Long‐term mental wellbeing of adolescents and young adults diagnosed with venous thromboembolism: results from a multistage mixed methods study

• Published in: Journal of thrombosis and haemostasis Vol. 15; no. 12; pp. 2333 - 2343
• Main Authors: Højen, A. A., Sørensen, E. E., Dreyer, P. S., Søgaard, M., Larsen, T. B.
• Format: Journal Article
• Language: English
• Published: England Elsevier Limited 01-12-2017
• Subjects: Adolescent; Adolescents; Adult; anxiety; Chronic illnesses; Cohort Studies; Denmark; Diabetes mellitus; Diagnosis; Fear; Female; Financial planning; Humans; Inheritances; Insulin; Male; Mental Health; Mixed methods research; Perception; Pregnancy; psychology; Psychology, Adolescent; pulmonary embolism; Recurrence; Registries; Standard of living; Stress, Psychological; Teenagers; Thromboembolism; venous thromboembolism; Venous Thromboembolism - psychology; Young Adult; Young adults; anxiety; adolescent; young adult; psychology; pulmonary embolism; venous thromboembolism
• ISSN: 1538-7933; 1538-7836; 1538-7836
• DOI: 10.1111/jth.13873

Essentials
Long‐term mental wellbeing of adolescents and young adults with venous thromboembolism is unclear.
This multistage mixed methods study was based on Danish nationwide registry data and interviews.
Mental wellbeing is negatively impacted in the long‐term and uncertainty of recurrence is pivotal.
The perceived health threat is more important than disease severity for long‐term mental wellbeing.
Summary
Background
Critical and chronic illness in youth can lead to impaired mental wellbeing. Venous thromboembolism (VTE) is a potentially traumatic and life‐threatening condition. Nonetheless, the long‐term mental wellbeing of adolescents and young adults (AYAS) with VTE is unclear.
Objectives
To investigate the long‐term mental wellbeing of AYAS (aged 13–33 years) diagnosed with VTE.
Methods
We performed a multistage mixed method study based on data from the Danish nationwide health registries, and semistructured interviews with 12 AYAS diagnosed with VTE. An integrated mixed methods interpretation of the findings was conducted through narrative weaving and joint displays.
Results
The integrated mixed methods interpretation showed that the mental wellbeing of AYAS with VTE had a chronic perspective, with a persistently higher risk of psychotropic drug purchase among AYAS with a first‐time diagnosis of VTE than among sex‐matched and age‐matched population controls and AYAS with a first‐time diagnosis of insulin‐dependent diabetes mellitus. Impaired mental wellbeing was largely connected to a fear of recurrence and concomitant uncertainty. Therefore, it was important for the long‐term mental wellbeing to navigate uncertainty. The perceived health threat played a more profound role in long‐term mental wellbeing than disease severity, as the potential life threat was the pivot which pointed back to the initial VTE and forward to the perception of future health threat and the potential risk of dying of a recurrent event.
Conclusion
Our findings show that the long‐term mental wellbeing of AYAS diagnosed with VTE is negatively affected, and highlights these patients’ need for adequate support.