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Employment in adults with congenital heart disease
Mascha Kamphuis1, Ton Vogels, Jaap Ottenkamp
1Department of Pediatric Cardiology, Leiden University Medical Center, the Netherlands. kamphuis.m@freeler.nl
Insights
Adults with complex congenital heart disease (CHD) experience lower employment rates and more career challenges than those with mild CHD. Targeted career counseling can help mitigate these job-related issues.
Area of Science:
- Cardiology
- Occupational Health
- Public Health
Background:
- Adults with congenital heart disease (CHD) often face unique challenges transitioning to the workforce.
- Understanding employment disparities is crucial for improving long-term outcomes in this population.
Purpose of the Study:
- To compare job participation, career-related issues, and job-specific problems in adults with complex CHD versus mild CHD.
- To identify factors influencing employment in adults with CHD.
Main Methods:
- A cross-sectional study involving 76 adults with complex CHD and 80 with mild CHD (ages 17-32).
- Self-reported questionnaires assessed employment status and handicaps.
- Data were analyzed using logistic regression.
Main Results:
- Job participation was lower in complex CHD (59%) compared to mild CHD (76%).
- Adults over 25 with complex CHD had significantly lower job participation (64%) than the general population (83%).
- Complex CHD, type of CHD, and education level independently predicted job participation. 55% of complex CHD patients reported career problems, versus 1% with mild CHD.
Conclusions:
- Complex CHD is associated with reduced job participation and increased career problems compared to mild CHD and the general population.
- Many adults with complex CHD receive disability benefits or face job handicaps.
- Career counseling addressing physical capabilities and education is recommended to support employment.
Objective:
To evaluate job participation, career-related problems, and actual job problems in adults with complex congenital heart disease (CHD) compared with adults with mild CHD and reference groups.
Design:
Cross-sectional study.
Setting:
Patients were randomly selected from the archives of the Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
Patients And Main Outcome Measures:
In total, 76 patients with complex CHD and 80 with mild CHD (age range, 17-32 years) completed a self-reported questionnaire on employment and handicaps, with reference data available (response rate, 70%).
Results:
In the study groups, 45 (59%) of 76 patients with complex CHD had a paid job compared with 61 (76%) of 80 patients with mild CHD. Patients older than 25 years with complex CHD had significantly lower job participation (64%) than the general population (83%). Multiple logistic regression showed that type of CHD and level of education were significantly and independently related to job participation (odds ratio, 4.8; 99% confidence interval, 1.2-19.6; and odds ratio, 4.7; 99% confidence interval, 1.3-17.2, respectively). Of the 76 patients with complex CHD, 42 (55%) experienced disease-related career problems, in contrast to only 1 patient with mild CHD. Both CHD groups had more job-related mobility handicaps than did the reference group. However, in the mild CHD group, handicaps could be attributed to additional noncardiac diseases.
Conclusions:
Patients with complex CHD have reduced job participation compared with patients with mild CHD and the general population. Many receive disability benefits or experience career problems or job handicaps. Career counseling focusing on physical abilities and level of education may help prevent or reduce these job-related problems.