Illness Uncertainty and Posttraumatic Stress in Young Adults With Congenital Heart Disease.
Patricia Moreland, Sheila Judge Santacroce
PMID 29601372WHAT IT FOUND
Uncertainty about symptoms, information, care transitions and the future was central for young adults with congenital heart disease.
Participants with severe posttraumatic stress symptoms described danger appraisals, avoidance of care and medication nonadherence.
Key findings
01Uncertainty about unpredictable illness course and outcome was expressed by all participants, and women's childbearing worries were a prominent source of distress.
02Six participants (24%) exceeded the PTSD-RI cutoff of 38, which the paper identifies as clinically significant PTSD.
03Participants with severe PTSS scores appraised uncertainty as danger and reported avoidance of reminders, medication nonadherence and missed routine appointments.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 25 participants were studied, and the sample was predominantly Caucasian, so the themes may not apply to other groups. Most participants had moderate or complex cardiac defects, so findings may not apply to people with milder congenital heart disease. Data were collected at one time point, so the study cannot show that uncertainty caused PTSD or that PTSS caused avoidance. The study used interviews and a self-report questionnaire cutoff, not a tested clinical intervention.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that uncertainty causes PTSD or that screening and education will improve adherence. This was a small descriptive mixed-methods study, and only six participants exceeded the posttraumatic stress questionnaire cutoff.