title: Parental mental health moderates the efficacy of exercise training on health-related quality of life in adolescents with congenital heart disease.
abstract: To evaluate the moderating influence of parental variables on changes in health-related quality of life (HRQoL) in adolescents with Tetralogy of Fallot (ToF) or a Fontan circulation after participation in standardized exercise training. A multicenter randomized controlled trail in which 56 patients, aged 10-15, were randomly allocated (stratified by age, gender, and congenital heart disease) to a 12-week period with either: (a) 3 times per week standardized exercise training or (b) care-as-usual (randomization ratio 2:1). Adolescents and their parents filled in online questionnaires at baseline and at 12-week follow-up. In this randomized controlled trail, primary analyses involved influence of parental mental health and parental social support for exercise on changes in the TNO/AZL Child Quality of Life Questionnaire Child Form at follow-up. Secondary analyses concerned comparing levels of parental characteristics with normative data. Compared with controls, adolescents in the exercise group reported a decrease in social functioning when their parents had more anxiety/insomnia or severe depression themselves. Adolescents also reported a decrease in social functioning when their parents showed poorer overall mental health themselves. Parents reported comparable or even better mental health compared with normative data. The effect of a standardized exercise program on HRQoL changes in adolescents with ToF or a Fontan circulation is moderated by parental mental health, more specifically by parental anxiety/insomnia and severe depression. The trial registration number of this article is NTR2731 ( www.trialregister.nl ).
authors: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands, k.dulfer@erasmusmc.nl.
authors: Karolijn
authors: K
authors: Dulfer
authors: Nienke
authors: N
authors: Duppen
authors: Arie P J
authors: AP
authors: Van Dijk
authors: Irene M
authors: IM
authors: Kuipers
authors: Ron T
authors: RT
authors: Van Domburg
authors: Frank C
authors: FC
authors: Verhulst
authors: Jan
authors: J
authors: Van der Ende
authors: Willem A
authors: WA
authors: Helbing
authors: Elisabeth M W J
authors: EM
authors: Utens
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D005081:Exercise Therapy; D005260:Female; D006330:Heart Defects, Congenital / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D008297:Male; D008603:Mental Health; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires; D013771:Tetralogy of Fallot / Q000534:rehabilitation / Q000601:surgery; D016896:Treatment Outcome