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Heart disease symptoms, cognitive functioning, health communication, treatment anxiety, and health-related quality of life in paediatric heart disease: a multiple mediator analysis

Published online by Cambridge University Press:  16 November 2022

James W. Varni Open the ORCID record for James W. Varni [Opens in a new window]  and
Karen Uzark Open the ORCID record for Karen Uzark [Opens in a new window]
James W. Varni*
Affiliation:
Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX, USA
Karen Uzark
Affiliation:
University of Michigan C.S. Mott Children’s Hospital, Ann Arbor, MI, USA
*
Author for correspondence: James W. Varni, Colleges of Architecture and Medicine, Texas A&M University, 3137 TAMU, College Station, Texas 77843-3137, USA. Tel: +1 (979) 845-7009; Fax: +1 (979) 862-2735. E-mail: jvarni@tamu.edu
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Abstract

Objectives:

The objective was to investigate the serial mediating effects of perceived cognitive functioning, patient health communication, and treatment anxiety in the relationship between heart disease symptoms and overall generic health-related quality of life in children with heart disease from the patient perspective.

Methods:

Heart Disease Symptoms, Cognitive Problems, Communication and Treatment Anxiety Scales from Pediatric Quality of Life Inventory™ (PedsQL™) Cardiac Module and PedsQL™ 4.0 Generic Core Scales were completed by 278 children with CHD ages 8–18. A serial multiple mediator model analysis was conducted to test the sequential mediating effects of perceived cognitive functioning, patient health communication, and treatment anxiety as intervening variables in the relationship between the heart disease symptoms predictor variable and overall generic health-related quality of life.

Results:

Heart disease symptoms predictive effects on overall generic health-related quality of life were serially mediated in part by cognitive functioning, patient health communication, and treatment anxiety. In a predictive analytics model with age and gender demographic covariates, heart disease symptoms, perceived cognitive functioning, patient health communication, and treatment anxiety accounted for 67% of the variance in patient-reported overall generic health-related quality of life (p < 0.001), representing a large effect size.

Conclusions:

Perceived cognitive functioning, patient health communication, and treatment anxiety explain in part the mechanism of heart disease symptoms predictive effects on overall generic health-related quality of life in paediatric heart disease. Identifying the mediators of heart disease symptoms on overall generic health-related quality of life from the patient perspective may inform targeted clinical interventions and future patient-centred clinical research to improve overall daily functioning.

Keywords

CHDsymptomscognitionhealth communicationhealth-related quality of lifePedsQL
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 10 , October 2023 , pp. 1920 - 1925
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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Footnotes

The PedsQL is available at http://www.pedsql.org.

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