BACKGROUND Previous studies have found that sense of coherence (SOC) is positively related to quality of life (QoL) in persons with chronic conditions. In congenital heart disease (CHD), the evidence is scant. AIMS We investigated (i) intercountry variation in SOC in a large international sample of adults with CHD; (ii) the relationship between demographic and clinical characteristics and SOC; (iii) the relationship between cultural dimensions of countries and SOC; and (iv) variation in relative importance of SOC in explaining QoL across the countries. METHODS APPROACH-IS was a cross-sectional, observational study, with 4028 patients from 15 countries enrolled. SOC was measured using the 13-item SOC scale (range 13-91) and QoL was assessed by a linear analog scale (range 0-100). RESULTS The mean SOC score was 65.5±13.2. Large intercountry variation was observed with the strongest SOC in Switzerland (68.8±11.1) and the lowest SOC in Japan (59.9±14.5). A lower SOC was associated with a younger age; lower educational level; with job seeking, being unemployed or disabled; unmarried, divorced or widowed; from a worse functional class; and simple CHD. Power distance index and individualism vs collectivism were cultural dimensions significantly related to SOC. SOC was positively associated with QoL in all participating countries and in the total sample, with an explained variance ranging from 5.8% in Argentina to 30.4% in Japan. CONCLUSION In adults with CHD, SOC is positively associated with QoL. The implementation of SOC-enhancing interventions might improve QoL, but strategies would likely differ across countries given the substantial variation in explained variance.

中文翻译：

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15 个国家先天性心脏病成人患者的一致性感：患者特征、文化维度和生活质量

背景 先前的研究发现，连贯感 (SOC) 与慢性病患者的生活质量 (QoL) 呈正相关。在先天性心脏病 (CHD) 中，证据不足。目的 我们调查了 (i) 大型国际冠心病成人样本中 SOC 的国家间差异；(ii) 人口统计学和临床​​特征与 SOC 之间的关系；(iii) 国家文化层面与 SOC 之间的关系；(iv) SOC 在解释各国生活质量方面的相对重要性的差异。方法 APPROACH-IS 是一项横断面观察性研究，共有来自 15 个国家的 4028 名患者参加。使用 13 项 SOC 量表（范围 13-91）测量 SOC，并通过线性模拟量表（范围 0-100）评估 QoL。结果平均SOC评分为65.5±13.2。瑞士的 SOC 最强（68.8±11.1）和日本的 SOC 最低（59.9±14.5）观察到较大的国家间差异。较低的 SOC 与较年轻有关；受教育程度较低；有求职、失业或残疾的；未婚、离异或丧偶；来自更差的功能类；和简单的冠心病。权力距离指数和个人主义与集体主义是与 SOC 显着相关的文化维度。在所有参与国家和总样本中，SOC 与 QoL 呈正相关，解释方差从阿根廷的 5.8% 到日本的 30.4% 不等。结论 在患有 CHD 的成人中，SOC 与 QoL 呈正相关。实施 SOC 增强干预措施可能会改善生活质量，但鉴于解释差异的巨大差异，各国的策略可能会有所不同。