Background: Congenital heart disease (CHD) is a leading cause of
childhood morbidity, with an estimated prevalence of 0.8–1%. However, advances
in diagnosis and treatment now allow 90% of childhood CHD patients to survive to
adulthood, leading to increased interest in their quality of life (QoL). In this
study, we examine the impact of clinical and psychosocial variables, including
the number of surgical interventions (NSI), age at surgery, school achievement,
and social support, as mediating factors of QoL in CHD patients.
Methods: The study included 233 CHD patients (132 males) with an average
age of 15.2 2.07 years, including 80 with cyanotic CHD and 153 with
acyanotic CHD. The severity of illness ranged from mild to severe, with 30
patients having a severe illness, 119 having a moderate illness, and 84 having a
mild illness. One-hundred-sixty-three patients underwent surgery. Clinical data
on diagnosis, the severity of CHD, the type of CHD, and surgical interventions
were collected from patient records, and a semi-structured interview was
conducted to explore the relationship between CHD diagnosis and various aspects
of life. QoL was assessed using the Abbreviated World Health Organization Quality
of Life questionnaire (WHOQOL-Bref) questionnaire. Results:
Ten mediation models were analyzed, each with three hypotheses (paths). In all
models the first hypothesis was supported. Analyses of the second and third
hypotheses revealed three feasible models of mediation through the effect of NSI
on QoL in CHD patients. Conclusions: Our findings indicate that
patients with more severe and cyanotic CHD generally require more surgical
interventions, which may increase the risk of negative outcomes and affect
patients’ perception of QoL. These results have important implications for
healthcare providers and psychologists who work with childhood CHD patients.