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Examination of the physical and psychosocial determinants of health behaviour in 4–5-year-old children with congenital cardiac disease

Published online by Cambridge University Press:  02 June 2010

Frank A. Casey ,
M. Stewart ,
C. G. McCusker ,
M. L. Morrison ,
B. Molloy ,
N. Doherty ,
B. G. Craig ,
A. J. Sands ,
N. Rooney  and
H. C. Mulholland
Frank A. Casey*
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom The Queen’s University of Belfast, University Road, Belfast, Northern Ireland, United Kingdom
M. Stewart
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
C. G. McCusker
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom The Queen’s University of Belfast, University Road, Belfast, Northern Ireland, United Kingdom
M. L. Morrison
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
B. Molloy
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
N. Doherty
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
B. G. Craig
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
A. J. Sands
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
N. Rooney
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
H. C. Mulholland
Affiliation:
Department of Paediatric Cardiology, The Royal Belfast Hospital for Sick children, Belfast, Northern Ireland, United Kingdom
*
Correspondence to: Dr F. A. Casey, Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, 180 Falls Road, Belfast, Northern Ireland, BT12 6BE, United Kingdom. Tel: 02 89 063 5350; Fax: 02 89 063 5608; E-mail: frank.casey@belfasttrust.hscni.net
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Abstract

Objectives

To assess the general health and activity levels of 4- and 5-year-old children after intervention for congenital cardiac disease.

Methods

Health behaviour outcomes were assessed in 91 children who had surgery or catheter intervention for congenital cardiac disease. The children were classified into four groups according to severity. The main parameters of classification were the presence of residual symptoms, frequency of visits to general practitioner or the Accident and Emergency Department, and ability to participate in physical activity according to a calculated “activity score”.

Results

Children had very few residual symptoms after “corrective surgery”. Those with complex congenital cardiac disease post-Fontan-type repair still had symptoms on average 18.2 days per month. Surprisingly, the complex group had fewer days “sick” from non-cardiac causes and had fewer visits to general practitioner or Accident and Emergency Departments. Regression analysis indicates that three variables had significant relevance to the general practitioner or Accident and Emergency visits: complex congenital cardiac disease, fewer visits; Townsend score – more deprivation – more visits; and maternal worry – higher maternal worry score – more visits. Regression analysis indicates that lower activity score is significantly related to complex cardiac disease and higher maternal worry score.

Conclusions

The majority of this group of 4- and 5-year-old children had few residual symptoms and had good exercise tolerance. Maternal worry is a significant factor in influencing both activity levels and frequency of unscheduled health service demands – general practitioner or Accident and Emergency visits.

Keywords

Paediatric cardiologyoutcomesactivitypsychological well-being
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 5 , October 2010 , pp. 532 - 537
Copyright
Copyright © Cambridge University Press 2010

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