Abstract 2082: A Model of Quality of Life in Adolescents with Congenital Heart Disease

Abstract

Objective : This study was examined to identify the variables related to quality of life (QOL) in adolescents with congenital heart disease (CHD). Methods : The subjects were 266 adolescents with CHD under observation following cardiac surgery in three cardiac centers in Korea. The adolescents each completed twenty questionnaires. The exogenous variables in the model were individual risk factors, individual protective factors, family protective factors and social protective factors, while QOL and resilience were an endogenous variable. These six theoretical variables were assessed by 20 measurable variables (anxiety, depression, symptom distress, NYHA Functional class, oxygen saturation, number of operations, self-esteem, hope, attitude toward CHD, body image, academic achievement, family cohesion, family function, parental support, parental overprotection, socioeconomic status, friend support, teacher support, resilience and QOL) and 15 paths were established. Data were analysed using structural equation modelling. Results: The overall fit indices of the hypothetical model were χ2=26.63, GFI=.96, RMR=.02, NFI=.95, RFI=.85, IFI=.98 and PNFI=.87. All 15 paths in the hypothetical model were found to be significant(all, p<0.01). Higher resilience (t=11.93), family (t=7.88), individual (t=5.75), and social (t=4.14) protective factors were associated with increased QOL, as were lower individual risk factors (t=−5.30). Resilience had the greatest impact on QOL. Individual protective factors correlated positively with both family (t=8.88) and social (t=8.33) protective factors, while family factors correlated positively with social protective factors (t=9.31). Individual risk factors correlated negatively with family (t=−7.13), individual (t=−7.00) and social (t=−4.69) protective factors. Thus, the higher each of these protective factors was, the smaller the effect of individual risk factors. Conclusion: To increase the QOL of adolescents with CHD, it is important to develop a strategy to increase resilience. Furthermore, nursing interventions that will enhance individual, family, and social protective factors must be developed and implemented in order to reduce the negative effects of individual risk factors.