Impact of a paediatric cardiac rehabilitation programme upon patient quality of life

Abstract

Introduction: Cardiac rehabilitation programmes for paediatric patients with congenital heart disease (CHD) have been shown to promote emotional and physical health without any associated adverse events. While prior studies have demonstrated the effectiveness of these types of interventions, there has been limited research into how the inclusion of psychological interventions as part of the programme impacts parent-reported and patient-reported quality of life. Materials and methods: Patients between the ages of 7 and 24 years with CHD completed a cardiac rehabilitation programme that followed a flexible structure of four in person-visits with various multidisciplinary team members, including paediatric psychologists. Changes in scores from the earliest to the latest session were assessed regarding exercise capacity, patient functioning (social, emotional, school, psychosocial), patient general and cardiac-related quality of life, patient self-concept, and patient behavioural/emotional problems. Results: From their baseline to final session, patients exhibited significant improvement in exercise capacity (p = 0.00009). Parents reported improvement in the patient’s emotional functioning, social functioning, school functioning, psychosocial functioning, cognitive functioning, communication, and overall quality of life. While patients did not report improvement in these above areas, they did report perceived improvement in certain aspects of cardiac-related quality of life and self-concept. Discussion: This paediatric cardiac rehabilitation programme, which included regular consultations with paediatric psychologists, was associated with divergent perceptions by parents and patients on improvement related to quality of life and other aspects of functioning despite improvement in exercise capacity. Further investigation is recommended to identify underlying factors associated with the differing perceptions of parents and patients.

Facility-Based and Virtual Cardiac Rehabilitation in Young Patients with Heart Disease During the COVID-19 Era

“…Regular exercise has been shown in non-HD populations to improve mental health, dietary habits, sleep hygiene, and quality of life [ 33 , 34 ]. Less is known whether this can be reproduced in children and young adults with HD who engage in CR [ 35 – 37 ]. Kroll et al were able to demonstrate improved parent perception of social and emotional health but not improved patient social and emotional functioning in a largely pediatric HD cohort [ 37 ].…”

“…Less is known whether this can be reproduced in children and young adults with HD who engage in CR [ 35 – 37 ]. Kroll et al were able to demonstrate improved parent perception of social and emotional health but not improved patient social and emotional functioning in a largely pediatric HD cohort [ 37 ]. Our cohort of pediatric and young adult HD patients did see an improvement in emotional health as evidenced by a lower PHQ-9 and improved perceived fitness based on improvements in the Duke Activity and Physical Component Scores.…”

Facility-based and virtual cardiac rehabilitation in young patients with heart disease during the COVID-19 era

“…Regular exercise has been shown in non-HD populations to improve mental health, dietary habits, sleep hygiene, and quality of life [35][36] . Less is known whether this can be reproduced in children and young adults with HD who engage in CR [37][38][39] . Kroll et al were able to demonstrate improved parent perception of social and emotional health but not improved patient social and emotional functioning in a largely pediatric HD cohort 39 .…”

“…Less is known whether this can be reproduced in children and young adults with HD who engage in CR [37][38][39] . Kroll et al were able to demonstrate improved parent perception of social and emotional health but not improved patient social and emotional functioning in a largely pediatric HD cohort 39 . Our cohort of pediatric and young adult HD patients did see an improvement in emotional health as evidenced by a lower PHQ-9 and 13 improved perceived fitness based on improvements in the Duke Activity and Physical Component Scores.…”

Clinical Commentary on From Patient to Physician: a Journey of Resilience

“…It is now widely accepted that most patients with congenital heart disease (CHD) are not only safe to exercise but that their long-term health and quality of life depend on it. 1,2 Dr Glenn notes that his cardiologist always encouraged him to participate in any activity he wished and to set his goals high. This motivated him to take on and achieve incrementally larger challenges.…”