Abstract
Children with complex congenital heart disease are less active than recommended for optimal health, with social and physical environments important determinants. The purpose of this study was to examine the physical activity perceptions of children with complex congenital heart disease and their parents to identify social and physical environment intervention targets. A semi-structured discussion guide elicited physical activity perceptions from children (26 boys, 19 girls, 6.0–12.4 years) with complex congenital heart disease (single ventricle n = 42) and their parents during three child and three parent focus groups and 41 interviews. Interviews and focus groups were audio-recorded and transcribed verbatim for inductive thematic analysis. Children and parents identified home, peer and health environments as impacting on their children’s physical activity participation. Peer environments, such as school or daycare, were supportive by providing physical activity facilities and enabling fun with peers and time outdoors. At home, parent and sibling interactions both encouraged and discouraged physical activity. The children’s unique health environment fostered physical activity uncertainty, discouraging activity despite minimal or no physician recommendations to restrict physical activity. Children with complex congenital heart disease and their parents recognize the importance of physical activity and fun with friends. Physical activity uncertainty contributes to their inactive lifestyles despite minimal restrictions from health professionals. Positive clinical encouragement and health environment interventions that better support physical activity are required.
Highlights
Introduction published maps and institutional affilPhysical activity is critically important for children’s physical and psychosocial health, both during childhood and for the rest of their lives [1,2,3,4]
The third environment emphasized supportive social and physical environments related to peer interactions at school/daycare
Contrary to earlier healthcare narratives regarding overprotection [26], the results from this study suggest that parents of children with complex congenital heart disease (CCHD) do not “bubble wrap” their children into inactive lifestyles
Summary
Introduction published maps and institutional affilPhysical activity is critically important for children’s physical and psychosocial health, both during childhood and for the rest of their lives [1,2,3,4]. Exercise training can improve the fitness of these children [10,11,12], with benefits maintained over the short [13] and long term [14] Their physical activity participation is lower, and unrelated to their exercise capacity [7], even when exercise capacity is near-normal [8]. Studies consistently indicate that a small proportion of these children are able to achieve the physically active lifestyles associated with optimal health [15,16]. Taken together, these findings suggest the need to examine factors other than the physiological effects of the CCHD as important determinants of their physical activity behaviour
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