Objectives: To examine the physical and psychosocial determinants of activity and health behaviour in children after surgery for congenital heart disease (CHD).
Methods: Health Behaviour outcomes were assessed in 91 children (mean age 4.6 years) with surgically treated CHD. Subjects were classified into 4 groups according to severity: The three main outcome measures were. 1. Presence of residual symptoms. 2. Frequency of visits to General Practitioner (G.P.) or Accident and Emergency (A&E) Department. 3. Ability to participate in physical activity using a calculated “Activity Score”. Predictor variables examined included socio-economic and maternal factors in addition to medical status.
Results: Children had very few residual symptoms post “corrective surgery”. Those with complex CHD post “Fontan”repair had symptoms on average 18.2 days per month. Surprisingly the complex group had less days “sick” from non cardiac causes and made less visits to G.P. or A&E departments. Regression analysis indicates that 3 variables had significant relevance to G.P./A&E. visits: Complex CHD- less visits (p=0.046), Townsend Score- more deprivation-more visits (p=0.002) Maternal worry-higher maternal worry score-more visits (p=0.015). Regression analysis indicates lower activity score is significantly related to complex heart disease (p=0.034) and higher maternal worry score (p<0.001)
Conclusions: The majority of this group of children reported few residual symptoms and had good exercise tolerance. Maternal worry is a significant factor in influencing both activity levels and frequency of unscheduled health service demands. Identification of “non cardiac” factors influencing health behaviour helps inform management plans aimed at care of the whole child and family.