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Effects of Familial Relationships on School Adjustment of Adolescents and Young Adults With Congenital Heart Disease. J Cardiovasc Nurs 2023; 38:52-59. [PMID: 35020708 DOI: 10.1097/jcn.0000000000000884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND As more than 85% of patients with congenital heart disease (CHD) have grown to adulthood through improvement in treatment and surgery, the difficulties they experience are expanding into areas related to daily life. Accordingly, adjustment to school in adolescents and young adults (AYAs) with CHD is of increasing interest and is influenced by familial factors. OBJECTIVE This was a cross-sectional descriptive study to examine the effects of parental positive emotional expressiveness and sibling relationships on school adjustment of AYAs with CHD. METHODS In this study, a self-reported questionnaire survey was used to collect the data. The participants were 104 AYAs with CHD aged 13 to 21 years who were attending school and had siblings. RESULTS Maternal positive emotional expressiveness ( r = 0.584, P < .01), paternal positive emotional expressiveness ( r = 0.584, P < .01), and sibling warmth/closeness ( r = 0.478, P < .01) were significantly correlated with school adjustment. However, the results of multiple regression analysis showed that only maternal positive emotional expressiveness (ß = 0.459, P < .05) and sibling warmth/closeness (ß = 0.236, P < .05) were significantly associated with school adjustment. CONCLUSIONS Adolescents and young adults with CHD who reported higher maternal positive emotional expressiveness and sibling warmth/closeness exhibited better school adjustment. Findings suggest that intervention programs to increase parental positive expressiveness and enhance warmth/closeness of sibling relationships may contribute to improving school adjustment.
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[Psychocardiological intervention in the cardiovascular rehabilitation of school children with congenital heart disease: A systematic review]. Rehabilitacion (Madr) 2022; 56:353-363. [PMID: 35523617 DOI: 10.1016/j.rh.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 10/02/2021] [Accepted: 01/16/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE A systematic review is presented with the objective of determining whether school children with congenital heart disease participate in psychological interventions in the cardiovascular rehabilitation process. METHOD Guided review by the PRISMA method was carried out in the databases: Dialnet, Pub Med, Redalyc, Science Direct, Scielo, Google Academic of articles published in English, Portuguese and Spanish. The inclusion criteria are: rehabilitative interventions that contain actions for the management of psychological factors. 23 reports were evaluated for eligibility, only 1 was chosen through the data tabulation method. RESULTS It was evidenced that these programs for children with heart disease are scarce, they focus on physical activity, neglecting socio-psychological variables. It is proposed to implement standardized intervention actions with congenital cardiovascular patients and their families from psychocardiology according to their needs.
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The effects of rational emotive behavior therapy for depressive symptoms in adults with congenital heart disease. Heart Lung 2021; 50:906-913. [PMID: 34411872 DOI: 10.1016/j.hrtlng.2021.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/06/2021] [Accepted: 07/28/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Over 30% of adults with congenital heart disease (CHD) experience depression. OBJECTIVES To evaluate the effectiveness of Rational Emotive Behavior Therapy (REBT) in reducing depressive symptoms in adults with CHD. METHODS Forty-two adults with CHD were recruited from an outpatient clinic and randomized to a study group (n = 21), which comprised 8-weekly group-based counseling sessions, or a control group (n = 21), which received usual care. REBT effectiveness was examined using the Hamilton Depression Rating Scale, Beck Depression Inventory, Shorten General Attitude and Belief Scale, and salivary cortisol levels before therapy, after the last session, and at follow-up 4 weeks later. RESULTS Average participant ages were 30.1 ± 7.58 and 33.3 ± 7.1 years in study and control groups, respectively; 52.4% of participants in each group were female. After REBT, depression (p < 0.001), irrational beliefs (p < 0.001), and salivary cortisol levels (p = 0.006) were significantly lower in the study group than in the control group. Effects of REBT in the study group remained consistent at the 4-week follow-up. CONCLUSION REBT may be effective in reducing depression in adults with CHD.
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Lee D, Jeong DC, Chung NG, Lee S. Factor analysis of the Korean version of the Illness Cognition Questionnaire for adolescents with chronic illness. Int J Nurs Pract 2020; 27:e12889. [PMID: 33314524 PMCID: PMC8244091 DOI: 10.1111/ijn.12889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 02/27/2020] [Accepted: 08/23/2020] [Indexed: 01/28/2023]
Abstract
Aim The purpose of this study was to examine the reliability and validity of the Korean version of the Illness Cognition Questionnaire. Methods A total of 237 adolescent Participants ages 13–20 years were collected from two hospitals for purposes of the study. The participants were diagnosed with blood cancer, congenital heart disease, paediatric rheumatoid arthritis, multiple sclerosis and diabetes mellitus. Results The Illness Cognition Questionnaire is composed of three subscales and 18 items. Exploratory factor analysis and confirmatory factor analysis were performed for all 18 items. The data used in the exploratory factor analysis were obtained from 126 adolescents with blood cancer. The data used for confirmatory factor analysis were obtained from 111 adolescents who had chronic diseases. The three‐factor model of 18 items showed general fitness close to the standard but not a very good fit. Conclusions This study indicated that the Korean version of the Illness Cognition Questionnaire is reasonable to use for Korean adolescents with chronic illness. The authors recommend that the meaning of Item 10 be clarified from ‘I have learned to accept the limitations imposed by my illness’ to ‘I have learned to positively accept the limitations imposed by my illness’. What is already known about this topic?
Illness cognition is the process of evaluating the meaning of a negative event. Illness cognition has a significant impact on patients' quality of life because it is inherently involved in long‐term stresses caused by chronic or serious illnesses.
What this paper adds?
The Korean version of the Illness Cognition Questionnaire is reliable and valid. The Korean version of Illness Cognition Questionnaire consisted of three categories of disease awareness: acceptance, helplessness and perceived benefits The meaning of Item 10 in the Illness Cognition Questionnaire Korean version needs to be clarified as ‘I have learned to positively accept the limitations imposed by my illness’.
The implications of this paper:
The Korean version of the Illness Cognition Questionnaire can be used for adolescent participants experiencing serious or chronic illnesses. The Korean version of the Illness Cognition Questionnaire can be used in developing the psychological intervention for adolescents with chronic illness.
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Affiliation(s)
- Dasuel Lee
- College of Nursing, The Catholic University of Korea, Seoul, South Korea
| | - Dae-Chul Jeong
- Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Nack-Gyun Chung
- Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sunhee Lee
- College of Nursing, The Catholic University of Korea, Seoul, South Korea
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Kwon SJ, Choi EK, Lee KH, Im YM. Factors Influencing Physical Activity in Adolescents with Complex Congenital Heart Disease. CHILD HEALTH NURSING RESEARCH 2019; 25:262-272. [PMID: 35004419 PMCID: PMC8650962 DOI: 10.4094/chnr.2019.25.3.262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/20/2019] [Accepted: 03/23/2019] [Indexed: 11/27/2022] Open
Abstract
Purpose We aimed to identify factors influencing physical activity in adolescents with complex congenital heart disease. Methods We recruited 92 adolescents with complex congenital heart disease from a tertiary medical center in Seoul, measured their levels of physical activity, and identified factors that influenced their physical activity levels using the Global Physical Activity Questionnaire, the New York Heart Association classification, congenital heart disease complexity, the Self-Efficacy Scale, and the Parental Bonding Instrument scale. Stepwise multiple linear regression was used to determine factors influencing physical activity. Results Total physical activity was higher in males than in females (t=4.46, p<.001). Adolescents who participated in school physical education classes engaged in more physical activity than those who did not (t=6.77, p<.001). Higher self-efficacy (β=.41, p<.001), male gender (β=.37, p<.001) and participation in school physical education classes (β=.19, p=.042) were associated with a higher likelihood of engagement in physical activity. Conclusion It is necessary to develop nursing interventions that enhance self-efficacy in order to promote physical activity in adolescents with complex congenital heart disease. Physical activity should also be promoted in an individualized manner, taking into account gender, disease severity, and parental attitude.
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Affiliation(s)
- Su Jin Kwon
- Advanced Practice Nurse, Congenital Heart Disease Center, Asan Medical Center, Seoul, Korea
| | - Eun Kyoung Choi
- Assistant Professor, College of Nursing · Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Kyung Hee Lee
- Assistant Professor, College of Nursing · Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Yu-Mi Im
- Assistant Professor, Seoul Women's College of Nursing, Seoul, Korea
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Abstract
Mothers of children with congenital heart disease (CHD) tend to be concerned about their child's normal life. The majority of these mothers tend to experience negative psychological problems. In this study, the adaptation process of mothers raising a child with complex CHD was investigated based on the sociocultural context of Korea. The data collection was conducted by in-depth interviews and theoretical sampling was performed until the data were saturated. The collected data were analyzed using continuous theoretical comparisons. The results of the present study showed that the core category in the mothers' adaptation process was 'anxiety regarding the future', and the mothers' adaptation process consisted of the impact phase, standing against phase, and accepting phase. In the impact phase, the participants emotionally fluctuated between 'feelings of abandonment' and 'entertaining hope'. In the standing against phase, participants tended to dedicate everything to child-rearing while being affected by 'being encouraged by support' and 'being frustrated by tasks beyond their limits'. In the accepting phase, the subjects attempted to 'accept the child as is', 'resist hard feelings', and 'share hope'. Health-care providers need to develop programs that include information regarding CHD, how to care for a child with CHD, and effective child-rearing behaviors.
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Affiliation(s)
- Jeong-Ah Ahn
- College of Nursing, Institute of Nursing Science, Ajou University, Suwon, Korea
| | - Sunhee Lee
- College of Nursing, The Catholic University of Korea, Seoul, Korea
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Moon JR, Huh J, Song J, Kang IS, Park SW, Chang SA, Yang JH, Jun TG. The Center for Epidemiologic Studies Depression Scale is an adequate screening instrument for depression and anxiety disorder in adults with congential heart disease. Health Qual Life Outcomes 2017; 15:176. [PMID: 28874154 PMCID: PMC5585982 DOI: 10.1186/s12955-017-0747-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 08/22/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Center for Epidemiological Studies Depression Scale (CES-D) is an instrument that is commonly used to screen for depression in patients with chronic disease, but the characteristics of the CES-D in adults with congenital heart disease (CHD) have not yet been studied. The aim of this study was to investigate the criterion validities and the predictive powers of the CES-D for depression and anxiety disorders in adults with CHD. METHODS Two hundred patients were screened with the CES-D and secondarily interviewed with a diagnostic instrument, i.e., the Mini International Neuropsychiatric Instrument. The sensitivity and specificity values of the CES-D were calculated by cross-tabulation at different cutoff scores. Receiver operating characteristic (ROC) curves were used to assess the optimal cutoff point for each disorder and to assess the predictive power of the instrument. RESULTS The CES-D exhibited satisfactory criterion validities for depression and for all combinations of depression and/or anxiety. With a desired sensitivity of at least 80%, the optimal cutoff scores were 18. The predictive power of the CES-D in the patients was best for major depression and dysthymia (area under the ROC curve: 0.92) followed by the score for any combination of depression and/or anxiety (0.88). CONCLUSION The use of CES-D to simultaneously screen for both depression and anxiety disorders may be useful in adults with CHD. TRIAL REGISTRATION CESDEP 212. Registered 2 March 2014 (retrospectively registered).
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Affiliation(s)
- Ju Ryoung Moon
- Department of Nursing, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - June Huh
- Department of Pediatrics, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Jinyoung Song
- Department of Pediatrics, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - I-Seok Kang
- Department of Pediatrics, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Woo Park
- Division of Cardiology, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung-A Chang
- Division of Cardiology, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Hyuk Yang
- Department of Thoracic & Cardiovascular Surgery, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae-Gook Jun
- Department of Thoracic & Cardiovascular Surgery, Grown-Up Congenital Heart Clinic, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee S, Kim DH. The relationship between perceived parental rearing behaviors and school adjustment of adolescent cancer survivors in Korea: A cross-sectional study. Medicine (Baltimore) 2017; 96:e7758. [PMID: 28796068 PMCID: PMC5556234 DOI: 10.1097/md.0000000000007758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 04/06/2017] [Accepted: 05/19/2017] [Indexed: 11/22/2022] Open
Abstract
Return and adjustment to school in adolescents who have survived cancer have become of increasing interest as the numbers of childhood cancers survivors have grown due to advances in treatments. Perceived parental rearing behavior is an important factor related to school adjustment. This study examined the relationships between maternal and parental rearing practices, general characteristics, and school adjustment in adolescent cancer survivors in Korea. We conducted a descriptive, exploratory study of 84 adolescents with cancer using the Korean version of the Fragebogen zum erinnerten elterlichen Erziehungsverhalten: FEE (Recalled Parental Rearing Behavior) and a school adjustment measurement. Descriptive, Pearson correlational, and multiple regression analyses were used to investigate the data. In bivariate analysis, age (r = -0.358, P < .05), mother's emotional warmth (r = 0.549, P < .01), and father's emotional warmth (r = 0.391, P < .05) were significantly associated with school adjustment. However, the results of multiple regression analysis showed that only mother's emotional warmth (β = .720, P < .05) was significantly associated with school adjustment. Adolescent cancer survivors who reported higher mother's emotional warmth exhibited better school adjustment. This finding indicates that it is important to help parents of adolescent cancer survivors enhance their parental rearing behaviors, such as emotional warmth, to help adolescents adjust to school.
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Affiliation(s)
- Sunhee Lee
- College of Nursing, Catholic University, Seocho-gu
| | - Dong Hee Kim
- College of Nursing, Sungshin University, Dobong-ro, Kangbuk-gu, Seoul, Korea
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Lee S, Lee J, Choi JY. The effect of a resilience improvement program for adolescents with complex congenital heart disease. Eur J Cardiovasc Nurs 2016; 16:290-298. [DOI: 10.1177/1474515116659836] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sunhee Lee
- College of Nursing, The Catholic University of Korea, Seoul, Korea
| | - Junga Lee
- Postdoctoral Research Fellow, Exercise Medicine Center for Diabetes and Cancer Patients, Yonsei University, Seoul, Korea
| | - Jae Young Choi
- Division of Pediatric Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea
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Abstract
PURPOSE This study aims to evaluate the health-related quality of life of adolescents with congenital heart disease, describing health-related quality of life according to the diagnosis and severity of congenital heart disease, identified by variables such as the presence of symptoms, surgical interventions, use of medication, and residual lesion. METHODS A cross-sectional study was conducted on 203 adolescents with congenital heart disease attended at the Pediatric Cardiology ambulatory of a reference hospital in Brazil. The Brazilian version of the questionnaire KIDSCREEN-27 was used for the assessment of health-related quality of life. Information related to the congenital heart disease diagnosis and clinical variables were collected from the medical records of the patients. RESULTS There was no statistically significant difference between acyanotic and cyanotic groups, as well as for the different diagnosis of congenital heart disease. A trend for better health-related quality of life in the dimension of Psychological Well-Being (p=0.054) was found in the groups with surgical intervention and use of medication. Adolescents that referred a good general health presented significantly better results in all dimensions of health-related quality of life, except for Autonomy and Parent Relation, than those who presented clinical symptoms (p<0.05). CONCLUSIONS Type of congenital heart disease and initial diagnosis did not seem to affect the perception of health-related quality of life, corroborating findings of several studies. Surgical interventions and the use of medication can improve previous clinical status, and therefore it seems to be beneficial in terms of Psychological Well-Being. The presence of clinical symptoms was the variable that caused the largest impact on the perception of health-related quality of life, possibly because of the impairment they bring to the daily lives of these patients.
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Comparison of Coping Strategy and Disease Knowledge in Dyads of Parents and Their Adolescent With Congenital Heart Disease. J Cardiovasc Nurs 2014; 29:508-16. [DOI: 10.1097/jcn.0000000000000090] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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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