Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, 1102 Cardiorespiratory Medicine and Haematology, 1103 Clinical Sciences, Cardiovascular System & Hematology, 3201 Cardiovascular medicine and haematology, 3202 Clinical sciences

Abstract:

Purpose: The present study examined how depressive symptoms, loneliness, paternal and maternal support, perceived health and quality of life influenced one another over time in adolescents with congenital heart disease (CHD). Methods: We conducted a 3-wave longitudinal study, spanning 18 months (9 month intervals). Patients were selected from the database of paediatric and congenital cardiology of a university hospital in Belgium. Inclusion criteria were: confirmed CHD; aged 14-18 years at the start of the study; last cardiac consult ≤5 years ago at our centre; being able to read and write Dutch; and availability of valid contact details. Exclusion criteria were: cognitive and/or physical limitations inhibiting filling out questionnaires; prior heart transplantation; and absence of informed consent. Of the 498 eligible patients, 429 participated (median age 16 years; 53% boys). We used a linear analogue scale (quality of life and perceived health status); the CESD-20 (depressive symptoms); the 8-item version of the UCLA loneliness scale (loneliness); and the responsiveness subscale of the child report of parent behaviour inventory (parental support). Cross-lagged path analysis was applied to examine the direction of effects over time, controlled for age, sex and disease complexity. Results: Figure 1 shows the significant relations and their coefficients. Depressive symptoms and loneliness mutually reinforced each other and led to relative decreases in quality of life. Parental support and perceived health were influenced by previous levels of depressive symptoms, which in turn influenced quality of life. Paternal support predicted relative changes in all variables. Conclusions: The observed temporal sequences provided information on the dynamics of psychosocial functioning of adolescents with CHD.