Measuring hassles in adults with congenital heart disease

Objectives Medical professionals who care for young adults with congenital heart disease (CHD) provide not only medical care, but also address psychosocial issues unique to this patient population. Still, little is known about the daily stressors encountered among adults with CHD. The present study investigated daily stressors within the adult CHD population. Design A prospective, cross-sectional study of daily Hassles was conducted in patients ≥ 18 years in our adult CHD clinic. Participants completed surveys to assess demographics, CHD severity, lifestyle behaviors and psychological distress using the 9-item Patient Health Questionnaire (PHQ-9). Perceived stress was measured by the Hassles portion of the Combined Hassles and Uplifts scale. Results Of the 128 patients enrolled in the study (48% men; median age 29 years (23–38 IQR), severe CHD complexity (45.8%) most were ≤ NYHA-FC II (87.6%). Financial hassles were greater in those reporting annual household income less than $40,000. A moderate inverse relationship was detected between depression and level of education (p = 0.022). The level of depression was associated with income level (p = 0.001). Conclusions Commonly encountered stressors in adults with CHD include unemployment and lower annual household income. This was compounded by an inverse correlation between depression and employment status/household income. Given the impact of depression on cardiovascular disease, this may now justify screening in this population. Identification of these psychosocial factors may become an essential method to identify the ‘at-risk’ patient and target preventive efforts.