Sense of coherence, rather than exercise capacity, is the stronger predictor to obtain health-related quality of life in adults with congenital heart disease

Abstract

Irrespective of their cardiovascular findings, quality of life in patients with congenital heart disease (CHD) is good or even superior to that in healthy controls. The sense of coherence (SOC), a psychological resource that focuses on factors that support human health and well-being, was suggested to act as a potential pathway for maintaining and improving quality of life independently from the disease status. From April 2010 to May 2011, we consecutively included 546 young adults (236 female, median age 26.9 years, aged from 16 to 71 years) with various CHD into the study. Patients completed the SOC-13 questionnaire and the health-related quality of life questionnaire SF-36. Afterwards they performed a cardiopulmonary exercise test. In adults with CHD, SOC was slightly enhanced compared with reference values (CHD: median 74.0 [IQR: 63.8;81.0] vs. reference value: 69.7 [68.5;69.7]; p < 0.001) corresponding to 106.1% [91.8;116.7%] of predicted reference value. SOC was not associated with the underlying heart defect (Kruskal-Wallis test, p = 0.565) or heart defect severity (Spearman r = 0.044; p = 0.301). It was moderately related to all dimensions of quality of life (r = 0.260 to r = 0.686; p < 0.001) except to health transition. It was only poorly associated with exercise capacity (r = 0.098; p = 0.023) and age (r = -0.097; p = 0.023). Adults with CHD have an enhanced SOC. SOC is moderately correlated with quality of life, and seems to be a stronger predictor of health-related life quality than exercise capacity. SOC might explain the rather good quality of life in patients with CHD despite their reduction in exercise capacity.