Jacqueline H Sanz1, Jichuan Wang2, Madison M Berl3, Anna C Armour4, Yao I Cheng5, Mary T Donofrio6. 1. Division of Neuropsychology, Children's National Health System, Washington, DC; Department of Psychiatry and Behavioral Sciences at The George Washington University School of Medicine, Washington, DC; Department of Pediatrics at The George Washington University School of Medicine, Washington, DC. Electronic address: jsanz@childrensnational.org. 2. Biostatistics, Children's National Health System, Washington, DC; Research Professor of Epidemiology and Biostatistics, George Washington University, Washington, DC. 3. Division of Neuropsychology, Children's National Health System, Washington, DC; Department of Psychiatry and Behavioral Sciences at The George Washington University School of Medicine, Washington, DC; Department of Pediatrics at The George Washington University School of Medicine, Washington, DC. 4. Division of Neuropsychology, Children's National Health System, Washington, DC. 5. Biostatistics, Children's National Health System, Washington, DC. 6. Department of Pediatrics at The George Washington University School of Medicine, Washington, DC; Division of Cardiology, Children's National Health System, Washington, DC.
Abstract
OBJECTIVE: To test a model to predict psychosocial quality of life (QOL) in children with congenital heart disease (CHD) via executive dysfunction. STUDY DESIGN: Parents of 91 children with CHD requiring surgery in the first year of life completed questionnaires by mail or as part of their cardiology clinic visit. Latent class analysis identified 2 groups of patients with different likelihoods of executive dysfunction. Select medical and demographic characteristics and executive dysfunction group membership were evaluated as predictors of QOL using structural equation modeling. RESULTS: In children with CHD, aortic obstruction, male sex, and premature birth predicted worse executive function, explaining 59% of the variance. Structural equation modeling results indicated that executive dysfunction plays an important mediating role, through which CHD with aortic obstruction, male sex, and premature birth indirectly affect psychosocial QOL. Neurologic abnormalities and single-ventricle CHD did not significantly predict executive dysfunction or QOL. CONCLUSIONS: Executive dysfunction is a strong predictor of psychosocial QOL at school age. Select medical and demographic risk factors did not directly predict QOL at school age in CHD; however, aortic obstruction, premature birth, and male sex impacted QOL indirectly by contributing to executive dysfunction. These findings suggest important risk factors for executive dysfunction that can be monitored, allowing for provision of early supports for executive skills development in an effort to improve long term psychosocial QOL in at-risk children with CHD.
OBJECTIVE: To test a model to predict psychosocial quality of life (QOL) in children with congenital heart disease (CHD) via executive dysfunction. STUDY DESIGN: Parents of 91 children with CHD requiring surgery in the first year of life completed questionnaires by mail or as part of their cardiology clinic visit. Latent class analysis identified 2 groups of patients with different likelihoods of executive dysfunction. Select medical and demographic characteristics and executive dysfunction group membership were evaluated as predictors of QOL using structural equation modeling. RESULTS: In children with CHD, aortic obstruction, male sex, and premature birth predicted worse executive function, explaining 59% of the variance. Structural equation modeling results indicated that executive dysfunction plays an important mediating role, through which CHD with aortic obstruction, male sex, and premature birth indirectly affect psychosocial QOL. Neurologic abnormalities and single-ventricle CHD did not significantly predict executive dysfunction or QOL. CONCLUSIONS: Executive dysfunction is a strong predictor of psychosocial QOL at school age. Select medical and demographic risk factors did not directly predict QOL at school age in CHD; however, aortic obstruction, premature birth, and male sex impacted QOL indirectly by contributing to executive dysfunction. These findings suggest important risk factors for executive dysfunction that can be monitored, allowing for provision of early supports for executive skills development in an effort to improve long term psychosocial QOL in at-risk children with CHD.
Authors: J S Lee; N Cinanni; N Di Cristofaro; S Lee; R Dillenburg; K B Adamo; T Mondal; N Barrowman; G Shanmugam; B W Timmons; P W Longmuir Journal: Pediatr Cardiol Date: 2019-11-07 Impact factor: 1.655
Authors: Daryaneh Badaly; Sue R Beers; Rafael Ceschin; Vincent K Lee; Shahida Sulaiman; Alexandria Zahner; Julia Wallace; Aurélia Berdaa-Sahel; Cheryl Burns; Cecilia W Lo; Ashok Panigrahy Journal: Front Neurol Date: 2022-03-09 Impact factor: 4.003
Authors: John F Strang; Diane Chen; Eric Nelson; Scott F Leibowitz; Leena Nahata; Laura G Anthony; Amber Song; Connor Grannis; Elizabeth Graham; Shane Henise; Eric Vilain; Eleonora Sadikova; Andrew Freeman; Cara Pugliese; Ayesha Khawaja; Tekla Maisashvili; Michael Mancilla; Lauren Kenworthy Journal: Child Psychiatry Hum Dev Date: 2021-06-19
Authors: Rachel E Siciliano; Lexa K Murphy; Kemar V Prussien; Lauren M Henry; Kelly H Watson; Niral J Patel; Chelsea A Lee; Colleen M McNally; Larry W Markham; Bruce E Compas; Lori C Jordan Journal: J Clin Psychol Med Settings Date: 2020-11-22