Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-24T05:56:44.708Z Has data issue: false hasContentIssue false
  • English
  • Français

Gender differences in health conditions and socio-economic status of adults with congenital heart disease in a developing country

Published online by Cambridge University Press:  26 April 2012

Bahareh Eslami ,
Örjan Sundin ,
Gloria Macassa ,
Hamid Reza Khankeh  and
Joaquim J. F. Soares
Bahareh Eslami*
Affiliation:
Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Örjan Sundin
Affiliation:
Department of Psychology, Institution for Social Sciences, Mid Sweden University, Östersund, Sweden
Gloria Macassa
Affiliation:
Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
Hamid Reza Khankeh
Affiliation:
Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Joaquim J. F. Soares
Affiliation:
Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
*
Correspondence to: Dr B. Eslami, MD, Department of Health Sciences, Mid Sweden University, Holmgatan 10, SE-851 70 Sundsvall, Sweden. Tel:+46 (0) 760 850 667; Fax:+46 (0) 60 14 89 10; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Providing appropriate care for adults with congenital heart disease requires the evaluation of their current situation. There is limited research in Iran about these patients, particularly in relation to gender differences in the demographic/socio-economic and lifestyle factors, as well as disease parameters.

Materials and methods

The sample consisted of 347 congenital heart disease patients in the age group of 18–64 years, including 181 women, assessed by an analytical cross-sectional study. The patients were recruited from the two major heart hospitals in Tehran. Data were collected using questionnaires.

Results

The mean age of the patients was 33.24 years. Women were more often married and more often had offspring than men (p < 0.001). Educational level and annual income were similar between women and men. Unemployment was higher among women (p < 0.001), but financial strain was higher among men (p < 0.001). Smoking, alcohol, and water-pipe use was higher among men than among women (p < 0.001). Cardiac factors, for example number of cardiac defects, were similar among women and men, except that there were more hospitalisations owing to cardiac problems, for example arrhythmia, among men. Disease was diagnosed mostly at the hospital (57.4%). Most medical care was provided by cardiologists (65.1%). Only 50.1% of patients had knowledge about their type of cardiac defect.

Conclusion

Gender differences exist in the socio-economic and lifestyle characteristics of adults with congenital heart disease, in some cases related to the disease severity. Our findings also point to the need for interventions to increase patients’ knowledge about, and use of, healthier lifestyle behaviours, irrespective of gender. Furthermore, providing appropriate jobs, vocational training, and career counselling may help patients to be more productive.

Keywords

Grown-up with congenital heart diseaselifestylesocio-demographic status
Type
Original Article
Information
Cardiology in the Young , Volume 23 , Issue 2 , April 2013 , pp. 209 - 218
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Warnes, CA, Libethson, R, Danielson, GK, et al. Task Force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol 2001; 37: 1170–1175.Google Scholar
2. Hoffman, JIE, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.CrossRefGoogle ScholarPubMed
3. Deanfield, J, Thaulow, E, Warnes, C, et al. Management of grown up congenital heart disease. Eur Heart J 2003; 24: 1035–1084.Google Scholar
4. Hoffman, JIE, Kaplan, S, Liberthson, RR. Prevalence of congenital heart disease. Am Heart J 2004; 147: 425–439.Google Scholar
5. Rahim, F, Ebadi, A, Saki, G, Remazani, A. Prevalence of congenital heart disease in Iran: a clinical study. J Med Sci 2008; 8: 547–552.Google Scholar
6. Marelli, AJ, Mackie, AS, Ionescu-Ittu, R, Rahme, E, Pilote, L. Congenital heart disease in the general population changing prevalence and age distribution. Circulation 2007; 115: 163–172.Google Scholar
7. Shiina, Y, Toyoda, T, Kawasoe, Y, et al. Prevalence of adult patients with congenital heart disease in Japan. Int J Cardiol 2011; 146: 13–16.Google Scholar
8. Webb, CL, Jenkins, KJ, Karpawich, PP, et al. Collaborative care for adults with congenital heart disease. Circulation 2002; 105: 2318–2323.Google Scholar
9. Wren, C, O'Sullivan, JJ. Survival with congenital heart disease and need for follow up in adult life. Heart 2001; 85: 438–443.CrossRefGoogle ScholarPubMed
10. Warnes, CA. The adult with congenital heart disease, born to be bad? J Am Coll Cardiol 2005; 46: 1–8.Google Scholar
11. Perloff, JK. Congenital heart disease in adults. A new cardiovascular subspecialty. Circulation 1991; 84: 1881–1890.Google Scholar
12. Kantoch, MJ, Collins-Nakai, RL, Medwid, S, Ungstad, E, Taylor, DA. Adult patient's knowledge about their congenital heart disease. Can J Cardiol 1997; 13: 641–645.Google Scholar
13. Moons, P, De Volder, E, Budts, W, et al. What do adult patients with congenital heart disease know about their disease, treatment, and prevention of complications? A call for structured patient education. Heart 2001; 86: 74–80.Google Scholar
14. Simko, LC, McGinnis, KA, Schembri, J. Educational needs of adults with congenital heart disease. J Cardiovasc Nurs 2006; 21: 85–94.Google Scholar
15. Edwin, F, Sereboe, LA, Tettey, MM, et al. Experience from a single centre concerning the surgical spectrum and outcome of adolescents and adults with congenitally malformed hearts in West Africa. Cardiol Young 2010; 20: 159–164.Google Scholar
16. Mocumbi, AO, Lameira, E, Yaksh, A, Paul, L, Ferreira, MB, Sidi, D. Challenges on the management of congenital heart disease in developing countries. Int J Cardiol 2011; 148: 285–288.CrossRefGoogle ScholarPubMed
17. Kamphius, M, Vogels, T, Ottenkamp, J, Van der Wall, EE, Verloove-Vanhorick, SP, Vliegen, HW. Employment in adults with congenital heart disease. Arch Pediatr Adolesc Med 2002; 156: 1143–1148.Google Scholar
18. Simko, LC, McGinnis, KA. Quality of life experienced by adults with congenital heart disease. AACN Clin Issues 2003; 14: 42–53.CrossRefGoogle ScholarPubMed
19. Van Rijen, EHM, Utens, EMWJ, Roos-Hesselink, JW, et al. Psychosocial functioning of the adult with congenital heart disease: a 20–33 years follow-up. Eur Heart J 2003; 24: 673–683.Google Scholar
20. Crossland, DS, Jackson, SP, Lyall, R, Burn, J, O'sullivan, JJ. Employment and advice regarding careers for adults with congenital heart disease. Cardiol young 2005; 15: 391–395.CrossRefGoogle ScholarPubMed
21. Vigl, M, Niggemeyer, E, Hager, A, Schwedler, G, Kropf, S, Bauer, U. The importance of socio-demographic factors for the quality of life of adults with congenital heart disease. Qual Life Res 2011; 20: 169–177.Google Scholar
22. Nieminen, H, Sairanen, H, Tikanoja, T, et al. Long-term results of pediatric cardiac surgery in Finland: education, employment, marital status, and parenthood. Pediatrics 2003; 112: 1345–1350.Google Scholar
23. Somerville, J. The woman with congenital heart disease. Eur Heart J 1998; 19: 1766–1775.CrossRefGoogle ScholarPubMed
24. Utens, EMWJ, Verhulst, FC, Erdman, RAM, et al. Psychosocial functioning of young adults after surgical correction for congenital heart disease in childhood: a follow-up study. J Psychosom Res 1994; 38: 745–758.Google Scholar
25. Kokkonen, J, Paavilainen, T. Social adaptation of young adults with congenital heart disease. Int J Cardiol 1992; 36: 23–29.Google Scholar
26. Balon, YE, Then, KL, Rankin, JA, Fung, T. Looking beyond the biophysical realm to optimize health: results of a survey of psychological well-being in adults with congenital cardiac disease. Cardiol Young 2008; 18: 494–501.Google Scholar
27. Horner, T, Liberthson, R, Jellinek, MS. Psychosocial profile of adults with complex congenital heart disease. Mayo Clin Proc 2000; 75: 31–36.CrossRefGoogle ScholarPubMed
28. Moons, P, De Bleser, L, Budts, W, et al. Health status, functional abilities, and quality of life after the Mustard or Senning operation. Ann Thorac Surg 2004; 77: 1359–1365.CrossRefGoogle ScholarPubMed
29. U.S. Department of State; Secretary for Public Diplomacy and Public Affairs; Bureau of Public Affairs: Electronic Information and Publications; Background Notes Iran at http://www.state.gov/r/pa/ei/bgn/5314.htm (accessed August 2011).Google Scholar
30. Popelova, J, Slavik, Z, Skovranek, J. Are cyanosed adults with congenital cardiac malformations depressed? Cardiol Young 2001; 11: 379–384.Google Scholar
31. Kamphius, M, Verloove-Venhorick, SP, Vogels, T, Ottenkamp, J, Vliegen, HW. Disease-related difficulties and satisfaction with level of knowledge in adults with mild or complex congenital heart disease. Cardiol Young 2002; 12: 266–271.CrossRefGoogle Scholar
32. Statistical Center of Iran, Summary results of the Urban and Rural Household Income and Expenditure. Survey 2009 at http://www.amar.org.ir/Upload/Modules/Contents/asset0/english/summary_results-final_1388_2009_docx.pdf (accessed August 2011).Google Scholar
33. Thaulow, E, Fredriksen, PM. Exercise and training in adults with congenital heart disease. Int J Cardiol 2004; 97: 35–38.CrossRefGoogle ScholarPubMed
34. Maddah, M, Eshraghian, MR, Djazayery, A, Mirdamadi, R. Association of body mass index with educational level in Iranian men and women. Eur J Clinc Nutr 2003; 57: 819–823.Google Scholar
35. Engelfriet, P, Drenthen, W, Pieper, PG, et al. Smoking and its effects on mortality in adults with congenital heart disease. Int J Cardiol 2008; 127: 93–97.Google Scholar
36. Fotouhi, A, Khabazkhoob, M, Hashemi, H, Mohammad, K. The prevalence of cigarette smoking in residents of Tehran. Arch Iranian Med 2009; 12: 358–364.Google ScholarPubMed
37. Engelfriet, P, Mulder, BJM. Gender differences in adult congenital heart disease. Neth Heart J 2009; 17: 414–417.Google Scholar
38. Rönning, H, Nielsen, NE, Swahn, E, Strömberg, A. Educational needs in adults with congenitally malformed hearts. Cardiol Young 2008; 18: 473–479.Google Scholar