Executive Function and Psychosocial Quality of Life in School Age Children with Congenital Heart Disease

• Published in: The Journal of pediatrics Vol. 202; pp. 63 - 69
• Main Authors: Sanz, Jacqueline H., Wang, Jichuan, Berl, Madison M., Armour, Anna C., Cheng, Yao I., Donofrio, Mary T.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2018
• Subjects: Adolescent; Arterial Occlusive Diseases - physiopathology; Child; congenital heart defects; executive function; Executive Function - physiology; Female; Heart Defects, Congenital - classification; Heart Defects, Congenital - physiopathology; Heart Defects, Congenital - psychology; Humans; Male; Models, Statistical; neurodevelopmental outcome; Parents - psychology; Pregnancy; Premature Birth; Quality of Life; Sex Factors; Stress, Psychological; Surveys and Questionnaires; BRIEF; neurodevelopmental outcome; SEM; quality of life; CHD; congenital heart defects; executive function; QOL
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2018.07.018

To test a model to predict psychosocial quality of life (QOL) in children with congenital heart disease (CHD) via executive dysfunction.
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.
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.
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.