Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T21:50:59.271Z Has data issue: false hasContentIssue false

Behavioural and emotional outcomes in school-aged children after surgery or transcatheter closure treatment for ventricular septal defect

Published online by Cambridge University Press:  24 September 2013

Guotao Guan
Affiliation:
Department of Pediatric, Provincial Hospital Affiliated to Shandong University, Shandong, China
Haiyan Liu
Affiliation:
Department of Pediatric, Provincial Hospital Affiliated to Shandong University, Shandong, China
Yulin Wang
Affiliation:
Department of Pediatric, Provincial Hospital Affiliated to Shandong University, Shandong, China
Bo Han
Affiliation:
Department of Pediatric, Provincial Hospital Affiliated to Shandong University, Shandong, China
Youpeng Jin*
Affiliation:
Department of Pediatric, Provincial Hospital Affiliated to Shandong University, Shandong, China
*
Correspondence to: Y. Jin, MD, Department of Pediatric, Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China. Tel: +86 15168863809; Fax: +86 53168778316; E-mail: [email protected]

Abstract

Objection

We aimed to assess and compare the behavioural and emotional outcomes of school-aged children after surgery or transcatheter closure for ventricular septal defect and investigate the risk factors for developing abnormal behavioural problems with the condition.

Methods

In this study, we included 29 children, including 20 boys, with ventricular septal defect who underwent surgery and 35 children, including 21 boys, who underwent transcatheter closure (6–13 years old) and their age- and sex-matched best friends (n = 56) and their parents. The Child Behavior Checklist was used to obtain standardised parents’ reports of behavioural and emotional problems in children. The 28-item version of the General Health Questionnaire was used to assess parents’ psychological distress. Pearson correlation and logistic regression were used to analyse risk factors for developing behaviour problems.

Results

Behavioural problems were greater for boys and girls undergoing surgery or transcatheter closure than controls. The behavioural problems were mainly depression, somatic complaints, and social withdrawal for boys and thought problems, depression, somatic complaints, and social withdrawal for girls. Depression and somatic complaints were greater for boys undergoing surgery than for boys undergoing transcatheter closure. Behavioural problems did not differ between treatment groups for girls. Risk factors for developing behavioural problems were age at the time of ventricular septal defect repair (p = 0.03; odds ratio = 2.35), skin scar (p = 0.04; odds ratio = 3.12), post-operative atrioventricular block (p = 0.03; odds ratio = 2.81), and maternal anxiety (p < 0.01; odds ratio = 4.5).

Conclusion

School-aged children who underwent repair of ventricular septal defect regardless of the type of treatment (surgery or transcatheter closure) exhibit internalising behavioural problems. Risk factors for developing problems are young age, scarring, post-operative atrioventricular block, and maternal anxiety. In particular, maternal anxiety is the most important risk factor.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Both authors contributed equally to the work.

References

1. Latal, B, Helfricht, S, Fischer, JE, et al. Psychological adjustment and quality of life in children and adolescents following open-heart surgery for congenital heart disease: a systematic review. BMC Pediatrics 2009; 9: 6.CrossRefGoogle ScholarPubMed
2. Karsdorp, PA, Everaerd, W, Kindt, M, et al. Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis. J Ped Psychol 2007; 32: 527541.CrossRefGoogle ScholarPubMed
3. Landolt, MA, ValsangiacomoBuechel, ER, Latal, B. Health-related quality of life in children and adolescents after open-heart surgery. J Pediatr 2008; 152: 349355.CrossRefGoogle ScholarPubMed
4. Bellinger, DC, Newburger, JW. Neuropsychological, psychosocial and quality of life outcomes in children and adolescents with congenital heart disease. Prog Ped Cardiol 2010; 29: 8792.CrossRefGoogle Scholar
5. Bellinger, DC, Newburger, J, Wypij, D, et al. Behavior at eight years in children with surgically corrected transposition: the Boston circulatory arrest trial. Cardiol Young 2009; 19: 8697.CrossRefGoogle ScholarPubMed
6. Gupta, S, Mitchell, I, Giuffre, R, Crawford, S. Covert fears and anxiety in asthma and congenital heart disease. Child Care Health Dev 2001; 27: 335348.CrossRefGoogle ScholarPubMed
7. Miatton, M, DeWolf, D, Francois, K, Thiery, E, Vingerhoets, G. Neuropsychological performance in school aged children with surgically corrected congenital heart disease. J Ped 2007; 151: 7378.CrossRefGoogle ScholarPubMed
8. Shillingford, A, Glanzman, M, Ittenbach, R, et al. Inattention, hyperactivity, and school performance in a population of school-age children with complex congenital heart disease. Paediatrics 2008; 121: 759767.CrossRefGoogle Scholar
9. Karsdorp, P, Everaerd, W, Kindt, M, Mulder, B. Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis. J Ped Psychol 2007; 32: 527541.CrossRefGoogle ScholarPubMed
10. Van Rijen, E, Utens, E, Roos-Hesselink, J, et al. Longitudinal development of psychopathology in an adult congenital heart disease cohort. Int J Cardiol 2005; 99: 315323.CrossRefGoogle Scholar
11. Guan, GT, Jin, YP, Zheng, RP, Liu, FQ, Wang, YL. Cognitive P300-evoked potentials in school-age children after surgical or transcatheter intervention for ventricular septal defect. Pediatr Int 2011; 53: 9951001.CrossRefGoogle ScholarPubMed
12. Achenbach, TM. Manual for the Child Behavior Checklist/4-18 and 1991 Profile. University of Vermont, Department of Psychiatry, Burlington (Vt), 1991.Google Scholar
13. Achenbach, TM, Rescorla, LA. Manual for the ASEBA School-Age Forms and Profiles. University of Vermont, Research Center for Children, Youth & Families, Burlington (Vt), 2001.Google Scholar
14. Verhulst, FC, Van der Ende, J, Koot, HM. Handleiding Voor de Child Behavior Checklist/4-18. Department of Child and Adolescent Psychiatry, Sophia Children's Hospital. Erasmus University Rotterdam, Rotterdam, 1996.Google Scholar
15. Chen, C, Zhang, HJ, Jiang, H, Li, WJ, Lu, L. Assessing the general mental health of college students: psychometric properties of GHQ-28. J Shandong Univ 2010; 48: 159162.Google Scholar
16. Koeter, MWJ, Ormel, J. General Health Questionnaire. Dutch Version. Manual. Swets & Zeitlinger, Lisse, 1992.Google Scholar
17. Fredriksen, PM, Mengshoel, AM, Frydenlund, A, Sørbye, Ø, Thaulow, E. Follow-up in patients with congenital cardiac disease more complex than haemodynamic assessment. Cardiol Young 2004; 14: 373379.CrossRefGoogle ScholarPubMed
18. Utens, EMWJ, Verhulst, FC, Meijboom, FJ, et al. Behavioural and emotional problems in children and adolescents with congenital heart disease. Psychol Med 1993; 23: 415424.CrossRefGoogle ScholarPubMed
19. Oates, RK, Turnbull, JAB, Simpson, JM, Cartmill, TB. Parent and teacher perceptions of child behaviour following cardiac surgery. Acta Paediatr 1994; 83: 13031307.CrossRefGoogle ScholarPubMed
20. Gupta, S, Mitchell, I, Giuffre, RM, Crawford, S. Covert fears and anxiety in asthma and congenital heart disease. Child Care Health Dev 2001; 27: 335348.CrossRefGoogle ScholarPubMed
21. Hövels-Gürich, HH, Konrad, K, Skorzenski, D, et al. Long-term behavior and quality of life after corrective cardiac surgery in infancy for tetralogy of Fallot or ventricular septal defect. Pediatr Cardiol 2007; 28: 346354.CrossRefGoogle ScholarPubMed
22. Van Rijen, EHM, Utens, EMWJ, Roos-Hesselink, JW, et al. Medical predictors for psychopathology in adults with operated congenital heart disease. Eur Heart J 2004; 25: 16051613.CrossRefGoogle ScholarPubMed
23. Karsdorp, PA, Everaerd, W, Kindt, M, Mulder, BJ. Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis. J Pediatr Psychol 2007; 32: 527541.CrossRefGoogle ScholarPubMed
24. Teixeira, FM, Coelho, RM, Proença, C, et al. Quality of life experienced by adolescents and young adults with congenital heart disease. Pediatr Cardiol 2011; 32: 11321138.CrossRefGoogle Scholar
25. van Rijen, EH, Utens, EM, Roos-Hesselink, JW, et al. Medical predictors for psychopathology in adults with operated congenital heart disease. Eur Heart J 2004; 25: 16051613.CrossRefGoogle ScholarPubMed
26. Lawoko, S, Soares, JJ. Distress and hopelessness among parents of children with congenital heart disease, parents of children with other diseases, and parents of healthy children. J Psychosom Res 2002; 52: 193208.CrossRefGoogle ScholarPubMed
27. Gudermuth, S. Mothers’ reports of early experiences of infants with congenital heart disease. Matern – Child Nurs J 1975; 4: 155164.Google ScholarPubMed
28. Hendry, J, Mitton, J. Childhood cardiac anomalies: a review. Can Nurse 1976; 72: 2832.Google ScholarPubMed
29. Pinelli, JM. A comparison of mothers’ concerns regarding the caretaking tasks of newborns with congenital heart disease before after assuming their care. J Adv Nurs 1981; 6: 261270.CrossRefGoogle ScholarPubMed
30. Cadman, D, Rosenbaum, P, Boyle, M, Offord, DR. Children with chronic illness. In: Charney DS, Deutch AY (eds). Neurobiological and Clinical Consequences of Stress. Lippincott-Raven, Philadelphia, 1991: 403412.Google Scholar
31. Crnic, K, Friedrich, W, Greenberg, M. Adaptation of families with mentally retarded children. A model of stress, coping, and family ecology. Am J Ment Defic 1983; 88: 125138.Google Scholar
32. Gallagher, JJ, Beckman, P, Cross, AH. Families of handicapped children: sources of stress and its amelioration. Exceptional Child 1983; 50: 1019.CrossRefGoogle ScholarPubMed
33. Goldberg, S, Marcovitch, S, MacGregor, D, Lojkasek, M. Family responses to developmentally delayed preschoolers: etiology and the father's role. Am J Ment Defic 1986; 90: 610617.Google ScholarPubMed
34. Jessop, DJ, Riessman, CK, Stain, RE. Chronic childhood illness and maternal mental health. J Dev Behav Pediatr 1988; 9: 147156.CrossRefGoogle ScholarPubMed
35. Ninio, A, Rinott, N. Fathers’ involvement in the care of their infants and their attributions of cognitive competence to infants. Child Dev 1988; 59: 652663.CrossRefGoogle ScholarPubMed
36. Svavarsdottir, EK, McCubbin, M. Parenthood transition for parents of an infant diagnosed with a congenital heart condition. J Pediatr Nurs 1996; 11: 207216.CrossRefGoogle ScholarPubMed
37. Gilliom, M, Shaw, DS. Codevelopment of externalizing and internalizing problems in early childhood. Dev Psychopathol 2004; 16: 313333.CrossRefGoogle ScholarPubMed