Perceptions of Disease-Related Stress: A Key to Better Understanding Patient-Reported Outcomes Among Survivors of Congenital Heart Disease.
Jamie L Jackson, Gina M Gerardo, Curt J Daniels and 1 others
PMID 27685861WHAT IT FOUND
Higher disease-related stress was linked to worse emotional symptoms and lower quality of life in adolescents and adults with congenital heart disease, even after age, functional status and sex were considered.
Key findings
01Higher perceived congenital heart disease-related stress was associated with worse emotional distress, physical quality of life, and emotional quality of life beyond age, functional status and sex.
02Participants with impaired functional status reported more disease-related stress and lower physical and emotional quality of life than those with normal functional status.
03Almost half of participants rated worry about future health and scars or other visible signs of past medical procedures as somewhat or very stressful.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show that stress causes poorer outcomes or that poorer outcomes cause stress. The emotional distress measure was added after data collection had begun at one site, and only a subset of participants were re-contacted, so that outcome may not represent all eligible participants. Participants were recruited from outpatient cardiology clinics and excluded genetic syndromes or cognitive limitations, so findings may not apply to inpatients, those with genetic syndromes, or people unable to complete self-report measures. The study used New York Heart Association functional class split into normal versus impaired and did not fully account for other medical factors such as lesion severity, rehospitalisation, or surgical history. No treatment was tested, so the paper cannot show that asking about stress, counselling, or cognitive behavioural therapy improves outcomes.
The easy way to misread this
Do not read the association between stress and poorer outcomes as proof that treating stress will improve quality of life. The study measured stress and outcomes at one time and did not test any treatment.