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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Latal
Beatrice
B
University Children's Hospital Zurich, Department of Psychosomatics and Psychiatry, Steinwiesstrasse 75, Zurich, Switzerland. bea.latal@kispi.uzh.ch
Helfricht
Susanne
S
Fischer
Joachim E
JE
Bauersfeld
Urs
U
Landolt
Markus A
MA
D000223:Adaptation, Psychological; D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000523:psychology* / Q000601:surgery*; D006801:Humans; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome