title: Hopelessness among adults with congenital heart disease: Cause for despair or hope?
abstract: BACKGROUND
  Adults with congenital heart disease (CHD) face unique life courses and challenges that may negatively influence their psychological functioning. The aims of this study were to (1) examine the level of hopelessness among adults with CHD in comparison with non-CHD participants and (2) identify correlates of elevated hopelessness among adults with CHD.
  
  
  METHODS
  We enrolled 347 patients with CHD (18-64years, 52.2% female) and 353 matched (by sex/age) non-CHD persons in this cross-sectional study. Hopelessness was assessed by Beck Hopelessness Scale. Hierarchical multiple logistic regression analyses were performed to explore correlates of elevated hopelessness.
  
  
  RESULTS
  The mean total hopelessness score did not significantly differ between the CHD and non-CHD groups. Twenty-eight percent of CHD patients had elevated hopelessness scores. Within the CHD patient sample, regression analyses revealed that being male (odds ratio=2.62), not having children (odds ratio=3.57), being unemployed (odds ratio=2.27), and elevated depressive symptoms (odds ratio=1.21) were significantly associated with hopelessness. Regular physical activity (odds ratio=0.36) emerged as a protective factor and all CHD disease parameters were unrelated to hopelessness. The final model explained 43% of the variance in hopelessness.
  
  
  CONCLUSIONS
  Adult CHD teams are encouraged to continue to explore strategies to support patients to live as rich and full as lives as possible by pursuing relationships, employment and physical activity, as well as managing depression and hopelessness.
authors.affiliation: Division of Public Health Science, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden; Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: bahareh.eslami@miun.se.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Eslami
authors.affiliation: Knight Cardiovascular Institute, Oregon Health & Science University, Oregon, USA. Electronic address: kovacs@ohsu.edu.
authors.forename: Adrienne H
authors.initials: AH
authors.lastname: Kovacs
authors.affiliation: Department of Public Health and Primary Care, KU Leuven- University of Leuven, Leuven, Belgium; Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden. Electronic address: philip.moons@kuleuven.be.
authors.forename: Philip
authors.initials: P
authors.lastname: Moons
authors.affiliation: Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: kyomarsabbasi@yahoo.com.
authors.forename: Kyomars
authors.initials: K
authors.lastname: Abbasi
authors.affiliation: Center for Biobehavioral Health, Nationwide Children's Hospital, Ohio, USA; College of Medicine, The Ohio State University, Ohio, USA. Electronic address: Jamie.Jackson2@nationwidechildrens.org.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Jackson
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006330:Heart Defects, Congenital / Q000523:psychology*; D065026:Hope; D006801:Humans; D007492:Iran; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Depression; Grown up; Loneliness; Physical activity; Psychosocial