Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Sisters by Heart, El Segundo, CA, USA.
Cardiol Young. 2021 Jun;31(6):888-899. doi: 10.1017/S1047951121002158. Epub 2021 Jun 4.
In 2018, the Neurodevelopmental and Psychosocial Interventions Working Group of the Cardiac Neurodevelopmental Outcome Collaborative convened through support from an R13 grant from the National Heart, Lung, and Blood Institute to survey the state of neurodevelopmental and psychosocial intervention research in CHD and to propose a slate of critical questions and investigations required to improve outcomes for this growing population of survivors and their families. Prior research, although limited, suggests that individualised developmental care interventions delivered early in life are beneficial for improving a range of outcomes including feeding, motor and cognitive development, and physiological regulation. Interventions to address self-regulatory, cognitive, and social-emotional challenges have shown promise in other medical populations, yet their applicability and effectiveness for use in individuals with CHD have not been examined. To move this field of research forward, we must strive to better understand the impact of neurodevelopmental and psychosocial intervention within the CHD population including adapting existing interventions for individuals with CHD. We must examine the ways in which dedicated cardiac neurodevelopmental follow-up programmes bolster resilience and support children and families through the myriad transitions inherent to the experience of living with CHD. And, we must ensure that interventions are person-/family-centred, inclusive of individuals from diverse cultural backgrounds as well as those with genetic/medical comorbidities, and proactive in their efforts to include individuals who are at highest risk but who may be traditionally less likely to participate in intervention trials.
2018 年,心脏神经发育结局协作组织的神经发育和心理社会干预工作组通过美国国立心肺血液研究所 R13 资助召集会议,旨在调查先天性心脏病神经发育和心理社会干预研究的现状,并提出一系列关键问题和调查,以改善这一不断增长的幸存者及其家庭的结局。尽管先前的研究有限,但表明在生命早期提供个体化的发育护理干预措施有利于改善一系列结局,包括喂养、运动和认知发育以及生理调节。针对自我调节、认知和社会情感挑战的干预措施在其他医疗人群中显示出了希望,但尚未对其在先天性心脏病患者中的适用性和有效性进行研究。为了推动这一研究领域的发展,我们必须努力更好地了解神经发育和心理社会干预在先天性心脏病人群中的影响,包括为先天性心脏病患者改编现有的干预措施。我们必须研究专门的心脏神经发育随访计划如何增强适应能力,并通过与先天性心脏病相关的无数过渡来支持儿童和家庭。而且,我们必须确保干预措施以个人/家庭为中心,包括来自不同文化背景的个体以及具有遗传/医学合并症的个体,并积极努力将处于最高风险但传统上不太可能参与干预试验的个体包括在内。