Abstract 18621: Self-care Confidence is Important in Self-care in Emerging Adults With Congenital Heart Disease

Abstract

Background: Emerging adults (ages 18-25 years) with congenital heart disease (CHD) are expected to perform self-care, behaviors that maintain physiologic stability and the response to symptoms as they occur. In spite of the seriousness of CHD, some emerging adults forego self-care. Identifying those unlikely to perform self-care is essential.Objective: The purpose of this study was to describe self-care and to identify the correlates of self-care in emerging adults with CHD. We hypothesized that knowledge and beliefs would be the primary determinants of self-care. Methods: In this descriptive, cross-sectional study, we enrolled a convenience sample (n=57) of emerging adults from two outpatient CHD centers (adult, n=37; pediatric, n=20) in the Northeastern US. All participants completed neuropsychological testing (PMR, DSST, Trail-Making Tests and the Letter Number Sequencing Tests) and scales measuring developmental stage (Course of Life), mood, knowledge of CHD (Leuven Knowledge Questionnaire), self-efficacy (the NGSES), family functioning (FAD), and a demographic survey. Disease severity was determined by the diagnosis and the number of repairs. Variables were tested as correlates of self-care measured using the Self-Care in CHD Scale (SC-CHD). Scores are standardized 0-100; higher scores indicate higher self-care. Multivariate regression was conducted in two blocks. First age, disease severity, developmental stage, mood, family functioning, cognition, and self-care confidence were entered. Second, knowledge and beliefs were entered for hypothesis testing. Results: Participants (42% female, mean age 21 years, SD 2.32) had predominantly moderate (42%) to severely (45.6%) complex CHD. Self-care was low (SC-CHD=mean 57, SD 11.23). More CHD repairs, higher levels of self-care confidence, and older age explained 41% of the variance in self-care (Block 2: F=3.785, df=3, 46, p=0.17). The higher the level of self-care confidence, the more likely the performance of self-care. Conclusions: These results can be used to identify a subset of CHD patients at risk for poor self-care. Self-care confidence is the only modifiable determinant, suggesting that interventions designed to increase self-care confidence may be useful in this population.