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Examination of the physical and psychosocial determinants of health behaviour in 4–5-year-old children with congenital cardiac disease

Published online by Cambridge University Press:  02 June 2010

Frank A. Casey ,
M. Stewart ,
C. G. McCusker ,
M. L. Morrison ,
B. Molloy ,
N. Doherty ,
B. G. Craig ,
A. J. Sands ,
N. Rooney  and
H. C. Mulholland
Frank A. Casey*
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom The Queen’s University of Belfast, University Road, Belfast, Northern Ireland, United Kingdom
M. Stewart
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
C. G. McCusker
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom The Queen’s University of Belfast, University Road, Belfast, Northern Ireland, United Kingdom
M. L. Morrison
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
B. Molloy
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
N. Doherty
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
B. G. Craig
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
A. J. Sands
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
N. Rooney
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
H. C. Mulholland
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
*
Correspondence to: Dr F. A. Casey, Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, 180 Falls Road, Belfast, Northern Ireland, BT12 6BE, United Kingdom. Tel: 02 89 063 5350; Fax: 02 89 063 5608; E-mail: [email protected]
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Abstract

Objectives

To assess the general health and activity levels of 4- and 5-year-old children after intervention for congenital cardiac disease.

Methods

Health behaviour outcomes were assessed in 91 children who had surgery or catheter intervention for congenital cardiac disease. The children were classified into four groups according to severity. The main parameters of classification were the presence of residual symptoms, frequency of visits to general practitioner or the Accident and Emergency Department, and ability to participate in physical activity according to a calculated “activity score”.

Results

Children had very few residual symptoms after “corrective surgery”. Those with complex congenital cardiac disease post-Fontan-type repair still had symptoms on average 18.2 days per month. Surprisingly, the complex group had fewer days “sick” from non-cardiac causes and had fewer visits to general practitioner or Accident and Emergency Departments. Regression analysis indicates that three variables had significant relevance to the general practitioner or Accident and Emergency visits: complex congenital cardiac disease, fewer visits; Townsend score – more deprivation – more visits; and maternal worry – higher maternal worry score – more visits. Regression analysis indicates that lower activity score is significantly related to complex cardiac disease and higher maternal worry score.

Conclusions

The majority of this group of 4- and 5-year-old children had few residual symptoms and had good exercise tolerance. Maternal worry is a significant factor in influencing both activity levels and frequency of unscheduled health service demands – general practitioner or Accident and Emergency visits.

Keywords

Paediatric cardiologyoutcomesactivitypsychological well-being
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 5 , October 2010 , pp. 532 - 537
Copyright
Copyright © Cambridge University Press 2010

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References

1. Department of Health. Adult Congenital Heart Disease. A Commissioning Guide for Services for Young People and Grownups with Congenital Heart Disease (GUCH). DH, London, 2006.Google Scholar
2. Mahle, WT, Spray, TL, Wernovsky, G, Gaynor, JW, Clark, BJ III. Survival after reconstructive surgery for hypoplastic left heart syndrome: a 15-year experience from a single institution. Circulation 2000; 102 (Suppl 3): III136–III141.CrossRefGoogle ScholarPubMed
3. Binkhorst, M, van de Belt, T, de Hoog, M, et al. Exercise capacity and participation of children with a ventricular septal defect. Am J Cardiol 2008; 102: 1079–1084.CrossRefGoogle ScholarPubMed
4. Joshi, VM, Carey, A, Simpson, P, Paridon, SM. Exercise performance following repair of hypoplastic left heart syndrome: a comparison with other types of Fontan patients. Pediatr Cardiol 1997; 18: 357–360.Google Scholar
5. Mahle, WT, McBride, MG, Paridon, SM. Exercise performance after the arterial switch operation for D-transposition of the great arteries. Am J Card 2001; 87: 753–758.Google Scholar
6. McCrindle, BW, Williams, RV, Mitchell, PD, et al. Pediatric Heart Network Investigators. Relationship of patient and medical characteristics to health status in children and adolescents after the Fontan procedure. Circulation 2006; 113: 1123–1129.CrossRefGoogle ScholarPubMed
7. van der Rijken, RE, Maassen, BA, Walk, TL, Daniëls, O, Hulstijn-Dirkmaat, GM. Outcome after surgical repair of congenital cardiac malformations at school age. Cardiol Young 2007; 17: 64–71.CrossRefGoogle ScholarPubMed
8. Majnemer, A, Limperopoulus, C, Shevell, M, Rohlicek, C, Rosenblatt, B, Tchervenkov, C. Health and well-being of children with congenital cardiac malformations, and their families, following open-heart surgery. Cardiol Young 2006; 16: 125–127.CrossRefGoogle ScholarPubMed
9. Casey, FA, Sykes, DH, Craig, BG, Power, R, Mulholland, HC. Behavioural adjustment of children with surgically palliated complex congenital heart disease. J Pediatr Psychol 1996; 21: 335–352.CrossRefGoogle ScholarPubMed
10. McCusker, CG, Doherty, NN, Molloy, B, et al. Determinants of neuropsychological and behavioural outcomes in early childhood survivors of congenital heart disease. Arch Dis Child 2007; 92: 137–141.CrossRefGoogle ScholarPubMed
11. Townsend, P, Phillimore, P, Beattie, A. Health and Deprivation: Inequality and the North. Croom Helm, London, 1988.Google Scholar
12. Derogatis, LR. Brief Symptom Inventory: Administration, Scoring and Procedures Manual. National Computer Systems Inc., Minneapolis, Minnesota, 1993.Google Scholar
13. DeVet, KA, Ireys, HT. Psychometric properties of the maternal worry scale for children with chronic illness. J Pediatr Psychol 1998; 23: 257–266.Google Scholar
14. Spencer, NJ, Lewis, MA, Logan, S. Diagnostic and sociodemographic changes in multiple hospital admissions in children under two over a five year period. J Pub Health Med 1993; 15: 332–336.CrossRefGoogle ScholarPubMed
15. Beattie, TF, Gorman, DR, Walker, JJ. The aassociation between deprivation levels, attendance rate and triage category of children attending a children’s accident and emergency department. Emerg Med J 2001; 18: 110–111.CrossRefGoogle Scholar
16. Stewart, M, Werneke, U, MacFaul, R, Taylor-Meek, J, Smith, HE, Smith, IJ. Medical and social factors associated with the admission and discharge of acutely ill children. Arch Dis Child 1998; 79: 219–224.CrossRefGoogle ScholarPubMed
17. Goldbeck, L, Melches, J. The impact of the severity of disease and social disadvantage on quality of life in families with congenital cardiac disease. Cardiol Young 2006; 16: 67–75.CrossRefGoogle ScholarPubMed