title: The effect of a resilience improvement program for adolescents with complex congenital heart disease.
abstract: Adolescents with congenital heart disease need to increase their resilience in the face of challenges in order to preserve their health and quality of life.
  
  
  
  This study aimed to develop a resilience improvement program for adolescents with congenital heart disease and also to evaluate any change in resilience and quality of life as a measure of the effectiveness of the resilience improvement programs.
  
  
  
  A nonequivalent control group pretest-posttest study was designed. Twenty-five adolescents who attended the first resilience improvement program were included in the experimental group, and 31 adolescents who took part in the second program were placed in the control group. Adolescents with congenital heart disease completed a self-report questionnaire on three separate occasions: the pretest, the first posttest and the second posttest. The self-report questionnaire included general characteristics and instruments to measure resilience and quality of life. For the longitudinal analysis, generalized estimating equations were used to evaluate the difference in the estimated average trajectories of resilience and quality of life changes.
  
  
  
  Independent predictors of resilience improvement in adolescents with congenital heart disease were the experimental group ( p=0.02) and middle and high school students ( p=0.02). Quality of life was not associated with membership in the experimental group. However, males scored higher than females on quality of life measures ( p=0.02).
  
  
  
  It is essential for healthcare providers to apply various programs, including those targeted at accepting illness, improving autonomy and independently managing disease, to adolescents with congenital heart disease.
authors.affiliation: 1 College of Nursing, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sunhee
authors.initials: S
authors.lastname: Lee
authors.affiliation: 2 Postdoctoral Research Fellow, Exercise Medicine Center for Diabetes and Cancer Patients, Yonsei University, Seoul, Korea.
authors.forename: Junga
authors.initials: J
authors.lastname: Lee
authors.affiliation: 3 Division of Pediatric Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Choi
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D005260:Female; D006330:Heart Defects, Congenital / Q000523:psychology*; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D011788:Quality of Life / Q000523:psychology*; D055500:Resilience, Psychological; D057566:Self Report; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
keywords: Adolescents; program; quality of life; resilience