Category: Health Psychology / Behavioral Medicine - Adult
The impact of heart disease is pervasive across cultures. Congenital heart disease (CHD) is the world’s most common birth defect, occurring globally at 9.3 for every 1000 births (van der Linde et al., 2011). The survival rate of CHD patients has been steadily rising, leading to a growing population of adults with CHD (Marelli et al., 2014). Yet, these adults are at an increased risk for psychological issues, cardiac-related complications and other comorbid health concerns (Baumgartner et al., 2010). Research has supported the health benefits of physical activity in reducing the risk for cardiovascular disease and improving mental health and overall quality of life (Dua et al., 2010; Dulfer et al., 2014). Despite this, there is scant research documenting the rate of physical activity among CHD patients world wide, and the available research has reported mixed findings. While some studies cite that adults with CHD meet the recommended levels of physical activity, others have estimated that 85% of patients achieve suboptimal levels (Dua, Cooper, Fox & Graham, 2007). Anxiety may be an important factor associated with the adoption of healthy lifestyle choices. Patients with acquired heart disease may avoid physical activity due to unfounded perceptions about the risk of engaging in physically demanding tasks imparted by medical professionals and close others (Sable et al., 2011; Swan & Hillis, 2000). The aim of this study is to examine the rates of physical activity among CHD adults across 15 countries and to investigate the association between anxiety and physical activity.
Data was from an international collaborative research group and the APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease–International Study). APPROACH–IS is a large-scale, cross-national study of individuals with CHD from 15 countries. A total of 4,028 participants were recruited. All subjects were at least 18 years of age and diagnosed with CHD prior to the age of 10. Physical activity was assessed using the Health Behavior Scale for Congenital Heart Disease (HBS-CHD; Goossens et al., 2013). Overall, 58% of patients reported engaging in some physical activity. Across countries, the percentage of physical activity ranged from 42% (USA) to 75.9% (Norway). Anxiety was measured using the Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983). 72.3% of the overall sample reported anxiety levels within normal limits (M= 5.62, SD= 3.87), 19.2% scored within at-risk classification of possible anxiety and the remainder reported probable anxiety. Across countries, the means ranged from 4.37 (SD= 2.93; lowest anxiety; the Netherlands) to 6.85 (SD= 4.15; highest anxiety; France).Overall, physical activity was associated with less anxiety, r= -.087, p< .001. However, this inverse relationship was only found for USA, r= -.123, the Netherlands, r= -.136 and Canada, r=-.140. Results of this study will contribute to the limited research on physical activity in adults with CHD cross-culturally and elucidate the role of anxiety in engaging in this health behavior. Findings may hold clinical utility in considering physical activity as an auxiliary risk reduction method for adults with CHD.
Vien Cheung– Graduate Student, University of Missouri-St. Louis, Saint Louis, Missouri
Kamila White– University of Missouri- St. Louis
Ari Cedars– Washington University School of Medicine
APPROACH-IS Consortium– Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart Disease- International Study