| Summary: | Many survivors of congenital heart disease (CHD) are confronted with various medical complications and psychosocial issues arising from limitations related to the disease. They often feel that they are “being controlled by the disease” and experience feelings of depression and anxiety. The purpose of this study was to examine the relationship between types of social support, coping strategies, and psychological distress in individuals living with CHD. The study tested a model that explained psychological distress in the study population. A cross-sectional survey design was used to recruit 272 participants from the Adult CHD program clinic at a tertiary care hospital in Western Canada. The Mplus statistical software was used to analyze the data. Structural equation modeling was used to estimate a parsimonious model and goodness-of-fit indices were used to test the fit of the model with the data. The estimation and testing of two models were performed separately for the two outcomes of psychological distress, namely depression and anxiety. The results were similar for both anxiety and depression. One of the key findings was the impact of social support on psychological distress. Perceived social support was directly related to both anxiety and depression. Received social support influenced anxiety and depression but its effect was through perceived social support. Wishful-thinking coping strategies mediated the relationship between perceived social support and both anxiety and depression. The only difference evident between anxiety and depression was the partial mediation effect of problem-solving coping strategies on the relationship between perceived social support and depression; in anxiety, the same partial mediation effect of problem-solving coping strategies was absent. Findings of the study suggest that individuals with low perceived and received social support are especially vulnerable to experiences of psychological distress. Furthermore, individuals with low perceived social support tend to use more wishful-thinking coping strategies, which in turn, tend to increase their level of anxiety and depression. The findings imply that assessments of social support and type of coping strategies used are an integral part of the nursing care of adults living with CHD.
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