Psychosocial Development of Children Undergoing Open Cardiac Surgery
Condition: Cardiac Surgery
Study type: Observational

Summary: 
      In recent years, improvement of medical treatments leads to the effect, that 90% of children
      originally born with congenital heart disease (CHD) are reaching adulthood. Mortality rates
      have significantly decreased in the last decades. However several studies have shown that
      with multiple consequences have to face the survivors. Eg. neuronal and psychological
      injuries during the perioperative period. After all, the surgical interventions that save
      their lives might result in psychological and behavioral deviations and increased morbidity,
      which is strongly worsening the quality of life, learning abilities and behavioral
      development of these patients. Not yet available any clinical guidelines for managing or
      screening these patients for designing intervention, taking corrective actions.

      The investigators wish to identify those perioperative factors that might affect the
      well-being, coping, the behavior alteration and psychosocial status of children, who
      underwent open chest cardiac interventions in early ages. The investigators also wish to
      understand the long-term changes of the illness-representation of this population and to see
      its effect for the wellbeing and coping.
    

Detailed description: 
      The study population will include school-aged children treated and followed in the Gottsegen
      György Hungarian Institute of Cardiology in Budapest. The participants will be selected from
      patients who underwent open-chest cardiac surgery, under the age of four, between 2003- 2007
      and once followed up in 2013-2014.

      Psychosocial measures will be as follows: Beck Depression Inventory (BDI), Spielberger
      State-Trait Anxiety Inventory (STAI-S/T), KidScreen questionnaire, PRISM-D and person/organ
      test.

      A range of perioperative and psychosocial factors will be assessed as potential determinants
      of outcome. The data will be fully retrieved from the registries of our hospital center.
      Characteristics registered included pre-, intra- and postoperative variables such as age,
      gender, comorbidities (renal, hepatic, infectious, neurological, metabolic, hormonal or
      genetic disorders), type of surgery, laboratory parameters, operation time, cardiopulmonary
      bypass (CPB) time, aortic cross-clamp time, Risk Assessment for Congenital Heart Surgery
      (RACHS) points, length of mechanical ventilation, blood loss, transfusions, fluid balance,
      need for inotropic support or pulmonary vasodilatation, medications, anaesthetic and
      analgesic agents.

      By comparing the above mentioned perioperative data with the result of the psychological
      measures we expect to answer our hypothesis.
    

Observational model: Case-Only
Time perspective: Other
Sampling method: Non-Probability Sample
Study population: 
        The study population included school-aged children treated and followed in the Gottsegen
        György Hungarian Institute of Cardiology in Budapest. The operated subgroup enrolled
        patients who underwent open chest cardiac surgery, under the age of four, between 2003-2007