RT Journal Article
SR Electronic
T1 57 Can a structured intervention programme improve the biophysical and psychosocial wellbeing in children with congenital heart disease?
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP A29
OP A30
DO 10.1136/heartjnl-2016-310523.57
VO 102
IS Suppl 9
A1 S Callaghan
A1 L Morrison
A1 C McCusker
A1 FA Casey
YR 2016
UL http://heart.bmj.com/content/102/Suppl_9/A29.2.abstract
AB Introduction Improved survival among children with congenital heart disease (CHD) has shifted focus to the long-term physical and psychological outcomes for these patients. There is evidence that children with CHD have lower levels of daily physical activity and a higher prevalence of obesity compared to their normal peers. The benefits of an active lifestyle within the general population have been well described. They include better cardiovascular health, improved psychological, cognitive and social functioning and obesity prevention. This study aims to determine if a structured intervention programme can improve both physical and psychological functioning in children with CHD.Methods This study is a prospective randomised control trial. 430 patients aged between 5–10 years with CHD were identified on Heartsuite Database and invited to participate. Each patient underwent baseline biophysical and psychological assessment as detailed below:Biophysical assessmentsWeight, height, waist measurementsBaseline heart rate, blood pressure, oxygen saturationExercise stress test – Graded cycle ergometer protocolActigraph accelerometer worn for 1 week3 day food diaryPsychosocial assessmentsBrief Symptom Index: To profile general mental health of the parentKidscreen27Strengths and Difficulties QuestionnaireButler Self-image ProfilePsychosocial assessmentsFollowing baseline assessment patients were randomised into intervention and control groups. The intervention group were invited to attend a one day education session during which motivational interviewing techniques were used to deliver advice on diet, exercise and positive lifestyle choices. They also received an individual written exercise plan to take home and implement. The control group continued with their usual level of care. After 4 months all participants were invited back for reassessment.Baseline results163 patients were recruited, 100 were male (61.3%) with a mean age of 8.4 years (range 5.3–11.5)Patient subgroups: 18.4% acyanotic no intervention, 37.4% acyanotic repaired, 27.6% cyanotic corrected, 16.6% cyanotic palliatedEST: EST duration mean 5.89 mins (SD 2.02), METs mean 9.79 (SD 1.79), mean Maximal predicted HR 81% (SD 7.8)Actigraph: Average time spent in MVPA (Moderate-Vigorous Physical Activity) 45 mins (SD −27.2)The ‘cyanotic palliated’ subgroup had significantly lower EST duration, maximal HR and oxygen saturations at peak exercise compared with the other 3 subgroups, as well as significantly lower levels of daily MVPAThe ‘cyanotic palliated’ group also scored significantly lower on HrQOL subscale, physical wellbeingConclusions The baseline assessments suggest that overall physical and psychological wellbeing is well preserved in the majority of children aged 5–11 years with CHD. The follow up results and impact of the intervention will also be presented.