Journal List > J Korean Acad Nurs > v.47(2) > 1003226

Shin, Jang, and Kang: The Relationships among Perceived Parental Bonding, Illness Perception, and Anxiety in Adult Patients with Congenital Heart Diseases

Abstract

Purpose

The purposes of this study were to identify the relationships among perceived parental bonding, illness perception, and anxiety and to determine the influences of perceived parental bonding and illness perception on anxiety in adult patients with congenital heart diseases.

Methods

In this study a descriptive correlational design with survey method was utilized. The participants were 143 adult patients with congenital heart disease being cared for in the cardiology out-patient clinic of A medical center. Data were collected using the Parental Bonding Instrument, Illness Perception Questionnaire Revised Scale, and Cardiac Anxiety Questionnaire Scale. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation analysis, and hierarchial regression analyses.

Results

There showed significant positive relationships of anxiety with maternal overprotection, consequences, and personal control respectively. Among predictors, maternal overprotection (b=.45), consequence (b=.26), and personal control (b=-.03) had statistically significant influence on anxiety.

Conclusion

Nursing interventions to decrease maternal overprotection and negative consequence, and to enhance personal control are essential to decrease the anxiety of adult patients with congenital heart diseases.

References

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Table 1.
Differences in Anxiety by Demographic and Clinical Characteristics (N=143)
Characteristics Categories n (%) Anxiety
M±SD t/F/c2 (p) Duncan‘s test
Gender Male 70 (48.9) 1.30±0.30 -2.33 (.052)
Female 73 (51.0) 1.10±0.11
Age (yr) 19~29 108 (75.5) 2.41±0.12 8.45 (.015)*
30~39 11 (7.6) 2.19±0.57
40~49 13 (9.2) 1.26±0.16
≥50 11 (7.6) 1.52±0.28
Education (yr) Middle school (≤9) 2 (1.4) 1.00±0.39 1.70 (.188)
High school (10~12) 79 (56.1) 1.87±0.19
Undergraduate school (13~16) 57 (38.7) 2.00±0.58
Graduate school (≥16) 5 (3.8) 1.29±0.19
Marriage Married 26 (18.2) 2.70±0.62 1.58 (.200)
Not married 115 (80.4) 1.60±0.32
Divorced 2 (1.4) 2.11±0.55
Occupation Yes 87 (60.8) 1.88±0.31 1.11 (.241)
No 56 (39.2) 2.51±0.52
ACHD subtype Simplea 71 (45.9) 1.21±0.31 6.45 (<.001) a,b,c<d
Moderateb 50 (29.4) 2.06±0.76
Severec 12 (18.8) 3.06±1.52
Complexd 10 (5.9) 3.19±0.81
Cohabitation Yes 122 (85.3) 1.42±0.15 0.06 (.956)
No 21 (14.7) 2.12±0.62
Comorbidity Yes 113 (79.0) 2.91±0.87 0.84 (.400)
No 30 (21.0) 1.82±0.17
Dental treatment Yes 126 (88.1) 1.27±0.72 0.80 (.422)
No 17 (11.9) 2.80±0.34
Foot edema Yes 8 (5.6) 2.23±0.72 1.17 (.060)
No 135 (94.4) 1.83±0.66
Number of operations 0 56 (39.4) 1.51±0.43 4.90 (.004)
1 32 (22.3) 1.78±0.51
2 37 (25.8) 2.15±0.33
≥3 18 (12.5) 2.88±1.15
Exercise Yes 43 (30.1) 1.96±0.24 -1.67 (.095)
No 100 (69.9) 1.36±0.82
Regular hospital visits Yes 111 (77.6) 2.77±0.13 -0.43 (.666)
No 32 (22.4) 1.88±0.29

*Kruskal wallis test; ACHD=Adult congenital heart disease; Simple=Aortic valve disease, ventricular septal defect, patent ductus arteriosus, etc; Moderate=Ebstein's anoamaly, tetralogy of Fallot, etc; Severe=Single ventricle, transposition of the great arteries, cyanotic heart disease, etc; Complex=Functional single ventricle with atrial fibrillation, hypoplastic left heart syndrome with ventricular tachycardia, etc.

Table 2.
Summary of Descriptive Statistics for Parental Bonding, Illness Perception, and Anxiety (N=143)
Variables M±SD Min Max Range
Parental bonding
   Mother Care 22.87±8.97 6 36 0~36
      Overprotection 22.85±9.41 4 30 0~39
   Father Care 21.29±9.13 8 32 0~36
      Overprotection 22.09±9.36 0 30 0~39
Illness perception
   Identity 7.99±2.94 2 14 0~28
   Timeline (acute/chronic) 17.98±4.35 6 26 6~30
   Consequences 16.09±5.24 6 29 6~30
   Personal control 18.20±2.65 10 24 6~30
   Treatment control 16.52±3.46 6 25 5~25
   Illness coherence 18.14±3.40 11 25 5~25
   Timeline cyclical 10.26±3.21 4 18 4~20
   Emotional representations 15.04±4.26 6 26 6~30
Anxiety 1.24±0.31 0 5 0~5
   Fear 1.36±0.47 0 5 0~5
   Attention 1.04±0.59 0 5 0~5
   Avoidance 1.19±0.51 0 5 0~5
Table 3.
Correlation Matrix for Parental Bonding, Illness Perception, and Anxiety (N=143)
Variables Parental bonding Ilness perception
X1 X2 P1 P2 P3 P4 I1 I2 I3 I4 I5 I6 I7 I8
r (p) r (p) r (p)
Age (X1) 1.00
Number of operations .13 1.00
   (X2) (.068)
Parental bonding
   Maternal care (P1) .24 .11 1.00
(.15) (.423)
   Maternal .28 .14 -.16 1.00
      overprotection (P2) (<.001) (.062) (.053)
   Paternal care (P3) .17 -.21 .23 -.13 1.00
(.224) (<.001) (.001) (.472)
   Paternal -.16 .14 .17 -.13 -12 1.00
      overprotection (P4) (.003) (.513) (.325) (.552) (.692)
Ilness perception
   Identity (I1) -.28 .19 -.13 -.22 -.24 -.13 1.00
(.003) (<.001) (.678) (.770) (.607) (.793)
   Timeline (acute/ .13 .30 -.27 -.10 -.13 -.17 -.19 1.00
chronic) (I2) (.284) (.001) (.373) (.200) (.098) (.230) (.361)
   Consequences (I3) .21 .27 .15 .22 .13 .15 .25 .10 1.00
(<.001) (<.001) (.520) (.821) (.761) (.627) (.292) (.432)
   Personal control (I4) -.18 -.30 -.11 .24 -.14 .25 .11 -.17 -.23 1.00
(<.001) (.151) (.770) (.604) (.098) (.211) (.172) (.162) (.352)
   Treatment contol (I5) .22 -.13 .12 .15 27 .18 .18 .14 -.19 .27 1.00
(.009) (.201) (.806) (.520) (.195) (.419) (.371) (.111) (.071) (.082)
   Illness coherence (I6) .10 .21 .11 .19 .20 .25 .22 .16 -.29 .20 .11 1.00
(.003) (.311) (.185) (.269) (.848) (.330) (.123) (.062) (.243) (.099) (.102)
   Timeline cyclical (I7) .24 .18 -.01 .11 -.11 .12 .25 .27 .10 -.19 .17 .18 1.00
(.001) (<.001) (.868) (.162) (.187) (.352) (.191) (.203) (.301) (.136) (.327) (.201)
   Emotional -.31 -.27 -.14 .12 -.23 14 .13 .19 .13 .15 .15 .24 -.12 1.00
(<.001) representations (I8) (<.001) (.571) (.707) (.678) (.501) (.227) (.333) (.132) (248) (.115) (.131) (.351)
Anxiety -.11 .42 -.13 .31 .17 .31 .27 -.14 .16 -.19 -.16 -.12 -.19 -.23
(.039) (p<.001) (.122) (.017) (.390) (.866) (.932) (.092) (.046) (.021) (.475) (.146) (.920) (.678)
Table 4.
Regression Coefficients of Predictors on Anxiety (N=143)
Variables Categories Model 1 Model 2
b t p b t p
Constant 9.24 <.001 -0.01 .989
ACHD subtype* Simple -.07 -0.80 .422 -.07 -0.83 .408
Moderate -.05 -0.65 .581 -.06 -0.79 .513
Severe -.01 -0.20 .743 -.03 -0.36 .695
Number of operations .22 2.35 .020 .11 1.18 .240
Age -.03 -0.38 .698 -.01 -0.17 .858
Parental bonding Maternal overprotection .45 2.01 .046
Illness perception Consequences .26 2.55 .012
Personal control -.03 1.92 .047
F (p) 2.28 (.017) 3.20(<.001)
R2 .07 .30

*Dummy variable: ACHD subtype (reference group: complex); ACHD=Adult congenital heart disease; Simple=Aortic valve disease, ventricular septal defect, patent ductus arteriosus, etc; Moderate=Ebstein's anoamaly, tetralogy of Fallot, etc; Severe=Single ventricle, transposition of the great arteries, cyanotic heart disease, etc; Complex=Functional single ventricle with atrial fibrillation, hypoplastic left heart syndrome with ventricular tachycardia, etc.

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