Psychological adjustment and quality of life in children and adolescents following open-heart surgery for congenital heart disease: a systematic review

• Main Authors: Bauersfeld Urs, Fischer Joachim E, Helfricht Susanne, Latal Beatrice, Landolt Markus A
• Format: Article
• Language: English
• Published: BMC 2009-01-01
• Series: BMC Pediatrics
• Online Access: http://www.biomedcentral.com/1471-2431/9/6

<p>Abstract</p> <p>Background</p> <p>Children with congenital heart defects (CHD) requiring open-heart surgery are a group at high risk for health-related sequelae. Little consensus exists regarding their long-term psychological adjustment (PA) and health-related quality of life (QoL). Thus, we conducted a systematic review to determine the current knowledge on long-term outcome in this population.</p> <p>Methods</p> <p>We included randomized controlled trials, case control, or cohort studies published between 1990–2008 evaluating self- and proxy-reported PA and QoL in patients aged between two and 17 years with a follow-up of at least two years after open heart surgery for CHD.</p> <p>Results</p> <p>Twenty-three studies assessing psychological parameters and 12 studies assessing QoL were included. Methodological quality of the studies varied greatly with most studies showing a moderate quality. Results were as follows: (a) A considerable proportion of children experienced psychological maladjustment according to their parents; (b) studies on self-reported PA indicate a good outcome; (c) the studies on QoL suggest an impaired QoL for some children in particular for those with more severe cardiac disease; (d) parental reports of psychological maladjustment were related to severity of CHD and developmental delay.</p> <p>Conclusion</p> <p>A significant proportion of survivors of open-heart surgery for CHD are at risk for psychological maladjustment and impaired QoL. Future research needs to focus on self-reports, QoL data and adolescents.</p>