Abstract 19793: Relationship Between Self-care, Functional Health, and Health Resource Use in Adults With Congenital Heart Defects

Abstract

Introduction: Many adults with congenital heart disease (ACHD) face progressive functional decline and increasing health resource use (HRU) related to long-term complications. The ability of ACHD self-care to influence functional decline is relatively unknown. The purpose of this study was to determine the relationship between self-care (maintenance, monitoring, and management behaviors), functional health (exercise capacity, symptom burden) and HRU. Methods: Adults with moderate or severe ACHD (mean age 36 ± 11 years, 55% female, 81% Caucasian) were recruited from a single ACHD center (N=132). Participants completed baseline surveys on self-care, symptom burden, and sociodemographics, and a six-minute walk test (6MWT). Clinical data were collected by chart review. Self-reported HRU was collected prospectively for 3 months. Bivariate correlations, linear and logistic regression analyses were used. Results: Mean total distance walked on the 6MWT was 1365 ± 275 feet. Participants experienced 7.4 ± 4.8 symptoms in the previous month. A total of 101 (80.8%) participants experienced 310 healthcare encounters (275 office visits, 21 hospitalizations, 20 ED visits); 73 persons (58.4%) had > 1 HRU encounter. In multivariate analysis, self-care management (β=-44.20, p=.001) and monitoring (β=-14.59, p=.03) were independently associated with the 6MWT; self-care maintenance and monitoring were independently associated with symptom burden (β=-.39, p<.001; β=1.52, p<.001); higher self-care monitoring was an independent predictor of ≥ 1 HRU encounter (OR=1.21, 95% CI [1.09, 1.35], p<.001). Conclusions: Self-care may be an important, modifiable predictor of functional health and HRU in the ACHD population. The development of interventions to improve self-care should be pursued in future studies.