Congenital Heart Disease has no Negative Impact on Educational Achievements and Employment among Maltese Adult Patients under Clinical Follow-Up

Abstract

<p><strong>Background:</strong> Most children born with congenital heart disease (CHD) nowadays survive into adulthood. The aim of this study was to investigate the potential impact of CHD on educational achievements and employment in Maltese adult patients.</p><p><strong>Methods:</strong> A bespoke self-reporting questionnaire based on the 2008 European Health Interview Survey (EHIS 2008) was distributed to 162 consecutive Maltese adult congenital heart disease (ACHD) patients at time of hospital follow-up for the 1-year period May 2013-May 2014. Education and employment in the ACHD cohort were compared with those from 372 randomly-selected age- and sex-matched EHIS 2008 responders (general population cohort). Chi-squared and Fisher Exact tests were used for categorical variables, and Mann-Whitney <em>U</em> test was applied to numerical variables.</p><p><strong>Results:</strong> There were 125 ACHD responders (65 males, mean age 30.64±12.80 years). Nineteen patients had mild CHD, 85 had moderate lesions and 21 had severe disease. Patients with moderate/severe CHD had undergone significantly more cardiac procedures (mean 1.79; 95% CI 1.56,2.02) compared to patients with mild disease (mean 0.68; 95% CI 0.40,0.96) (p<0.001). There were no significant differences in educational achievements, employment rate or working patterns between the 2 cohorts, but significantly more ACHD patients had higher-skilled occupations (82.1%) compared to the general population (67.5%; p=0.01), with this difference being restricted to male subjects. There were no significant differences in education and employment upon comparison of patients with mild and moderate/severe disease.</p><p><strong>Conclusions:</strong> This study suggests that, in Malta, ACHD has no negative impact on educational achievements and employment.</p>

Education as important predictor for successful employment in adults with congenital heart disease worldwide

“…However, in contrast to previous guidelines, 6 education and employment are no longer mentioned in the latest European guidelines for the management of grown-up CHD. [14][15][16] Research in other chronic diseases (eg, rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease) has consistently shown that employment and work ability are negatively influenced by these conditions. [8][9][10][11][12][13] In contrast, studies from Finland, Sweden, and Malta, have reported employment rates similar or even above those of the general population.…”

“…[8][9][10][11][12][13] In contrast, studies from Finland, Sweden, and Malta, have reported employment rates similar or even above those of the general population. [14][15][16] Research in other chronic diseases (eg, rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease) has consistently shown that employment and work ability are negatively influenced by these conditions. Patients with other chronic diseases are less often employed, work fewer hours when they work and report limitations at work.…”

“…Higher rates of unemployment, disease‐related work absences, and limitations at work have been reported in adults with CHD compared to the general population in The Netherlands, Germany, Denmark, the United Kingdom, and the United States . In contrast, studies from Finland, Sweden, and Malta, have reported employment rates similar or even above those of the general population . Research in other chronic diseases (eg, rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease) has consistently shown that employment and work ability are negatively influenced by these conditions.…”

Educational Attainment in Patients With Congenital Heart Disease: a Comprehensive Systematic Review and Meta-analysis

“…An overview of the included studies is presented in Table 1. The association of CHD with educational attainment was the main aim for 14 (33% of total) studies (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), while in the remaining 28 (67% of total) studies (35-62) it was not. For most of those, information on education attainment was extracted from tables describing study population characteristics.…”