title: The complexity of the psychosocial situation in children and adolescents with heart disease.
abstract: OBJECTIVE
  To describe the psychosocial situation of children/adolescents with heart disease and their families, an inventory method was worked out.
  
  
  METHODS
  Ninety-seven children/adolescents with congenital heart disease (CHD) were graded into three categories with respect to complexity of CHD. Group I included 42 patients with malformations requiring standardized operations. Group II included 20 patients with more complicated malformations, and group III included 35 patients with very complex malformations. The patients were compared with controls without heart disease, matched for age and gender. The psychosocial impact of CHD was measured by the inventory.
  
  
  RESULTS
  The most frequent problems in the patient group were healthcare and treatment-related needs (71/97) in the external sphere, family symptoms (68/97) in the interpersonal sphere, and somatic symptoms (19/97) in the personal sphere. Corresponding numbers in the controls were treatment-related needs (15/97), family (9/97) and somatic symptoms (25/97). Fifty per cent of the symptoms in the patient groups were mild, 30% moderate and 20% severe. The most severe symptoms were found in the interpersonal sphere, where family symptoms constituted the most severe variable. The frequency of severe problems in the personal sphere was 11% in the patients and 1% in the controls. This inventory method differentiates the grades of medical complexity both regarding number and severity of psychosocial symptoms. It indicates severe personal problems in the most complex group and shows that they have severe personal problems independent of family problems.
  
  
  CONCLUSIONS
  This study elucidates the psychosocial complexity in children/adolescents with CHD, which has clinical implications in developing a psychosocial care programme.
authors.affiliation: Division of Paediatrics, Department of Clinical Science, University Hospital of Umeå, Umeå, Sweden. annalena.birkeland@vll.se
authors.forename: Anna-Lena
authors.initials: AL
authors.lastname: Birkeland
authors.forename: Annika
authors.initials: A
authors.lastname: Rydberg
authors.forename: Bruno
authors.initials: B
authors.lastname: Hägglöf
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000191:economics* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D020380:Needs Assessment; D010287:Parent-Child Relations; D015995:Prevalence; D011584:Psychology; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013548:Sweden