title: Quality of life and life satisfaction among adults with and without congenital heart disease in a developing country.
abstract: BACKGROUND
  Life-expectancy of adults with congenital heart disease (CHD) has improved world-wide, but there are limited data on these patients' experiences of quality of life (QoL), life satisfaction (LS), and their determinants (e.g. social support), particularly among patients from developing countries.
  
  
  METHODS
  Cross-sectional case-control.
  
  
  METHODS
  A total of 347 CHD patients (18-64 years, 52.2% women) and 353 non-CHD participants, matched by sex/age, were recruited from two heart hospitals in Tehran, Iran. LS and QoL served as dependent variables, and demographic/socioeconomic status, mental-somatic symptoms, social support, and clinical factors (e.g. defect category) served as independent variables in multiple regression analyses once among all participants, and once only among CHD patients.
  
  
  RESULTS
  The CHD patients had significantly lower scores in LS and all domains of QoL than the control group. However, having CHD was independently negatively associated only with overall QoL, physical health, and life and health satisfaction. Additionally, multivariate analyses among the CHD patients revealed that female sex, younger age, being employed, less emotional distress, and higher social support were significantly associated with higher perceived QoL in most domains, while LS was associated with female sex, being employed, less emotional distress, and better social support. Neither QoL nor LS was associated with cardiac defect severity.
  
  
  CONCLUSIONS
  The adults with CHD had poorer QoL and LS than their non-CHD peers in our developing country. Socio-demographics, emotional health, and social support were important 'determinants' of QoL and LS among the CHD patients. Longitudinal studies are warranted to establish causal links.
authors.affiliation: Department of Public Health Sciences, Institution of Health Sciences, Mid Sweden University, Sundsvall, Sweden Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Bahareh.eslami@miun.se.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Eslami
authors.affiliation: Department of Public Health Sciences, Institution of Health Sciences, Mid Sweden University, Sundsvall, Sweden Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden Department of Public Health Sciences, Institution of Social Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Gloria
authors.initials: G
authors.lastname: Macassa
authors.affiliation: Department of Psychology, Institution of Social Sciences, Mid Sweden University, Östersund, Sweden.
authors.forename: Örjan
authors.initials: Ö
authors.lastname: Sundin
authors.affiliation: Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Khankeh
authors.affiliation: Department of Public Health Sciences, Institution of Health Sciences, Mid Sweden University, Sundsvall, Sweden Department of Public Health Sciences, Institution of Social Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Joaquim J F
authors.initials: JJ
authors.lastname: Soares
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006330:Heart Defects, Congenital / Q000523:psychology*; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D055815:Young Adult
keywords: Grown-up congenital heart disease; heart defect; mental health; psychosocial; social support