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Predictors of psychosocial adaptation in children with CHD

Published online by Cambridge University Press:  18 April 2024

Jessica L. Metelski*
Affiliation:
Northwestern Feinberg School of Medicine, Chicago, IL, USA
Kiona Y. Allen
Affiliation:
Northwestern Feinberg School of Medicine, Chicago, IL, USA Division of Cardiology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
L. Barrera
Affiliation:
Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
M. Heffernan
Affiliation:
Northwestern Feinberg School of Medicine, Chicago, IL, USA Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
Clayton D. Hinkle
Affiliation:
Northwestern Feinberg School of Medicine, Chicago, IL, USA Pritzker Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
Pooja Parikh
Affiliation:
Division of Cardiology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
Carolyn C. Foster
Affiliation:
Northwestern Feinberg School of Medicine, Chicago, IL, USA Advanced General Pediatrics and Primary Care, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
*
Corresponding author: J. L. Metelski; Email: jessica.metelski@northwestern.edu

Abstract

Survival of CHD has significantly improved, but children with CHD remain susceptible to neurodevelopmental and psychosocial impairments. Our goal was to investigate the association between socio-demographic factors and psychosocial adaptation for future intervention. A retrospective cross-sectional study of an independent children’s hospital’s records was conducted. Psychosocial adaptation was measured by the Pediatric Cardiac Quality of Life Inventory Psychosocial Impact score (range 0–50, higher score indicates greater psychosocial adaptation). Bivariate and regression analyses were performed to estimate relationships between Psychosocial Impact score and socio-demographic variables including Child Opportunity Index, family support, financial support, academic support, and extracurricular activities. A total of 159 patients were included. Compared to patients in high opportunity neighbourhoods, patients in low opportunity neighbourhoods had a 9.27 (95% confidence interval [−17.15, −1.40], p = 0.021) point lower Psychosocial Impact score, whereas patients in moderate opportunity neighbourhoods had a 15.30 (95% confidence interval [−25.38, −5.22], p = 0.003) point lower Psychosocial Impact score. Compared to patients with adequate family support, those with limited support had a 6.23 point (95% confidence interval [−11.82, −0.643], p = 0.029) lower Psychosocial Impact score. Patients in moderate opportunity neighbourhoods had a higher Psychosocial Impact score by 11.80 (95% confidence interval [1.68, 21.91], p = 0.022) when they also had adequate family support compared to those with limited family support. Our findings indicate that among children with CHD, psychosocial adaptation is significantly impacted by neighbourhood resources and family support structures. These findings identify possible modifiable and protective factors to improve psychosocial adaptation in this vulnerable population.

Type
Original Article
Copyright
© The Author(s), 2024. Published by Cambridge University Press

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References

Marino, BS, Shera, D, Wernovsky, G, et al. The development of the pediatric cardiac quality of life inventory: a quality of life measure for children and adolescents with heart disease. Qual Life Res 2008; 17: 613626.CrossRefGoogle ScholarPubMed
Warnes, CA, Liberthson, R, Danielson, GK, et al. Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol 2001; 37: 11701175.CrossRefGoogle ScholarPubMed
Sanz, JH, Anixt, J, Bear, L, et al. Characterisation of neurodevelopmental and psychological outcomes in CHD: a research agenda and recommendations from the cardiac neurodevelopmental outcome collaborative. Cardiol Young 2021; 31: 876887.CrossRefGoogle ScholarPubMed
Majnemer, A, Limperopoulos, C, Shevell, M, Rohlicek, C, Rosenblatt, B, Tchervenkov, C. Developmental and functional outcomes at school entry in children with congenital heart defects. J Pediatr 2008; 153: 5560.CrossRefGoogle ScholarPubMed
Latal, B, Helfricht, S, Fischer, JE, Bauersfeld, U, Landolt, MA. Psychological adjustment and quality of life in children and adolescents following open-heart surgery for congenital heart disease: a systematic review. BMC Pediatr 2009; 9: 6.CrossRefGoogle ScholarPubMed
Johnston, MC, Porteous, T, Crilly, MA, et al. Physical disease and resilient outcomes: a systematic review of resilience definitions and study methods. Psychosomatics 2015; 56: 168180.CrossRefGoogle ScholarPubMed
Piqueras, JA, Mateu-Martínez, O, Cejudo, J, Pérez-González, J-C. Pathways into psychosocial adjustment in children: modeling the effects of trait emotional intelligence, social-emotional problems, and gender. Front Psychol 2019; 10: 507.CrossRefGoogle ScholarPubMed
Rolland, JS, Walsh, F. Facilitating family resilience with childhood illness and disability. Curr Opin Pediatr 2006; 18: 527538.CrossRefGoogle Scholar
Howard Sharp, KM, Willard, VW, Okado, Y, et al. Profiles of connectedness: processes of resilience and growth in children with cancer. J Pediatr Psychol 2015; 40: 904913.CrossRefGoogle ScholarPubMed
Dong, C, Wu, Q, Pan, Y, Yan, Q, Xu, R, Zhang, R. Family resilience and its association with psychosocial adjustment of children with chronic illness: a latent profile analysis. J Pediatr Nurs 2021; 60: e6e12.CrossRefGoogle ScholarPubMed
Anderson, V, Darling, S, Mackay, M, et al. Cognitive resilience following paediatric stroke: biological and environmental predictors. Eur J Paediatr Neurol 2020; 25: 5258.CrossRefGoogle ScholarPubMed
Noelke, C, Ressler, R, McArdle, N et al. Child Opportunity Index 2.0 ZIP Code Data Technical Documentation. Retrieved from https://data.diversitydatakids.org/dataset/coi20-child-opportunity-index-2-0-database?_external=True. Accessed November 21, 2022.Google Scholar
Moskovitz, DN, Maunder, RG, Cohen, Z, McLeod, RS, MacRae, H. Use of community resources before inflammatory bowel disease surgery is associated with postsurgical quality of life. Can J Gastroenterol 2000; 14: 9598.CrossRefGoogle ScholarPubMed
Kroenke, CH, Kwan, ML, Neugut, AI, et al. Social networks, social support mechanisms, and quality of life after breast cancer diagnosis. Breast Cancer Res Treat 2013; 139: 515527.CrossRefGoogle ScholarPubMed
Shiba, K, Kondo, N, Kondo, K. Informal and formal social support and caregiver burden: the AGES caregiver survey. J Epidemiol 2016; 26: 622628.CrossRefGoogle ScholarPubMed