparative, cross-sectional design, 54 adolescents and adults with single ventricle congenital heart disease who have undergone the Fontan procedure were compared with 66 age-matched healthy counterparts. Quality of life, health status, depression, and social support were measured using the Satisfaction With Life Scale, Short Form Survey Version 2, Patient Health Questionnaire Depression Module, and Multidimensional Scale of Perceived Social Support. Clinical variables were abstracted from medical records. Predictors of QOL were determined using multiple linear regression.
  
  
  RESULTS
  Adolescents and adults in the Fontan group reported lower physical health status (mean [SD] = 46.5 [9.3] vs mean [SD] = 55.9 [5.1], P < .001) and were more depressed (mean [SD] = 7.3 [5.9] vs mean [SD] = 4.5 [4.3], P < .004) than their healthy counterparts. There were no differences in QOL, mental health status, or social support between the 2 groups. Functional status (New York Heart Association class), depression, and social support accounted for 55% of the variance in QOL in the Fontan group.
  
  
  CONCLUSIONS
  Despite lower levels of physical health, the QOL of Fontan patients was comparable with that of their healthy counterparts; this finding contradicts previous proxy reports, self-reports, and assumptions that QOL is lower in patients with complex single ventricle congenital heart disease. However, because Fontan patients were more depressed than their healthy counterparts, the need for early screening and detection is warranted.
authors.affiliation: School of Nursing, University of California, Los Angeles, CA 90095-6919, USA. npike@sonnet.ucla.edu
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Pike
authors.forename: Lorraine S
authors.initials: LS
authors.lastname: Evangelista
authors.forename: Lynn V
authors.initials: LV
authors.lastname: Doering
authors.forename: Jo-Ann
authors.initials: JA
authors.lastname: Eastwood
authors.forename: Alan B
authors.initials: AB
authors.lastname: Lewis
authors.forename: John S
authors.initials: JS
authors.lastname: Child
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D006304:Health Status; D006801:Humans; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult