title: Psychosocial factors influencing mental health in adults with congenital heart disease.
abstract: BACKGROUND
  Although adult congenital heart disease (ACHD) patients encounter unique challenges related to social adaptation and mental health, only minimal research has been conducted on this functioning in Japanese ACHD patients. The aims of this study were to describe aspects of the psychosocial functioning of ACHD patients and to determine the psychosocial factors influencing their mental health.
  
  
  RESULTS
  Seventy-two ACHD patients (aged 18-39 years) and 86 control participants (aged 18-39 years) completed the 36-item Short Form Health Survey, a measure of mental health, and 4 self-report questionnaires measuring aspects of psychosocial functioning: Independent-Consciousness, Problem-solving, Locus of Control, and Self-esteem. Compared to the control group, ACHD patients had significantly lower scores for Independence, Problem-solving, and Self-esteem; whereas they had higher scores for Dependence on Parents. To examine the psychosocial factors influencing mental health, a structural equation model was used. The psychosocial factor Problem-solving was found to have the most direct influence on mental health. This factor was associated with Independence and Self-esteem.
  
  
  CONCLUSIONS
  ACHD patients in Japan have psychosocial difficulties, and the psychosocial factors influencing patients' mental health are social problem-solving, independence, and self-esteem. The patients have poorer abilities than the control group in all of these areas and hence, they run the risk of developing poor mental health.
authors.affiliation: Toyo University, Toyo, Japan. enomoto@toyo.jp
authors.forename: Junko
authors.initials: J
authors.lastname: Enomoto
authors.forename: Jun
authors.initials: J
authors.lastname: Nakazawa
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Takeaki
authors.initials: T
authors.lastname: Shirai
authors.forename: Junko
authors.initials: J
authors.lastname: Ogawa
authors.forename: Koichiro
authors.initials: K
authors.lastname: Niwa
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006331:Heart Diseases / Q000151:congenital* / Q000523:psychology*; D006801:Humans; D057187:Independent Living / Q000523:psychology; D007564:Japan; D008297:Male; D008603:Mental Health; D011340:Problem Solving; D011584:Psychology; D012649:Self Concept; D055815:Young Adult