PURPOSE: The purpose of this study was to explore the relationships of family strain, perceived social support, family hardiness, and family adaptation and identify the family resiliency factors for the adaptation of families who have a child with congenital heart disease. METHOD: The sample consisted of 90 families who had a child diagnosed with congenital heart disease and completed surgical treatment. Data was collected from parents using a questionnaire. RESULTS: Results from path analyses revealed that family strain had a direct effect on both perceived social support and family hardiness, and an indirect effect on family adaptation. Also, the findings revealed that perceived social support had a direct effect on both family hardiness and family adaptation, and family hardiness had a direct effect on family adaptation. Thus, these results indicated that perceived social support and family hardiness had a mediating effect on family strain. CONCLUSION: Findings provide the evidence for the theoretical and empirical significance of perceived social support and family hardiness as family resiliency factors for family adaptation. Clinical implications of these findings might be discussed in terms of family-centered nursing interventions for the families who have a child with congenital heart disease based on an understanding of family resiliency for adaptation.
*Adaptation, Psychological ; Child ; Family/*psychology ; Female ; Heart Defects, Congenital/*psychology/surgery ; Humans ; Male ; Questionnaires ; Social Support

PURPOSE: The aim of this study was to evaluate the psychopathological influence of congenital heart disease (CHD) in Korean 19-year-old males. MATERIALS AND METHODS: The authors compared the Korean military multiphasic personal inventory (KMPI) military profiles of 211 CHD cases (atrial septal defect, ventricular septal defect, patent ductus arteriosus, or combined CHD) with the KMPI profiles of 300 normal controls. The CHD group was also divided according to whether or not the subjects had undergone open cardiac surgery in order to evaluate the psychopathological effects of an operation among the subjects. RESULTS: A decreased result on the faking-good response scale and an increased result on the faking-bad response were observed in the CHD group compared to the control (p<0.01). The neurosis scale results, including anxiety, depression and somatization symptoms, were markedly increased in the CHD group compared to the control (p<0.01). The severity level of personality disorder was also increased in the CHD group (p<0.001). Differences in KMPI scale scores were not related to open cardiac surgery history. CONCLUSION: In this study, young males with CHD tended to report more abnormal results on the multiphasic personal inventory test in comparison to normal subjects, suggesting that CHD may be related to psychopathology in young males in Korea. Therefore, clinicians are recommended to evaluate the psychopathological traits of patients with CHD.
Adult ; Asian Continental Ancestry Group ; Heart Defects, Congenital/*psychology ; Humans ; Male ; *Personality Inventory ; Young Adult

OBJECTIVEThe present study was designed to investigate the influence of Congenital Heart Disease (CHD) on the mentality and behavior in children, and to compare post operative mentality and behavior in children receiving interventional therapy and congenital heart surgery.

METHODMentality and behavior of 232 children suffering from CHD were examined with Achenbach Child Behavior Checklist (CBCL) edited by XU Tao-yuan in 1992 and 100 sex, age, education and achievement-matched children with pneumonia were enrolled as controls.

RESULTSThe mentality and behavior abnormal rates of the boys and girls suffering from CHD were significantly higher than those of controls (P < 0.01, P < 0.05). The behavior abnormities of the boys presented as depression, social flinch, physical complains, assault and violate rules. Whereas the girls presented as depression, social flinch, physical complains and violate rules. The total cursory mark of postoperative check result of the interventional and surgical children, both in girls and in boys, were significantly lower than those of the preoperative children (P < 0.05). The total and assault cursory mark of postoperative check result of children treated with interventional therapy were significantly lower than those of children treated with the surgical operations (P < 0.05). The abnormal rates of mentality and behavior positively correlated with the disease course.

CONCLUSIONSCHD is associated with increased abnormal mentality and behavior of the children. Early treatment, especially the interventional therapy can significantly improve the mentality and behavior of the children with CHD.

Child ; Child Behavior ; Child Behavior Disorders ; etiology ; Female ; Heart Defects, Congenital ; psychology ; Humans ; Male

BACKGROUND AND OBJECTIVES: Adults with congenital heart disease (CHD) are an increasing group of patients thanks to the survival of over 85% of children with CHD. 20% of these patients shall warrant a surgical procedure during their life span. However, currently there is no one risk score that assess correctly the mortality of these procedures. Thus, we analyse the risk scores used at our institution. METHODS: From May 1991 till June 2017, 608 procedures in adults with CHD were performed. The 3 risk scores (risk adjustment for congenital heart surgery [RACHS-1], Aristotle, and Euroscore I) of each procedure were analysed. We used area under the receiver operating characteristic curve (c-index) to measure model discrimination, and Hosmer-Lemeshow (H-L) statistic along with calibration plots to measure calibration. RESULTS: There was no statistical difference between the area under the curve for the 3 scores (χ²=0.58 with 2 df, p=0.750). There was no evidence of lack of fit for RACHS-1 (H-L, χ²=2.61; p=0.271) and Aristotle score (H-L, χ²=5.69; p=0.459). However, there was evidence in lack of calibration in the Euroscore I scoring system (H-L, χ²=33.69; p<0.001). The calibration slope for RACHS-1 was 0.912, for Aristotle (stratified in risk groups) was −0.14 and for Euroscore 1 (stratified in risk groups) was 0.46. CONCLUSIONS: RACHS-1 seems to be best risk scoring system for calculating mortality applied to surgery in adults with CHD.
Adult ; Calibration ; Child ; Discrimination (Psychology) ; Heart Defects, Congenital ; Humans ; Mortality ; ROC Curve ; Thoracic Surgery

PURPOSE: In the present study, an analysis of the life of adolescents with complex congenital heart disease (CHD) was done using grounded theory. Consideration was given to the socio-cultural context of Korea. METHODS: After approval from the institutional review board of Y hospital, 12 patients ranging in age from 14 to 35 were recruited. Data were gathered using in-depth interviews. Theoretical sampling was performed until the concepts were saturated. RESULTS: The results confirmed the life of adolescents with complex CHD as a 'journey to finding uniqueness of oneself as a person with CHD'. The life consisted of 3 stages. In the crisis stage, participants had a feeling of threat to self-existence, and made an effort to be the same as others. In the self-recognition stage, participants who had sufficient role-performance built self-esteem while those who did not fell into self-accusation. In the self-establishment stage, participants who reached sufficiency in independence and knowledge planned the future, whereas those who did not conformed to the realities of life. CONCLUSION: The results of present study provide help in understanding the experiences of adolescents with CHD and provide a basis for developing nursing intervention strategies for these patients.
Adolescent ; *Adolescent Psychology ; Adult ; Female ; Heart Defects, Congenital/*psychology ; Humans ; Interviews as Topic ; Male ; Perception ; Quality of Life ; Self Concept

OBJECTIVECongenital heart disease (CHD) is a chronic illness with a high frequency in the worldwide population, and is normally diagnosed at birth or in uterus. Because of better conditions in diagnosis and early medical and surgical treatment, patients have survival rates of 90% and go further and further in life, facing different challenges in life cycle. In this study, we tested the effects of different demographic, clinical and psychosocial variables on the perception of quality of life (QOL), on psychosocial adjustment (PSA) and psychiatric morbidity (PM) of adolescents and young adults with CHD. We aimed to evaluate QOL, PM and PSA of adolescents and young adults with CHD and to determine which variables (demographic, clinical, and psychosocial) play a role in buffering stress and promoting resilience and which ones have a detrimental effect.

METHODSThe study enrolled 150 CHD patients (87 males and 63 females), 12 to 26 years (17.45±3.373 years). The participants were interviewed regarding social support, family educational style, self-image, demographic information and physical limitations. They responded to questions in a standardized psychiatric interview (SADS-L) and completed self-reports questionnaires for assessment of QOL (WHOQOL-BREF) and PSA (YSR/ASR).

RESULTSWe found a 18.7% lifetime prevalence of psychopathology in our participants (25.4% in females and 13.8% in males). 57.1% had retentions in school (1.53±0.804 year). The perception of QOL of CHD patients is better compared to the Portuguese population in the social relationships, environmental, physical and general dimensions. However, it is worse in female CHD patients and patients with poor academic performance and social support as well as in patients with complex or cyanotic CHD, moderate-to-severe residual lesions and physical limitations, and undergoing surgery. All of these variables, except presence of cyanosis, are also associated to a worse PSA.

CONCLUSIONSFemale patients and patients with poor academic performance and poor social support refer worse PSA and QOL.

Adaptation, Psychological ; Adolescent ; Adult ; Child ; Female ; Heart Defects, Congenital ; psychology ; Humans ; Male ; Morbidity ; Quality of Life ; Social Support ; Young Adult

Maternal diabetes is known to have teratogenic effects which increase the risk for congenital anomalies, such as caudal dysplasia, cardiac defects, hydronephrosis, and small left colon syndrome. Infants of diabetic mothers have a 10-fold higher frequency of anomalies in the central nervous system and a 5-fold higher frequency of congenital heart defects. However, jejunal atresia combined with multiple anomalies of the face, ears, and hands has rarely been reported. Herein we report a neonate born to a diabetic mother, who had hemifacial microsomia, displacement of the lacrimal ducts, polydactyly of the right hand, microtia of the right ear and proximal jejunal atresia presenting as bile regurgitation on the 1st day of life.
Bile ; Central Nervous System ; Colon ; Congenital Abnormalities ; Diabetes, Gestational ; Displacement (Psychology) ; Ear ; Facial Asymmetry ; Female ; Hand ; Heart Defects, Congenital ; Humans ; Hydronephrosis ; Infant ; Infant, Newborn ; Intestinal Atresia ; Mothers ; Polydactyly ; Pregnancy

The incidence of people living with congenital heart disease (CHD) has been increasing every year owing to remarkable advances in surgical and catheter intervention techniques and devices, and improved knowledge of critical care for patients with CHD. However, these patients continue to face physical, psychosocial, and environmental challenges, and a number of studies have shown higher rates of depression and anxiety disorders than the general population. To improve psychosocial functioning and quality of life for adults with CHD, health care providers are recommended to inform CHD patients of an accurate diagnosis, and overall treatment process, beginning in adolescence to facilitate a smooth transition from adolescence to adulthood. Active cooperation with psychiatrists, psychologists, social workers, chaplains, and family members is highly recommended to help CHD patients feel normal and optimistic and to promote good social interactions, close family relationships, and a strong sense of coherence.
Adolescent* ; Adult* ; Anxiety ; Anxiety Disorders ; Catheters ; Critical Care ; Depression ; Diagnosis ; Family Relations ; Health Personnel ; Heart Defects, Congenital* ; Heart Diseases ; Humans ; Incidence ; Interpersonal Relations ; Psychiatry ; Psychology ; Quality of Life* ; Sense of Coherence ; Social Workers

PURPOSE: Common conditions, such as dehydration or respiratory infection can aggravate hypoxia and are associated with interstage mortality in infants who have undergone palliative surgery for congenital heart diseases. This study was done to evaluate the efficacy of a home monitoring program (HMP) in decreasing infant mortality. METHODS: Since its inception in May 2010, all infants who have undergone palliative surgery have been enrolled in HMP. This study was a prospective observational study and infant outcomes during HMP were compared with those of previous comparison groups. Parents were trained to measure oxygen saturation, body weight and feeding volume and to contact the hospital through the hotline for emergency situations. Telephone counseling was conducted by clinical nurse specialists every week post discharge. RESULTS: Forty-one infants were enrolled in HMP. Nine hundred telephone counseling sessions were conducted. Seventy-three infants required telephone triage with the most common conditions being gastrointestinal (50.7%) and respiratory symptoms (32.9%). With HMP intervention, interstage mortality decreased from 18.6% (8/43) to 9.8% (4/41) (chi2=1.15, p=.283). CONCLUSION: Results indicate that active measures and treatments using the HMP decrease mortality rates, however further investigation is required to identify various factors that contribute to hemodynamic complications during the interstage period.
Body Temperature ; Body Weight ; Caregivers/education/psychology ; Counseling ; Female ; Heart Defects, Congenital/mortality/prevention & control/*surgery ; Heart Rate ; Hospitalization ; Hotlines ; Humans ; Infant ; Infant, Newborn ; Male ; Monitoring, Physiologic/*methods ; Oxygen Consumption ; Palliative Care ; *Program Evaluation ; Prospective Studies ; Time Factors