Department of Pediatrics, Division of Pediatric Cardiology, Medical College of Wisconsin, Wauwatosa, WI, USA.
Department of Pediatrics, Division of Pediatric Cardiology, University of Colorado School of Medicine, Aurora, CO, USA.
Cardiol Young. 2021 May;31(5):804-811. doi: 10.1017/S1047951120004710. Epub 2021 Jan 7.
Cardiac rehabilitation programmes for paediatric patients with congenital heart disease (CHD) have been shown to promote emotional and physical health without any associated adverse events. While prior studies have demonstrated the effectiveness of these types of interventions, there has been limited research into how the inclusion of psychological interventions as part of the programme impacts parent-reported and patient-reported quality of life.
Patients between the ages of 7 and 24 years with CHD completed a cardiac rehabilitation programme that followed a flexible structure of four in person-visits with various multidisciplinary team members, including paediatric psychologists. Changes in scores from the earliest to the latest session were assessed regarding exercise capacity, patient functioning (social, emotional, school, psychosocial), patient general and cardiac-related quality of life, patient self-concept, and patient behavioural/emotional problems.
From their baseline to final session, patients exhibited significant improvement in exercise capacity (p = 0.00009). Parents reported improvement in the patient's emotional functioning, social functioning, school functioning, psychosocial functioning, cognitive functioning, communication, and overall quality of life. While patients did not report improvement in these above areas, they did report perceived improvement in certain aspects of cardiac-related quality of life and self-concept.
This paediatric cardiac rehabilitation programme, which included regular consultations with paediatric psychologists, was associated with divergent perceptions by parents and patients on improvement related to quality of life and other aspects of functioning despite improvement in exercise capacity. Further investigation is recommended to identify underlying factors associated with the differing perceptions of parents and patients.
针对先天性心脏病(CHD)患儿的心脏康复计划已被证明可促进身心健康,且不会产生任何不良事件。尽管先前的研究已经证明了这些干预措施的有效性,但对于将心理干预纳入计划如何影响父母报告和患者报告的生活质量,研究还很有限。
年龄在 7 至 24 岁之间的 CHD 患者完成了心脏康复计划,该计划遵循灵活的结构,包括与各种多学科团队成员(包括儿科心理学家)进行四次面对面访问。评估了从最早到最晚一次就诊的得分变化,涉及运动能力、患者功能(社交、情感、学校、心理社会)、患者一般和心脏相关生活质量、患者自我概念和患者行为/情绪问题。
从基线到最后一次就诊,患者的运动能力显著提高(p = 0.00009)。父母报告患者的情绪功能、社交功能、学校功能、心理社会功能、认知功能、沟通和整体生活质量得到改善。尽管患者在这些方面没有报告改善,但他们确实报告在某些心脏相关生活质量和自我概念方面感知到了改善。
该儿科心脏康复计划包括定期与儿科心理学家进行咨询,尽管运动能力有所提高,但父母和患者对生活质量和其他功能方面的改善的看法却存在差异。建议进一步调查以确定与父母和患者不同看法相关的潜在因素。