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PUBLIC RELEASE DATE:
10-Jul-2014

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Contact: Connie Hughes
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For children with pacemakers, 'self-competence' affects quality of life

Young patients might benefit from programs to bolster feelings of competence, suggests study in Journal of Developmental & Behavioral Pediatrics

July 10,2014 – For children and teens living with a cardiac pacemaker, a low sense of self-competence seems to contribute to decreased quality of life, reports a study in the July Journal of Developmental & Behavioral Pediatrics, the official journal of the Society for Developmental and Behavioral Pediatrics. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"Self-competence may function as a protective factor against lower health-related quality of life in children with pacemakers," according to the study by Ana M. Gutierrez-Colina of University of Georgia, Athens, and colleagues. They suggest that the growing number of young patients with pacemakers might benefit from interventions to help them feel more confident in social interactions and other areas of life.

Self-Competence Linked to Quality of Life in Kids with Pacemakers

The researchers administered a self-competence questionnaire to 27 children and adolescents with pacemakers. The patients, average age 13.5 years, had pacemaker implantation because of disease causing abnormal heart rhythms (cardiac arrhythmias).

Self-competence refers to "how well an individual believes he or she generally functions" in various areas, such as academics and social life. The patients also completed evaluations of health-related quality of life, psychosocial adaptation, and behavioral and emotional problems.

Scores for self-competence were decreased for children with pacemakers, compared to healthy children. The patients had relatively large reductions in scores on all four questionnaire subscales: cognitive, social, physical, and general self-competence.

As the researchers hypothesized, patients with lower self-competence also had lower health-related quality of life. Low perceptions of social competence seemed particularly important, linked to lower scores in physical, social, psychosocial, and overall quality of life.

Unexpectedly, self-competence was not strongly associated with psychological problems, such as depression or anxiety. Self-competence was also unrelated to behavior problems.

Higher Self-Competence May Be a Protective Factor

For children with cardiac arrhythmias, pacemaker implantation is a standard treatment that leads to positive health outcomes. As survival improves for infants with congenital heart abnormalities, more children are living with pacemakers, which may affect their lives in many ways.

For example, children with pacemakers may have to limit their physical activity level. They may have scars and a visible chest bulge, and may require repeated surgeries. Few studies have focused on the social, behavioral, and emotional issues affecting children with pacemakers.

Based on the new study, higher self-competence may act as a "protective factor" against lower quality of life in children with pacemakers. The researchers write, "It is possible that children's belief in their ability to successfully engage in a variety of activities, including social interactions, prepares them to better cope with the challenges that they may face as a result of their illness."

Gutierrez-Colina and colleagues suggest that children with pacemakers might benefit from interventions aimed at enhancing their sense of self-competence. Children could be taught problem-solving skills to help them believe in their ability to succeed at school, in social situations, and in managing their health—ideally in a group setting, where they could meet and learn from peers with similar health conditions.

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Click here to read "Perceived Self-Competence, Psychosocial Adjustment, Quality of Life in Pediatric Patients with Pacemakers."

About the Journal of Developmental & Behavioral Pediatrics

Written for physicians, clinicians, psychologists and researchers, each issue of the Journal of Developmental & Behavioral Pediatrics is devoted entirely to the developmental and psychosocial aspects of pediatric health care. Each issue brims with original articles, case reports, challenging cases and reviews—the latest work of many of today's best known leaders in related fields—that help professionals across disciplines stay current with the latest information in the field. Relevant areas covered include learning disorders, developmental disabilities, and emotional, behavioral, and psychosomatic problems. Journal of Developmental & Behavioral Pediatrics is the official journal of the Society for Developmental and Behavioral Pediatrics.

About Wolters Kluwer Health

Wolters Kluwer Health is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries worldwide, clinicians rely on Wolters Kluwer Health's market leading information-enabled tools and software solutions throughout their professional careers from training to research to practice. Major brands include Health Language®, Lexicomp®, Lippincott Williams & Wilkins, Medicom®, Medknow, Ovid®, Pharmacy OneSource®, ProVation® Medical and UpToDate®.

Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company. Wolters Kluwer had 2013 annual revenues of €3.6 billion ($4.7 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America. Follow our official Twitter handle: @WKHealth.



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