title: Determinants of quality of life in children and adolescents with CHD: a systematic review.
abstract: OBJECTIVE
  This review aims to outline a systematic approach for the assessment of quality of life in children and adolescents with CHD and to cite its main determinants.
  
  
  METHODS
  A systematic critical literature search in PubMed, Scopus, and Cinahl databases resulted in 954 papers published after 2000. After the quality assessment, 32 original articles met the inclusion criteria.
  
  
  RESULTS
  Methodological quality of the included studies varied greatly, showing a moderate quality. Impaired quality of life was associated with more severe cardiac lesions. Children with CHD, after cardiac surgery, reported diminished quality of life concerning physical, psycho-social, emotional, and school functioning. The majority of clinical studies showed significant differences among children and their parents' responses regarding their quality of life, with a tendency of children to report greater quality of life scores than their parents. According to our analysis, concerning children with CHD, the most cited determinants of their quality of life were as follows: (a) parental support; (b) lower socio-economic status; (c) limitations due to physical impairment; (d) sense of coherence; as well as (e) the level of child's everyday anxiety and depression. These findings suggest that differences in quality of life issues may exist across lesion severities.
  
  
  CONCLUSIONS
  Quality of life in children with CHD should be assessed according to age; severity; therapeutic approach; acceptance of the disease; and personality features. Effective management and early recognition of significant impairments in quality of life could impact clinical outcomes in children with CHD.
authors: 1Faculty of Nursing,National and Kapodistrian University of Athens,Athens,Greece.
authors: Maria
authors: M
authors: Drakouli
authors: 2Cardiac-Cardiosurgical PICU,"Onassis" Cardiac Surgery Center (O.C.S.C.),Athens,Greece.
authors: Konstantinos
authors: K
authors: Petsios
authors: 1Faculty of Nursing,National and Kapodistrian University of Athens,Athens,Greece.
authors: Margarita
authors: M
authors: Giannakopoulou
authors: 1Faculty of Nursing,National and Kapodistrian University of Athens,Athens,Greece.
authors: Elisabeth
authors: E
authors: Patiraki
authors: 2Cardiac-Cardiosurgical PICU,"Onassis" Cardiac Surgery Center (O.C.S.C.),Athens,Greece.
authors: Ioanna
authors: I
authors: Voutoufianaki
authors: 1Faculty of Nursing,National and Kapodistrian University of Athens,Athens,Greece.
authors: Vasiliki
authors: V
authors: Matziou
mesh_terms: D000293:Adolescent; D001007:Anxiety; D002648:Child; D003863:Depression; D006330:Heart Defects, Congenital / Q000523:psychology*; D006801:Humans; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index
keywords: Quality of life; adolescents; children; congenital; heart defects