title: Impact of psychologic functioning, medical severity, and family functioning in pediatric heart transplantation.
abstract: METHODS
  This study examined (1) the psychologic functioning of children and adolescents before and after heart transplantation and (2) whether pretransplantation psychologic functioning, posttransplantation medical severity, and family functioning were related to the patients' posttransplantation psychologic functioning. The subjects were 23 patients, ages 3 to 20 years, who underwent heart transplant and survived at least 1 year after their transplantation. Psychologic functioning was assessed by the Children's Global Assessment Scale before and after heart transplantation. Medical severity was assessed by number of outpatient visits, hospitalizations, biopsies, and the Side Effect Severity Scale. Family functioning was rated on the Global Assessment of Family Relational Functioning Scale.
  
  
  RESULTS
  The majority of the patients (78.3%) had good psychologic functioning after their heart transplantation. Patients with psychologic difficulties before and after transplantation had more hospitalizations after transplantation.
  
  
  CONCLUSIONS
  Pretransplantation emotional functioning and family functioning were more correlated with posttransplantation psychologic functioning than medical side effect severity.
authors.affiliation: Department of Psychiatry and Cardiology, Children's Hospital, Harvard Medical School, Boston, Mass 02115, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: DeMaso
authors.forename: A W
authors.initials: AW
authors.lastname: Twente
authors.forename: E G
authors.initials: EG
authors.lastname: Spratt
authors.forename: P
authors.initials: P
authors.lastname: O'Brien
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000523:psychology*; D006801:Humans; D008297:Male; D010552:Personality Assessment; D011183:Postoperative Complications / Q000523:psychology*; D012803:Sick Role