# Investigation of Community Integration in Adults with Congenital Heart Disease Within the Scope of International Classification of Functioning, Disability, and Health

## TL;DR

This study explores how adults with congenital heart disease integrate into their communities, using a health framework to identify factors like physical activity and quality of life.

## Contribution

The study introduces a holistic ICF-based evaluation of community integration in adults with CHD, linking it to physical and psychosocial factors.

## Key findings

- Community integration correlates with physical activity barriers, quality of life, and 6-minute walk test results.
- Access to health personnel and 6-minute walk test distance predict community integration scores.
- The findings highlight the importance of evaluating community integration through patient-reported outcomes in CHD patients.

## Abstract

The number of adults living with congenital heart disease continues to rise, emphasizing the need to understand the challenges they encounter to enhance disease management. This study aimed to evaluate adults with CHD using the International Classification of Functioning (ICF) framework and explore factors associated with community integration. Holistic assessments were conducted encompassing all dimensions of the ICF framework, including Body Structures (echocardiography and electrocardiography findings), Body Functions (6-Minute Walk Test, Muscle Strength, Hand Grip Strength, and Fatigue Severity Scale), Activity-Participation (International Physical Activity Questionnaire, Multidimensional Quality of Life Scale, and Community Integration Questionnaire), and Environmental-Personal factors (Depression, Anxiety, and Stress Scale- 21, and Physical Activity Barriers Scale). Pearson correlation analysis was conducted to examine the relationships between community integration and other parameters, with variables showing significant correlations included in the multiple linear regression analysis. The mean age of 42 CHD participants was 24.61 ± 7.27 years. The Community Integration Questionnaire correlated with the Physical Activity Barriers Scale (r = 0.310, p = 0.046), Multidimensional Quality of Life Scale (r = 0.441, p = 0.003), and 6-min walk test (r = 0.364, p = 0.021). “Access to health personnel,” a sub-dimension of the Multidimensional Quality of Life Scale, and 6-min walk test distance predicted the Community Integration Questionnaire score, explaining 30.7% of its variance (r = 0.554; r2 = 0.307; F = 8.197; p = 0.001). The findings suggest that community integration in individuals with CHD is linked to body function, activity-participation, and environmental-personal factors. This study highlights the importance of evaluating patient-reported outcome measures in the domain of community integration, especially considering the shifting demographics of congenital heart disease.

The online version contains supplementary material available at 10.1007/s00246-025-03850-4.