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Le HHTC, Vien NT, Dang TN, Ware RS, Phung D, Thai PK, Ranganathan S, Vinh NN, Dung PHT, Thanh HN, Dung TTT, Hien TT, Sly PD, Le An P. Wearing masks as a protective measure for children against traffic-related air pollution: A comparison of perceptions between school children and their caregivers in Ho Chi Minh City, Vietnam. Trop Med Int Health 2023; 28:753-762. [PMID: 37615211 PMCID: PMC10946546 DOI: 10.1111/tmi.13923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
BACKGROUND Traffic-related air pollution (TRAP) problems are unlikely to be solved in the short term, making it imperative to educate children on protective measures to mitigate the negative impact on their health. Children and their caregivers may hold differing views on wearing a face mask as a safeguard against air pollution. While many studies have focused on predicting children's health-protective behaviours against air pollution, few have explored the differences in perceptions between children and their caregivers. OBJECTIVES To examine this, we conducted a study that compared the health beliefs of two generations and evaluated the factors that influence the use of masks by children to reduce air pollution exposure. METHODS The study was conducted in 24 secondary schools and involved 8420 children aged 13-14 and their caregivers. We used a Health Belief Model (HBM)-based instrument containing 17-item self-administered health beliefs questionnaires to gather data. The results were analysed using hierarchical logistic regression to determine the probability of children frequently wearing masks to protect against TRAP. RESULTS Our study showed both children and caregivers recognised that several factors could influence mask-wearing among children: discomfort or difficulty breathing while wearing a mask and forgetting to bring a mask when going outside; perceived threats of the poor quality of air and children's respiratory health problems; and cues to mask use (i.e., seeing most of their friends wearing facemasks and ease of finding masks in local stores). However, only children were significantly concerned with public perception of their appearance while wearing a mask. Females were more likely to wear masks, and caregivers with higher levels of education were more likely to encourage their children to wear masks. Children who commuted to schools by walking, biking, or motorbiking were also more accepting of mask-wearing than those who travelled by car or bus. CONCLUSIONS Children and their caregivers hold different perceptions of wearing masks to protect against air pollution. Children are more susceptible to social judgements regarding their appearance when wearing a mask.
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Affiliation(s)
- Hong H. T. C. Le
- Faculty of MedicineThe University of QueenslandBrisbane CityQueenslandAustralia
- Children's Health and Environment ProgramCentre for Children's Health ResearchBrisbane CityQueenslandAustralia
| | - Nguyen Truong Vien
- Department of Environmental and Occupational HealthPham Ngoc Thach University of MedicineHo Chi Minh CityVietnam
| | - Tran Ngoc Dang
- Faculty of Public HealthUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Robert S. Ware
- Menzies Health Institute QueenslandGriffith UniversityBrisbane CityQueenslandAustralia
| | - Dung Phung
- School of Public HealthThe University of QueenslandBrisbane CityQueenslandAustralia
| | - Phong K. Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS)The University of QueenslandBrisbane CityQueenslandAustralia
| | | | - Nguyen Nhu Vinh
- Centre for the Training of Family Medicine, Faculty of MedicineUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Phan Hoang Thuy Dung
- Grant and Innovation CenterUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Huynh Ngoc Thanh
- Faculty of Public HealthUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Truong Thi Thuy Dung
- Faculty of Public HealthUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - To Thi Hien
- University of Science, Vietnam National UniversityHo Chi Minh CityVietnam
| | - Peter D. Sly
- Children's Health and Environment ProgramCentre for Children's Health ResearchBrisbane CityQueenslandAustralia
| | - Pham Le An
- Centre for the Training of Family Medicine, Faculty of MedicineUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
- Grant and Innovation CenterUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
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van Deutekom AW, Lewandowski AJ. Physical activity modification in youth with congenital heart disease: a comprehensive narrative review. Pediatr Res 2021; 89:1650-1658. [PMID: 33049756 PMCID: PMC8249230 DOI: 10.1038/s41390-020-01194-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/25/2020] [Accepted: 09/18/2020] [Indexed: 11/08/2022]
Abstract
Congenital heart disease (CHD) affects nearly 1% of births. As survival rates have dramatically improved, the majority of individuals with CHD now live into adulthood. As these patients age, they become prone to a large range of complications, such as chronic heart failure and acquired cardiovascular disease. Promotion of a healthy and active lifestyle from childhood onwards has been suggested as a sustainable and effective strategy to enhance cardiovascular health, improve quality of life and reduce immediate and long-term risk in people with CHD. Well-established physical activity consensus statements for youth with CHD have now been published. In this article, we review how increasing physical activity in youth with CHD may offer immediate and long-term cardiovascular benefits, what is known about physical activity in children with CHD, describe the unique factors that contribute to achieving sufficient and insufficient physical activity levels and summarize the evidence of trials on physical activity promotion in youth with CHD. Furthermore, we discuss some of the challenges that need to be addressed by further research regarding the optimal strategy, timing and format of physical activity intervention programmes in children and adolescents with CHD. IMPACT: Congenital heart disease (CHD) affects nearly 1% of births, with the majority of individuals with CHD now living into adulthood due to improved survival. As CHD patients age, they become prone to a large range of cardiovascular complications. This article discusses how and why increasing physical activity in youth with CHD may offer immediate and long-term cardiovascular benefits, the barriers to achieving sufficient physical activity levels and the evidence from trials on physical activity promotion in youth with CHD. The optimal strategy, timing and format of physical activity intervention programmes in children and adolescents with CHD are discussed.
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Affiliation(s)
- Arend W van Deutekom
- Division of Pediatric Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
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Siaplaouras J, Niessner C, Helm PC, Jahn A, Flemming M, Urschitz MS, Sticker E, Abdul-Khaliq H, Bauer UM, Apitz C. Physical Activity Among Children With Congenital Heart Defects in Germany: A Nationwide Survey. Front Pediatr 2020; 8:170. [PMID: 32426306 PMCID: PMC7203217 DOI: 10.3389/fped.2020.00170] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/25/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: In children with congenital heart defects (CHD), a sedentary lifestyle should be avoided and usually WHO recommendations on physical activity (PA) are supposed to be followed. In order to obtain representative data of the actual amount of PA (and potential influencing factors) in children with CHD we performed a nationwide online survey. Methods: All patients aged 6-17 years registered in the German National Register for CHD were contacted by email and asked to participate in the survey using the comprehensive questionnaire of the "Motorik-Modul" from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), thus allowing the comparison with a representative age-matched subset of 3.385 participants of the KiGGS study. The questionnaire for CHD-patients was amended by specific questions regarding medical care, sports recommendations and PA restrictions. Results: Complete datasets of 1.198 patients (mean age of 11.6 ± 3.1 years) were available for evaluation. Compared to the reference group, CHD patients significantly less frequently reached the WHO recommended level of 60 min of daily PA (8.8 vs. 12%; p < 0.001). Enjoyment in sports was almost equally distributed across CHD and reference groups, and strongly correlated with the level of PA (r = 0.41; p < 0.001). Remarkably, 49.2% of children with complex CHD, 31.7% with moderate, and even 13.1% with simple CHD were advised by their physician to restrict PA. Conclusions: According to this nationwide survey, PA is markedly reduced in children with CHD. An important reason for this might be an unexpected high rate of physician-recommended restrictions on levels of PA.
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Affiliation(s)
- Jannos Siaplaouras
- Division of Pediatric Cardiology, Children's Hospital, University of Ulm, Ulm, Germany
| | - Claudia Niessner
- Institute of Sports and Sports Science, Institute of Technology, Karlsruhe, Germany
| | - Paul C. Helm
- National Register for Congenital Heart Defects, DZHK (German Centre for Cardiovascular Research), Berlin, Germany
| | - Annika Jahn
- Division of Pediatric Cardiology, Children's Hospital, University of Ulm, Ulm, Germany
| | | | - Michael S. Urschitz
- Abteilung für Pädiatrische Epidemiologie, Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Elisabeth Sticker
- Department Psychology, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Hashim Abdul-Khaliq
- Klinik für Pädiatrische Kardiologie, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Ulrike M. Bauer
- National Register for Congenital Heart Defects, DZHK (German Centre for Cardiovascular Research), Berlin, Germany
| | - Christian Apitz
- Division of Pediatric Cardiology, Children's Hospital, University of Ulm, Ulm, Germany
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Brudy L, Hock J, Häcker AL, Meyer M, Oberhoffer R, Hager A, Ewert P, Müller J. Children with Congenital Heart Disease Are Active but Need to Keep Moving: A Cross-Sectional Study Using Wrist-Worn Physical Activity Trackers. J Pediatr 2020; 217:13-19. [PMID: 31740142 DOI: 10.1016/j.jpeds.2019.09.077] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/12/2019] [Accepted: 09/27/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To compare daily physical activity of children with congenital heart disease (CHD) with healthy peers measured using wearables bracelets in a large cohort. Additionally, subjectively estimated and objectively measured physical activity was compared. STUDY DESIGN From September 2017 to May 2019, 162 children (11.8 ± 3.2 years; 60 girls) with various CHD participated in a self-estimated and wearable-based physical activity assessment. Step-count and moderate-to-vigorous physical activity were recorded with the Garmin vivofit jr. for 7 consecutive days and compared with a reference cohort (RC) of 96 healthy children (10.9 ± 3.8 years; 49 girls). RESULTS Children with CHD were active and 123 (75.9%) achieved 60 minutes physical activity on a weekly average according to the World Health Organization criteria as 81 (84.3%) of the healthy peers did (P = .217). After correction for age, sex, and seasonal effects, only slightly lower step count (CHD: 10 206 ± 3178 steps vs RC: 11 142 ± 3136 steps; P = .040) but no lower moderate-to-vigorous physical activity (CHD: 80.5 ± 25.6 minutes/day vs RC: 81.5 ± 25.3 minutes/day; P = .767) occurred comparing CHD with RC. In children with CHD higher age (P = .004), overweight or obesity (P = .016), complex severity (P = .046), and total cavopulmonary connection (P = .027) were associated with not meeting World Health Organization criteria. Subjective estimation of daily moderate-to-vigorous physical activity was fairly correct in half of all children with CHD. CONCLUSIONS Even though the majority is sufficiently active, physical activity needs to be promoted in overweight or obese patients, patients with complex CHD severity, and in particular in those with total cavopulmonary connection.
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Affiliation(s)
- Leon Brudy
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Munich, Germany; Institute of Preventive Pediatrics, Technical University Munich, Munich, Germany.
| | - Julia Hock
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Munich, Germany
| | - Anna-Luisa Häcker
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Munich, Germany; Institute of Preventive Pediatrics, Technical University Munich, Munich, Germany
| | - Michael Meyer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Munich, Germany; Institute of Preventive Pediatrics, Technical University Munich, Munich, Germany
| | - Renate Oberhoffer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Munich, Germany; Institute of Preventive Pediatrics, Technical University Munich, Munich, Germany
| | - Alfred Hager
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Munich, Germany
| | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Munich, Germany
| | - Jan Müller
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Munich, Germany; Institute of Preventive Pediatrics, Technical University Munich, Munich, Germany
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Chen YJ, Wang JK, Liu CY, Yang CY, Chiang YT, Chen CW. Healthcare needs and Quality of Life in Youths with Congenital Heart Disease: Health-Promoting Behaviors as a Mediator. J Pediatr Nurs 2020; 50:e113-e118. [PMID: 30928310 DOI: 10.1016/j.pedn.2019.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE The aims of this study were to examine the relationship between healthcare needs, health-promoting behaviors and quality of life (QoL) of youths with congenital heart disease (CHD), and to determine whether health-promoting behaviors were a mediating variable. DESIGN AND METHODS This cross-sectional descriptive study was conducted recruiting 205 youths aged 15 to 24 with either ventricular septal defect (VSD) or tetralogy of Fallot (TOF). A self-reported questionnaire was used to collect demographic information; furthermore, the thickness of the triceps skinfold was measured. The Healthcare Needs Scale for Youth with CHD, Adolescent Health Promotion-short form scale, and World Health Organization QoL-BREF scale were administered, and Pearson's correlation, multiple regressions, and the Sobel test were conducted. RESULTS The triceps skinfold of participants with VSD was significantly thicker than that of participants with TOF (p < 0.05). Healthcare needs, health-promoting behaviors, and QoL were positively correlated. The overall health-promoting behaviors served as a partial mediator between overall healthcare needs and QoL, accounting for 40.1% of the total variation. CONCLUSIONS The study illustrates that health-promoting behaviors have an impact on healthcare needs and QoL of youths with CHD. The development of tailored health consulting interventions to fulfill healthcare needs is required to improve physical and psychosocial wellness among youths with CHD. PRACTICE IMPLICATIONS Targeting individual and public health strategies for enhancing health-promoting behaviors should be integrated in CHD care planning.
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Affiliation(s)
- Yan-Ju Chen
- Department of Nursing, KK Women's and Children's Hospital, Singapore
| | - Jou-Kou Wang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chieh-Yu Liu
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chiu-Yueh Yang
- School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | | | - Chi-Wen Chen
- School of Nursing, National Yang-Ming University, Taipei, Taiwan.
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Risk-Taking Behaviors in Adolescents With Chronic Cardiac Conditions: A Scoping Review. J Pediatr Nurs 2019; 48:98-105. [PMID: 31369964 DOI: 10.1016/j.pedn.2019.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 12/28/2022]
Abstract
PROBLEM Advances in treatment and therapy for children with chronic cardiac conditions have extended their life expectancy. Risk-taking behavior among adolescents requires further exploration. Researchers conducted a scoping review to address a literature gap specific to risk-taking behavior among adolescents with chronic cardiac conditions. ELIGIBILITY CRITERIA Sources were limited to (1) human subjects, (2) English language or translatable to English, (3) adolescents without age restrictions, (4) all research designs and (5) presence of a chronic cardiac condition. SAMPLE Searches of six electronic databases (CINAHL Plus Full Text, PubMed, Web of Knowledge, Scopus, ProQuest and Grey Literature Report) were conducted to verify the empirical literature between 1975 and 2018. Seventeen sources were included in this review. RESULTS Among the 17 sources, 12 sources examined risk-taking behavior by self-report among adolescents with chronic cardiac conditions. Tobacco, alcohol and/or other drug use and physical inactivity were the most prevalent risk-taking behaviors identified through this review. CONCLUSIONS Findings from this scoping review describe the types of risk-taking behaviors that adolescents with chronic cardiac conditions are engaging in, highlight similarities when compared to other types of chronic conditions, and serve as a foundation for future research among this population. IMPLICATIONS Discussion of risk-taking behaviors should be integrated into each healthcare encounter beginning in early adolescence and continuing through transition to adulthood and adult health care. Qualitative research studies may serve as an effective method by which to explore risk-taking behavior among adolescents with chronic cardiac conditions in greater detail.
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Flocco SF, Dellafiore F, Caruso R, Giamberti A, Micheletti A, Negura DG, Piazza L, Carminati M, Chessa M. Improving health perception through a transition care model for adolescents with congenital heart disease. J Cardiovasc Med (Hagerstown) 2019; 20:253-260. [DOI: 10.2459/jcm.0000000000000770] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Salari N, Farokhzadian J, Abazari F. Comparing health promotion behaviors of male and female high school students in Southeast of Iran. Int J Adolesc Med Health 2017; 32:/j/ijamh.ahead-of-print/ijamh-2017-0124/ijamh-2017-0124.xml. [PMID: 29168969 DOI: 10.1515/ijamh-2017-0124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 09/17/2017] [Indexed: 11/15/2022]
Abstract
Background Adolescence is one of the most challenging periods of human life. Many healthy or risky behaviors may be formed during this period and continue to the end of life. The aim of this study was to examine and compare the health promotion behaviors of male and female students in high schools. Methods In this descriptive-comparative study, 609 high school students were selected using multi-stage random sampling method. Data were collected using demographic and health-promoting lifestyle profile (HPLPII) questionnaires. Results The mean of health promotion behaviors was moderate in female (2.43 ± 0.46) and male (2.61 ± 0.45) students. The highest and lowest means in the male students were respectively the dimensions of spiritual growth and health responsibility. Also, the highest and lowest means in the female students were dimensions of interpersonal relationships as well as physical activity and exercise. The status of male health promotion behaviors was significantly more favorable than that of the female (p = 0.001, t = -4.71). The male students had a better situation than female in terms of all the six dimensions of HPLPII, so there was a significant difference between them in the four dimensions of spiritual growth, stress management, physical activity and health responsibility. There was also a significant relationship between the history of physical and mental illness in the past year and the students' health promotion behaviors (p < 0.05). Conclusion The results indicated the importance of promoting self-care and educational interventions in the aspects such as physical activity and health responsibility of young people in order to improve the health of the community.
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Affiliation(s)
- Nasibeh Salari
- Student of MSc Nursing, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Jamileh Farokhzadian
- Department of Community Health, School of Nursing and Midwifery, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Faroukh Abazari
- Department of Community Health, School of Nursing and Midwifery, Nursing Research Center, Kerman University of Medical Sciences, PO Box: 7716913555, Haft-bagh Highway, Kerman, Iran
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Huang HR, Chen CW, Chen CM, Yang HL, Su WJ, Wang JK, Tsai PK. A positive perspective of knowledge, attitude, and practices for health-promoting behaviors of adolescents with congenital heart disease. Eur J Cardiovasc Nurs 2017; 17:217-225. [DOI: 10.1177/1474515117728609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Health-promoting behaviors could serve as a major strategy to optimize long-term outcomes for adolescents with congenital heart disease. The associations assessed from a positive perspective of knowledge, attitudes, and practice model would potentially cultivate health-promoting behaviors during adolescence. Aim: The purpose of this study was to examine the relationships between disease knowledge, resilience, family functioning, and health-promoting behaviors in adolescents with congenital heart disease. Methods: A total of 320 adolescents with congenital heart disease who were aged 12–18 years were recruited from pediatric cardiology outpatient departments, and participated in a cross-sectional survey. The participants completed the Leuven Knowledge Questionnaire for Congenital Heart Disease; Haase Adolescent Resilience in Illness Scale; Family Adaptability, Partnership, Growth, Affection, and Resolve; and Adolescent Health Promotion scales. The collected data were analyzed using descriptive statistics and three multiple regression models. Results: Greater knowledge of prevention of complications and higher resilience had a more powerful effect in enhancing health-promoting behaviors. Having symptoms and moderate or severe family dysfunction were significantly more negatively predictive of health-promoting behaviors than not having symptoms and positive family function. The third model explained 40% of the variance in engaging in health-promoting behaviors among adolescents with congenital heart disease. Conclusion: The findings of this study provide new insights into the role of disease knowledge, resilience, and family functioning in the health-promoting behavior of adolescents with congenital heart disease. Continued efforts are required to plan family care programs that promote the acquisition of sufficient disease knowledge and the development of resilience for adolescents with congenital heart disease.
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Affiliation(s)
- Hui-Ru Huang
- Department of Nursing, Fu Jen Catholic University Hospital, Taiwan
| | - Chi-Wen Chen
- School of Nursing, National Yang-Ming University, Taiwan
| | - Chin-Mi Chen
- Department of Nursing, Fu Jen Catholic University, Taiwan
| | | | - Wen-Jen Su
- Department of Pediatrics, Chang Gung Children’s Hospital, Taiwan
| | - Jou-Kou Wang
- Department of Pediatrics, National Taiwan University Hospital, Taiwan
| | - Pei-Kwei Tsai
- Department of Public Health and Center of Biostatistics, Chang Gung University, Taiwan
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Chen CW, Ho CL, Su WJ, Wang JK, Chung HT, Lee PC, Lu CW, Hwang BT. Initial validation of a healthcare needs scale for young people with congenital heart disease. J Adv Nurs 2017; 74:223-231. [DOI: 10.1111/jan.13390] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Chi-Wen Chen
- School of Nursing; National Yang-Ming University; Taipei Taiwan
| | - Ciao-Lin Ho
- School of Nursing; National Yang-Ming University; Taipei Taiwan
| | - Wen-Jen Su
- Department of Pediatrics; Chang Gung Children's Hospital; Taoyuan Taiwan
| | - Jou-Kou Wang
- Department of Pediatrics; National Taiwan University Hospital; Taipei Taiwan
| | - Hung-Tao Chung
- Department of Pediatrics; Chang Gung Children's Hospital; Taoyuan Taiwan
| | - Pi-Chang Lee
- Department of Pediatrics; Taipei Veterans General Hospital; Taipei Taiwan
| | - Chun-Wei Lu
- Adult Congenital Heart Center & Department of Pediatrics; National Taiwan University Hospital; Taipei Taiwan
| | - Be-Tau Hwang
- Department of Pediatrics and Cardiovascular Center; Tungs’ Taichung MetroHarbor Hospital; Taichung Taiwan
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Chen CW, Su WJ, Chiang YT, Shu YM, Moons P. Healthcare needs of adolescents with congenital heart disease transitioning into adulthood: a Delphi survey of patients, parents, and healthcare providers. Eur J Cardiovasc Nurs 2016; 16:125-135. [DOI: 10.1177/1474515116643622] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Chi-Wen Chen
- School of Nursing, National Yang-Ming University, Taiwan
| | - Wen-Jen Su
- Department of Pediatrics, Chang Gung Children’s Hospital, Taiwan
| | | | - Ying-Mei Shu
- Department of Nursing, Chang Gung University of Science and Technology, Taiwan
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven-University of Leuven, Belgium
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Goossens E, Fieuws S, Van Deyk K, Luyckx K, Gewillig M, Budts W, Moons P. Effectiveness of structured education on knowledge and health behaviors in patients with congenital heart disease. J Pediatr 2015; 166:1370-6.e1. [PMID: 25841537 DOI: 10.1016/j.jpeds.2015.02.041] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 01/16/2015] [Accepted: 02/12/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate whether a single educational session increased the level of knowledge and changed the prevalence of health risk behaviors in young people with congenital heart disease (CHD). STUDY DESIGN We conducted a longitudinal study of patients transferred to adult CHD care who received a single educational session (n = 201) at a tertiary care center. Their knowledge level and prevalence of health risk behaviors were assessed via the Leuven Knowledge Questionnaire CHD and the Health Behavior Scale CHD, respectively. A general linear model for longitudinal measurements was used to analyze the natural progression of patients' knowledge during a 27-month period and the effect of one educational session on outcomes. RESULTS Participating in an educational session resulted in a small-to-moderate, but significant, increase in total knowledge level and better understanding of deterioration symptoms, and rationale and frequency of follow-up; however, it did not improve patients' health behaviors. CONCLUSIONS This type of education did improve knowledge but did not improve the patients' tendency to engage in better health behaviors. Future studies should assess the effect of repetitive exposure to educational sessions dealing with CHD.
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Affiliation(s)
- Eva Goossens
- Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven, Belgium; Research Foundation Flanders, Brussel, Belgium
| | - Steffen Fieuws
- I-BioStat, KU Leuven-University of Leuven, Leuven, Belgium; I-BioStat, UHasselt, Hasselt, Belgium
| | - Kristien Van Deyk
- Division of Congenital and Structural Cardiology, KU Leuven-University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Koen Luyckx
- School Psychology and Child and Adolescent Development, KU Leuven-University of Leuven, Leuven, Belgium
| | - Marc Gewillig
- Department of Pediatric Cardiology, KU Leuven-University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Werner Budts
- Division of Congenital and Structural Cardiology, KU Leuven-University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven, Belgium; The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark; Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
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Ardic A, Esin MN. Factors Associated With Healthy Lifestyle Behaviors in a Sample of Turkish Adolescents: A School-Based Study. J Transcult Nurs 2015; 27:583-592. [PMID: 26002620 DOI: 10.1177/1043659615587585] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE This was a descriptive-correlational study designed to determine factors associated with the healthy lifestyle behaviors of high school students in Turkey. DESIGN The study sample consisted of 812 high school adolescents. The Adolescent Lifestyle Profile scale was used to identify the healthy lifestyle behaviors of adolescents. RESULTS The total Adolescent Lifestyle Profile mean score of 2.75 ± 0.33 and the mean score on the Interpersonal relations subscale were found to be the highest scores while the mean score on the Health responsibility subscale was found to be the lowest. Significant predictors of healthy lifestyle behaviors of adolescents were good relationships with family and friends, having a father who was a college graduate, and good health perception. CONCLUSIONS The study revealed similar results among adolescents of different cultures. IMPLICATIONS FOR PRACTICE These findings can be used as a guide in developing an adolescent health promotion program for school nurses.
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Janssens A, Goossens E, Luyckx K, Budts W, Gewillig M, Moons P. Exploring the relationship between disease-related knowledge and health risk behaviours in young people with congenital heart disease. Eur J Cardiovasc Nurs 2014; 15:231-40. [DOI: 10.1177/1474515114565214] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 12/03/2014] [Indexed: 11/16/2022]
Affiliation(s)
- Astrid Janssens
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
| | - Eva Goossens
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
- Research Foundation Flanders, Belgium
| | - Koen Luyckx
- School of Psychology and Child and Adolescent Development, KU Leuven – University of Leuven, Belgium
| | - Werner Budts
- Division of Congenital and Structural Cardiology, KU Leuven – University of Leuven, University Hospitals Leuven, Belgium
| | - Marc Gewillig
- Department of Paediatric Cardiology, KU Leuven – University of Leuven, University Hospitals Leuven, Belgium
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
- The Heart Centre, Copenhagen University Hospital, Denmark
- Institute of Health and Care Sciences, University of Gothenburg, Sweden
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Abstract
Adolescents with congenital heart disease (CHD) are a rapidly growing population with complex medical needs and psychosocial challenges. Identity formation is an important developmental task accomplished during the teenage years. This article reviews different aspects of ongoing care that pertain to teenagers with CHD, with a particular focus on primary care issues and a summary of recommendations from various scientific societies. A successful smooth transition to the adult health care setting should achieve 2 important goals: to prevent loss of follow-up and to foster and encourage self-care behaviors.
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Affiliation(s)
- Pooja Gupta
- Division of Cardiology, The Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, 3901 Beaubien Boulevard, Detroit, MI 48201-2119, USA.
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Bertoletti J, Marx GC, Hattge Júnior SP, Pellanda LC. Quality of life and congenital heart disease in childhood and adolescence. Arq Bras Cardiol 2013; 102:192-8. [PMID: 24676375 PMCID: PMC3987336 DOI: 10.5935/abc.20130244] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 09/26/2013] [Indexed: 01/09/2023] Open
Abstract
Advances in cardiac surgery techniques and early diagnosis have enabled the increased
survival of individuals with congenital heart disease. The investigation of the
quality of life in children and adolescents with congenital heart disease provides
complementary information to clinical data that can assist in decision making on the
part of health professionals. Although many studies have been conducted to
investigate the quality of life of children and adolescents with congenital heart
disease, the results prove to be contradictory; while some studies show that
congenital heart disease can impact the quality of life, others describe a better
perception of quality of life among children and adolescents who suffer from the
disease when compared with healthy control subjects. The purpose of this study is to
review the literature on the assessment of health related quality of life in children
and adolescents with congenital heart disease, in order to systematize the existing
knowledge on this topic today. It is observed that research seeks to investigate
aspects of personality in cardiac patients, their coping strategies used and
perceived social support, aiming at better understanding the association of these
variables with the level of quality of life in this population.
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Affiliation(s)
- Juliana Bertoletti
- Instituto de Cardiologia, Fundacao Universitaria de Cardiologia, Porto Alegre, RS, Brasil
| | | | | | - Lucia Campos Pellanda
- Instituto de Cardiologia, Fundacao Universitaria de Cardiologia, Porto Alegre, RS, Brasil
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Behaviour problems in adolescents with cardiac disease: an exploratory study in a paediatric cardiology outpatient clinic. Cardiol Young 2013; 23:368-76. [PMID: 22995528 DOI: 10.1017/s1047951112001242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS To assess behavioural problems in adolescents with congenital and acquired heart disease in comparison with healthy controls. The perception of behavioural problems by the patients' parents was also assessed and compared. METHODS A cross-sectional study was carried out in 130 adolescents with congenital and acquired heart disease and 246 healthy controls. The second part of the Youth Self-Report was applied to the patients and controls, and the Child Behavior Checklist to the patients' parents. RESULTS Male patients showed significantly fewer behavioural problems compared with male controls. No significant difference was found in the female gender. Healthy male adolescents scored significantly higher in the Internalising, Externalising, and in the Total Problems scales. Patients scored significantly higher only on the Social Problems subscale. Female patients in middle and late adolescence and male patients in early adolescence displayed more problems. No significant difference was found between the diagnostic groups. Operated patients did not differ from the non-operated ones. Patients scored significantly lower than did their parents. CONCLUSIONS Male adolescents with cardiac disease reported fewer behavioural problems when compared with healthy controls, but no difference was observed in the female gender. Patients also reported fewer behavioural problems than did their parents. Adolescents with cardiac disease scored higher than did controls only on the Social Problems subscale. Analysing the patients' behavioural profile, female patients in middle and late adolescence and male patients in early adolescence were the most problematic ones. No difference was observed between the diagnostic groups, nor between operated and non-operated patients.
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Overgaard D, Schrader AM, Lisby KH, King C, Christensen RF, Jensen HF, Moons P. Substance use, dental hygiene, and physical activity in adult patients with single ventricle physiology. CONGENIT HEART DIS 2013; 9:75-82. [PMID: 23663529 DOI: 10.1111/chd.12086] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The study aims to describe substance use, dental hygiene, and physical activity in adult survivors with single ventricle physiology (SVP) and to compare the behaviors with matched controls, while the patients are particularly at risk for general health problems. DESIGN The present study is part of a larger research project on long-term outcomes in adult patients with SVP. A cross-sectional, case-control study including 59 patients out of 83 eligible patients participated in the study (response rate 71%). The patients were matched to 172 healthy controls. A questionnaire was mailed to the patients. Nonresponders did not differ significantly from the included participants on age, gender, or physical function. SETTING The study was conducted at the Heart Center of Copenhagen University Hospital or the Department of Cardiology, Aarhus University Hospital. RESULTS In these patients, 85% report alcohol consumption (92% in controls; odds ratio [OR] = 0.91; P = 0.575); 26% admit "binge drinking" (41% in controls; OR = 0.56; P = 0.041); 20% are cigarette smokers (36% in controls; OR = 0.59; P = 0.100); 12% have used cannabis over the past year (15% in controls; OR = 0.80; P = 0.596); 20% have had no dental visits during the last year (25% in controls; OR = 1.07; P = 0.684); 46% are not flossing their teeth (32% in controls; OR = 1.32; P = 0.239); and 39% are not physically active (24% in controls; OR = 1.63; P = 0.069). CONCLUSIONS While in general there was no significant differences in overall health behaviors between SVP patients and controls, SVP patients are less physically active and are less likely to binge drink.
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Affiliation(s)
- Dorthe Overgaard
- The Heart Center, Rigshospitalet, Copenhagen University Hospital, Skejby, Denmark
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Goossens E, Luyckx K, Mommen N, Gewillig M, Budts W, Zupancic N, Moons P. Health risk behaviors in adolescents and emerging adults with congenital heart disease: psychometric properties of the Health Behavior Scale-Congenital Heart Disease. Eur J Cardiovasc Nurs 2013; 12:544-57. [DOI: 10.1177/1474515113475934] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Eva Goossens
- Centre for Health Services and Nursing Research, KU Leuven, Belgium
- PhD fellowship of the Research Foundation Flanders, Belgium
| | - Koen Luyckx
- School of Psychology and Child and Adolescent Development, KU Leuven, Belgium
| | - Nele Mommen
- Centre for Health Services and Nursing Research, KU Leuven, Belgium
| | - Marc Gewillig
- Department of Paediatric Cardiology, University Hospitals Leuven, Belgium
| | - Werner Budts
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium
| | - Nele Zupancic
- Centre for Health Services and Nursing Research, KU Leuven, Belgium
- Department of Nursing and Midwifery, Leuven University College, Belgium
| | - Philip Moons
- Centre for Health Services and Nursing Research, KU Leuven, Belgium
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium
- Heart Centre, Rigshospitalet, Copenhagen, Denmark
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Chen CW, Chen YC, Su WJ, Wang JK, Lee PC, Beckstead JW. Social-cognitive determinants of exercise behaviour among adolescents with mild congenital heart disease. Eur J Cardiovasc Nurs 2012; 12:368-76. [PMID: 23045305 DOI: 10.1177/1474515112460797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Nowadays, most adolescents with mild congenital heart disease (CHD) undergo medical or surgical correction in early childhood for their congenital anomalies. There is a need to examine the determinants of exercise behaviour among adolescents (CHD) who are able to exercise. AIMS The aims of this study were to examine determinants of exercise among adolescents with mild CHD, including personal beliefs about exercise, interpersonal influences on exercise, and availability of physical environments for exercise, based on social-cognitive theory. METHOD A repeated-measures study was conducted at three medical centres in Taiwan. All participants, 126 adolescents with CHD aged 12 to 18 years, had a cardiologist's recommendation of exercise with no limits or limits only on vigorous exercise. Self-administered questionnaires were completed during a summer vacation and again in the fall semester of school along with a 7-day exercise log. The data were analysed using structured equation modelling. RESULTS The effect of interpersonal influences on total exercise and moderate-to-vigorous exercise was mediated by personal exercise beliefs. Peer influences had significant effects on moderate-to-vigorous exercise through the mediator of perceived exercise self-efficacy. There was no significant difference in the determinants of exercise behaviour during two periods. Personal exercise beliefs, particularly perceived exercise self-efficacy, played the most important role in determining the performance of moderate-to-vigorous exercise. CONCLUSIONS The social-cognitive determinants may serve as a clinical reference for promoting exercise among adolescents with mild CHD.
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Affiliation(s)
- Chi-Wen Chen
- Department of Nursing, College of Medicine, Fu-Jen Catholic University, Taiwan.
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Chen CW, Chen YC, Gau BS, Wang JK, Hung YT, Jwo JC. Exercise Behavior in Adolescents With Mild Congenital Heart Disease. J Cardiovasc Nurs 2012; 27:317-24. [DOI: 10.1097/jcn.0b013e31821efda7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Abstract
BACKGROUND More than 90% of infants born with congenital heart disease reach adulthood. International medical recommendations outline patient care needs in an effort to optimize patient health. There are, however, limited data focusing on the patient perspective. OBJECTIVES This study investigated adult congenital heart disease patient-reported (1) barriers to medical care, (2) healthcare behaviors, and (3) concerns regarding medical, psychosocial, and lifestyle matters. METHODS In this cross-sectional study, a questionnaire was distributed to all patients who attended a patient education conference. RESULTS There were 123 adult congenital heart disease participants (58% female; mean age, 37 [SD, 13] years). The most common self-reported cardiac diagnoses were tetralogy of Fallot and transposition of the great arteries. Most patients did not report transportation or financial barriers to care, but did report the following: not wanting further surgery even if it was recommended (18%), not liking to think or talk about one's heart (17%), and not understanding doctors' information; 8% of patients inaccurately considered themselves to be "cured." With regard to healthcare behaviors, more than 80% of patients reported annual family physician and dentist visits, but 34% of patients were unaware when to seek urgent medical attention. Patients reported moderate to extreme concern about the following medical topics: heart rhythm problems (82%), infections (74%), and understanding treatment options (71%). Patients most often reported moderate to extreme concern about the following lifestyle and psychosocial topics: physical activity (77%), insurance (72%), assuming increased health responsibility (73%), diet (71%), mental health (60%), and death and dying (57%). CONCLUSIONS This study provides important information about 3 specific areas. First, there are potential barriers to care beyond financial and transportation challenges. Second, many patients require education regarding when to seek urgent medical attention. Third, the concerns of this patient population are not limited to medical information. A patient-centered educational program is recommended.
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Chiang YT, Chen CW, Chen YC. From limitation to mastery: exercise experience for adolescents with mild congenital heart disease. J Clin Nurs 2011; 20:2266-76. [DOI: 10.1111/j.1365-2702.2011.03723.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Ortabag T, Ozdemir S, Bakir B, Tosun N. Health promotion and risk behaviors among adolescents in Turkey. J Sch Nurs 2011; 27:304-15. [PMID: 21551314 DOI: 10.1177/1059840511408322] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Adolescents experience the onset and development of several health-related behaviors. The purpose of this study is to determine health risk and promotion behaviors of adolescents between the ages of 11 and 19 who were attending and to test the reliability and validity analysis of the Turkish version of Adolescent Health Promotion Scale (AHPS). The study was a cross-sectional survey and the sample consisted of 1,351 participants. A questionnaire that included demographic information, health risk behaviors, and AHPS was used to collect data. In the current study, the Cronbach's α coefficient for the AHPS was calculated as .92. Female students had significantly higher mean total scale scores than males (p < .05). The 11-14 age group had a statistically significant higher scale total mean score than the 15-19 age group (p = .001). International directives highlight the important function nurses fulfill in health promotion. Nurses may play a key role in school health services.
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Affiliation(s)
- Tulay Ortabag
- Department of Public Health Nursing, Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey.
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26
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Sable C, Foster E, Uzark K, Bjornsen K, Canobbio MM, Connolly HM, Graham TP, Gurvitz MZ, Kovacs A, Meadows AK, Reid GJ, Reiss JG, Rosenbaum KN, Sagerman PJ, Saidi A, Schonberg R, Shah S, Tong E, Williams RG. Best Practices in Managing Transition to Adulthood for Adolescents With Congenital Heart Disease: The Transition Process and Medical and Psychosocial Issues. Circulation 2011; 123:1454-85. [DOI: 10.1161/cir.0b013e3182107c56] [Citation(s) in RCA: 317] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chen CW, Chen YC, Beckstead JW, Kennel S, Evans ME. R1 version, self-concept in Taiwanese adolescents with congenital heart disease. Pediatr Int 2011; 53:168-74. [PMID: 20667030 DOI: 10.1111/j.1442-200x.2010.03207.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The objectives of this study were to evaluate and compare differences in self-concept between male and female adolescents with congenital heart disease, and to compare the self-concepts of these adolescents to that of the general adolescent population using normative data. METHODS A total of 300 adolescents, 143 male and 157 female, from two medical centers in Taiwan completed the Tennessee Self-Concept Scales and the scores of male and female subjects were compared. The scores of adolescents with congenital heart disease were also compared with normative data of healthy Taiwanese adolescents. RESULTS Girls with congenital heart disease showed significantly lower mean scores in Physical Self, Social Self, Personal Self, Academic Self and Overall Self domains on the Tennessee Self-Concept Scales when compared to boys with congenital heart disease. When compared to the average value of normative data, adolescent boys with congenital heart disease had significantly higher mean T-scores on Physical Self, Family Self, Social Self, Personal Self, Academic Self and Overall Self, and adolescent girls had significantly higher mean T-scores in Moral-ethical Self, Social Self, Personal Self, Academic Self and Overall Self domains. There were weak negative correlations between severity of congenital heart disease and Physical Self T-scores, and between the number of heart operations and Academic T-scores. CONCLUSIONS Self-concept in adolescents with congenital heart disease is similar to or even higher than that of their normal counterparts. More holistic views of adolescents with congenital heart disease, including their self-concept, appear warranted, especially for adolescent girls with congenital heart disease.
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Affiliation(s)
- Chi-Wen Chen
- Department of Nursing, College of Medicine, Fu-Jen Catholic University, Taipei Hsien.
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Moons P, Budts W, Costermans E, Huyghe E, Pieper PG, Drenthen W. Pregnancy-related Health Behavior of Women with Congenital Heart Disease: Room for Behavioral Change Interventions. CONGENIT HEART DIS 2009; 4:348-55. [DOI: 10.1111/j.1747-0803.2009.00322.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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