Health-Related Quality of Life Declines Over 3 Years for Congenital Heart Disease Survivors.
Jamie L Jackson, Jennifer DeSalvo, Carine E Leslie and 1 others
PMID 33273250WHAT IT FOUND
Young adults with congenital heart disease reported declining quality of life across every measured area over three years.
Lower family income predicted faster physical and emotional decline, so ask patients about appointment travel and medical costs.
Key findings
01All HRQoL subscales declined significantly over age.
02Estimated family income predicted change in physical functioning and emotional functioning: the slope decreased by .5 and .3, respectively, for every $30,000 income reduction.
03Sex, distance from the medical center, NYHA functional class, and number of cardiac medications did not predict change in any HRQoL subscale.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Each participant had at most two time points, so the study cannot explain why quality of life changed. The design was mixed cross-sectional and longitudinal: some people were enrolled as adolescents and others as young adults, then followed for three years. This means it cannot show whether someone who enrolled as a teenager would follow the same trajectory as someone who enrolled later as an adult. Attrition occurred: 257 completed baseline measures and complete follow-up data were obtained for 172, although those who declined or could not be reached did not differ on measured variables. Estimated family income was derived from census data and address, not directly reported income. The sample came from a Midwestern metropolitan area, so results may not apply to other regions or countries. The study did not test whether asking about costs or transport changes outcomes.
Declared interests
The supplied article text does not include a funding or conflict-of-interest declaration. The publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that lower income causes quality-of-life decline or that asking patients about costs will improve their health. This was an observational study with two time points, estimated income from census data, and no tested intervention.