Executive Function and Psychosocial Quality of Life in School Age Children with Congenital Heart Disease

被引:40
|
作者
Sanz, Jacqueline H. [1 ,2 ,3 ]
Wang, Jichuan [4 ,5 ]
Berl, Madison M. [1 ,2 ,3 ]
Armour, Anna C. [1 ]
Cheng, Yao, I [4 ]
Donofrio, Mary T. [3 ,6 ]
机构
[1] Childrens Natl Hlth Syst, Div Neuropsychol, Washington, DC 20010 USA
[2] George Washington Univ, Sch Med, Dept Psychiat & Behav Sci, Washington, DC USA
[3] George Washington Univ, Sch Med, Dept Pediat, Washington, DC 20052 USA
[4] Childrens Natl Hlth Syst, Biostat, Washington, DC USA
[5] George Washington Univ, Epidemiol & Biostat, Washington, DC USA
[6] Childrens Natl Hlth Syst, Div Cardiol, Washington, DC USA
来源
JOURNAL OF PEDIATRICS | 2018年 / 202卷
基金
美国国家卫生研究院;
关键词
GENERIC CORE SCALES; ACADEMIC-ACHIEVEMENT; HEALTH; RELIABILITY; PEDSQL(TM); VALIDITY; MODEL; ADOLESCENTS; SURGERY; FEASIBILITY;
D O I
10.1016/j.jpeds.2018.07.018
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To test a model to predict psychosocial quality of life (QOL) in children with congenital heart disease (CHD) via executive dysfunction. Study design Parents of 91 children with CHD requiring surgery in the first year of life completed questionnaires by mail or as part of their cardiology clinic visit. Latent class analysis identified 2 groups of patients with different likelihoods of executive dysfunction. Select medical and demographic characteristics and executive dysfunction group membership were evaluated as predictors of QOL using structural equation modeling. Results In children with CHD, aortic obstruction, male sex, and premature birth predicted worse executive function. explaining 59% of the variance. Structural equation modeling results indicated that executive dysfunction plays an important mediating role, through which CHD with aortic obstruction, male sex, and premature birth indirectly affect psychosocial QOL. Neurologic abnormalities and single-ventricle CHD did not significantly predict executive dysfunction or QOL. Conclusions Executive dysfunction is a strong predictor of psychosocial QOL at school age. Select medical and demographic risk factors did not directly predict QOL at school age in CHD; however, aortic obstruction, premature birth, and male sex impacted QOL indirectly by contributing to executive dysfunction. These findings suggest important risk factors for executive dysfunction that can be monitored, allowing for provision of early supports for executive skills development in an effort to improve long term psychosocial QOL in at-risk children with CHD.
引用
收藏
页码:63 / 69
页数:7
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