Article

Self-concept: Comparison between school-aged children with congenital heart disease and normal school-aged children

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Abstract

The aim of this study was to evaluate and compare the self-concept of school-aged children with congenital heart disease to those of normal school-aged children. The primary objective was to analyse results of the Self-Concept Scale questionnaire administered to children with congenital heart disease aged 9-12 years. Sixty-four children with congenital heart disease (study group), and 71 without congenital heart disease (control group), completed the questionnaire. Little attention has focused on school-aged children with congenital heart disease who are in the important stages of developing self-concept. The mean score on the Physical self-concept of the Self-Concept Scale was significantly lower for the study group than the control group (P < 0.05). No significant differences were observed between children with congenital heart disease and normal children in terms of family self-concept, school self-concept, appearance self-concept, emotional self-concept and general self-concept for the Self-Concept Scale. Nurses should use the study findings to encourage positive self-concept development and improve their patient education about physical activity before the child is discharged. Thus, children with congenital heart disease could leave the hospital with a clear understanding of their body and condition, and how it affects daily life. The results of this study may provide more holistic views on self-concept for clinical nurses working with children who have congenital heart disease and their families and for school nurses working with elementary school children.

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... The body of studies on physical self-concept in children with a congenital heart defect is very limited [15][16][17]. Only the studies by Chen et al. [16] used a questionnaire specific to the physical self-concept, the Physical Self-Description Questionnaire (PSDQ). ...
... Only the studies by Chen et al. [16] used a questionnaire specific to the physical self-concept, the Physical Self-Description Questionnaire (PSDQ). In the other two studies [15,17], physical self-concept was asked as a subscale in a questionnaire used for general self-concept. ...
... Chen et al. [15,17] only made comparisons among children with CHD. Thereby, both studies found a significantly better physical self-concept among boys compared to girls. ...
Article
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Objective: Children with congenital heart defects (CHD) are at high risk for cardiovascular disease in addition to their congenital disease, so it is important to motivate this group of patients to live a physically active lifestyle. A potential influencing determinant of younger children's physical performance is the physical self-concept. The objective of the present study was first to evaluate the correlation between the physical self-concept (PSC) and the participation in physical activities (PA) of a representative group of children with congenital heart disease (CHD), and second to point out differences in comparison to their healthy peer group. Methods: Using the database of PA of the S-BAHn-Study we focused on physical self-concept assessed by the German version of the Physical Self-Description Questionnaire. We compare the obtained data of children with CHD to a representative age-matched sample of 3.385 participants of the Motorik Modul Study. Results: N = 1.198 complete datasets could be included in the analyses. The mean age of patients was 11.6 ± 3.1 years. For the total cohort of patients with CHD and the reference group, PA correlated significantly with a positive PSC (p < 0.001). PA was significantly reduced in all groups of patients despite the severity of their heart defect (p < 0.001). Remarkably, PSC did not differ statistically significantly in patients with simple CHD from the reference collective (p > 0.24). Conclusions: According to this representative survey, there is a clear relation between PA and PSC in the cohort of healthy children and the group of children with CHD throughout the severity of their heart defects. Although PSC did not differ in patients with simple CHD and their healthy peer group, PA was significantly reduced. This gap invites us to reflect on how we could break new ground to promote a physically active lifestyle in children with CHD regardless of the severity of their cardiac defects.
... Self-esteem or similar constructs, such as self-concept or self-confidence, is often viewed as the way an individual thinks or feels about themselves (i.e., self-worth) [19]. Conflicting results have been reported regarding sex differences in self-esteem or self-concept in adolescent and adult patients with CHD [3, 4, 10, 11, 20, 22]. A few studies identified male CHD patients as having lower self-esteem than female CHD patients, which was partly explained by decreased physical ability or sports restrictions interfering with peer relationships [9, 20]. ...
... A few studies identified male CHD patients as having lower self-esteem than female CHD patients, which was partly explained by decreased physical ability or sports restrictions interfering with peer relationships [9, 20]. However, most studies identified lower-self-esteem in CHD patients compared with healthy controls [3, 4, 20]. To our knowledge, no studies have been conducted to explore sex and age differences related to body-image, self-esteem, and BMI in an older group of patients with complex SVCHD who have undergone complete surgical palliation with the Fontan procedure. ...
... Male and female subjects' SVCHD scores were similar; there were no sex or age group differences. Our results contradict previous reports of primarily male or female sex having lower self-esteem [3, 11, 22] and patients with more severe disease having lower self-esteem [4]. The mean age of this study cohort was 26 ± 9 years (range 15–50 years), which, to our knowledge, is the oldest group of SVCHD patients reported. ...
Article
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Single-ventricle congenital heart disease (SVCHD) requires multiple palliative surgical procedures that leave visible surgical scars and physical deficits, which can alter body-image and self-esteem. This study aimed to compare sex and age differences in body-image, self-esteem, and body mass index (BMI) in adolescents and adults with SVCHD after surgical palliation with those of a healthy control group. Using a comparative, cross-sectional design, 54 adolescent and adult (26 male and 28 female) patients, age 15–50 years, with SVCHD were compared with 66 age-matched healthy controls. Body-image and self-esteem were measured using the Multidimensional Body-Self Relations Questionnaire–Appearance Scale and Rosenberg Self-Esteem Scale. Height and weight were collected from retrospective chart review, and BMI was calculated. Female adolescents and adult patients with SVCHD reported lower body image compared with males patients with SVCHD and healthy controls (p = 0.003). Specific areas of concern were face (p = 0.002), upper torso or chest (p = 0.002), and muscle tone (p = 0.001). Patients with SVCHD who were \21 years of age had lower body image compared with healthy controls (p = 0.006). Self-esteem was comparable for both patients with SVCHD and healthy peers. There were no sex differences in BMI; BMI was higher in subjects[21 years of age (p = 0.01). Despite the similarities observed in self-esteem between the two groups, female patients with SVCHD\21 years of age reported lower perceived body-image. Our findings support the need to recognize poor psychological adjustment related to low self-esteem in patients with SVCHD; female patients warrant increased scrutiny. Strategies to help patients with SVCHD cope with nonmodifiable aspects of body-image during the difficult adolescent–to–young adult years may potentially enhance self-esteem and decrease psychological distress.
... The research is mixed on the impacts of cardiac conditions on the self-concept. There are differences in the self-concept for mild and severe congenital heart defects (Chen, Li, Wang, 2005). Chen and colleagues found that children with congenital heart disease have significantly lower physical self-concept scores than their healthy peers. ...
... shown that chronic health conditions can have negative psychosocial impacts on children (Baker et al., 2005;Brosig et al., 2006;Brown et al., 2007;Chen et al., 2005). The CWHC's selfconcept scores remain significantly lower than their siblings at pre-and post-test. ...
Thesis
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This paper explores the impact of summer camp on the self-concept for children with health challenges (CWHC) and their siblings. Summer camp allows children a supportive environment in which to develop their own identities. Success in the camp setting can allow children to build their confidence and in turn can shift their self-concept. Medical specialty camps provide campers with health challenges, and in some cases their siblings, and opportunity to receive this camp experience in a medically supportive environment. The goal of this study was to see if there is an impact of summer camp on the self-concept and to see if that impact differs between CWHC and their siblings. To study these questions, sibling pairs were surveyed pre- and post-camp using their Piers-Harris 3 Self-Concept Assessment. Participants were 16 sibling pairs attending a medical specialty camp in the summer of 2019. To qualify to participate, one sibling was attending a diagnosis-specific camp session and the other sibling was attending the sibling specific session. The results show that pre- and post-test scores were significantly lower for CWHC than their siblings (F(1,18) = 4.517, p = 0.048). They also show an increase in self-concept scores in the physical appearance and attributes domain from pre- to post-camp (F(1,18) = 7.826, p = 0.012). There are positive changes from pre- to post-camp. In order to determine if camp is the cause of these, further studies are necessary.
... Studies using various tools (Self-Concept Scale, KINDL, and the Lindström method) in children with CHD 38-40 also reported QoL in most domains comparable with the reference group, except for physical self-concept. 39 For younger children (aged 5-7 years), self-perceived QoL (measured by using KINDL) was even better than in same-aged peers from the general population. 40 In contrast, in a study using PedsQL, for both 5-to 7year-olds and 8-to 12-year-olds, QoL in children with CHD was found to be significantly lower in all domains compared with the age-matched reference group. ...
... Studies assessing children who have different levels of condition severity reported that severity and presence of associated anomalies contributed to the lower scores in some domains of self-reported QoL, 33,34,38 which is in agreement with a previous review. 1 We observed a lack of consistency in the reviewed studies in relation to QoL in children with congenital conditions, with some reporting comparable 36,38,39 or even better 40 subjective QoL than control children, whereas others reported lower total or domain-specific scores. This inconsistency cannot be fully attributed to the type of condition, QoL measure used, or age differences, as some studies explored children of the same age groups with the same condition using the same instrument but reported discrepant findings. ...
Article
Background: Children born with gastroschisis have a good prognosis but require surgical correction and long-term follow up. There has been little research on the impact of gastroschisis on the child's health-related quality of life (QoL). The aim was to assess face and content validity of the KIDSCREEN-52 questionnaire as a measurement of self- and proxy-reported QoL in children born with gastroschisis and to evaluate self-reported QoL in these children compared with the reference population. Methods: In this cross-sectional exploratory study, we used the validated KIDSCREEN-52 questionnaire and individual interview with 8- to 11-year-old children born with gastroschisis who were identified from the Northern Congenital Abnormality Survey. Self-reported QoL scores were compared with age-matched UK norms by using the two-sample t test. Results: Ten children (median age 9.6 years, interquartile range 8.3-11.0) and their parents participated. Children found KIDSCREEN a helpful tool to explore their feelings and that it covered life aspects important to them. Parents believed that all priority areas were represented and that it was straightforward for their children to complete. In nine KIDSCREEN domains, children with gastroschisis had similar QoL scores to those in the reference population, and in one (psychological well-being) the mean score was significantly better (p = 0.03). All children described their health as good/very good or excellent; eight said they would not like to change anything about their body. Conclusion: The KIDSCREEN questionnaire has adequate face and content validity as a measure of QoL in children with gastroschisis and is acceptable to both children and parents.
... Studies using various tools (Self-Concept Scale, KINDL, and the Lindström method) in children with CHD 38-40 also reported QoL in most domains comparable with the reference group, except for physical self-concept. 39 For younger children (aged 5-7 years), self-perceived QoL (measured by using KINDL) was even better than in same-aged peers from the general population. 40 In contrast, in a study using PedsQL, for both 5-to 7year-olds and 8-to 12-year-olds, QoL in children with CHD was found to be significantly lower in all domains compared with the age-matched reference group. ...
... Studies assessing children who have different levels of condition severity reported that severity and presence of associated anomalies contributed to the lower scores in some domains of self-reported QoL, 33,34,38 which is in agreement with a previous review. 1 We observed a lack of consistency in the reviewed studies in relation to QoL in children with congenital conditions, with some reporting comparable 36,38,39 or even better 40 subjective QoL than control children, whereas others reported lower total or domain-specific scores. This inconsistency cannot be fully attributed to the type of condition, QoL measure used, or age differences, as some studies explored children of the same age groups with the same condition using the same instrument but reported discrepant findings. ...
Article
Background There is little consistency in the use of instruments for measuring self-reported quality of life (QoL) in young children. This study aimed to analyse self-reported QoL in children aged <12 years with a chronic health condition of perinatal origin, and to examine the agreement between self- and proxy-reports for these children. Methods We used systematic review methods for literature searches (MEDLINE, EMBASE, Web of Science, PsychINFO), development of the data extraction protocol and the review process. Original studies were included if they: (1) assessed QoL of children with a distinct chronic health condition of perinatal origin, i.e. either a congenital condition or anomaly, or a condition resulting from events during pregnancy or in the neonatal period; (2) had self-reported data on children aged <12 years; (3) used validated generic or condition-specific QoL instruments; (4) published in English between January 1989 and June 2013. Each eligible study underwent a detailed review by two independent reviewers who extracted data on study design, objective, sample characteristics, QoL assessment instrument, statistical techniques used and the results. Study quality assessment was conducted by the reviewers who evaluated recruitment (avoidance of selection and non-response bias), study design (course of measurement, informants and type of controls), QoL assessment (whether validated instruments were used), and the statistical analyses (adjustment for confounders. Due to the varied QoL measurements and summary measures, the results were synthesised narratively. Results From 403 full-text papers assessed for eligibility, 50 studies underwent detailed review and 37 were included in a narrative synthesis. Children’s self-reported QoL was assessed using a variety of generic and/or condition-specific instruments, with the Paediatric Quality of Life Inventory being the most frequently used (25%, nine studies). Irrespective of the condition or the instrument used, children often reported QoL similar to the reference population, except for lower scores in the physical functioning/health domain. There were differences between younger and older age groups by QoL domain. The child’s perception of QoL differed from that of their parents, in particular for subjective domains such as emotional functioning, and these differences were age-related. Conclusion This review suggests that young children with perinatal conditions often have similar self-reported QoL compared with age-matched controls. As their perception of QoL frequently differs from that of their parents, both child and parent perspectives are essential to understand the impact of the condition on a child’s QoL and on the family as a whole. Acknowledgments This abstract was first presented as a poster at Perinatal Medicine 2014, 9–11 June 2014, Harrogate International Centre, Harrogate, UK, and published as: Rankin J, Jardine J, Glinianaia SV, McConachie H, Embleton ND. Self-reported quality of life in children aged less than 12 years with chronic health conditions of perinatal origin: a systematic review. Archives of Disease in Childhood Fetal and Neonatal Ed. 99(Suppl 1):A39. 2014.
... Studies using various tools (Self-Concept Scale, KINDL, and the Lindström method) in children with CHD 38-40 also reported QoL in most domains comparable with the reference group, except for physical self-concept. 39 For younger children (aged 5-7 years), self-perceived QoL (measured by using KINDL) was even better than in same-aged peers from the general population. 40 In contrast, in a study using PedsQL, for both 5-to 7year-olds and 8-to 12-year-olds, QoL in children with CHD was found to be significantly lower in all domains compared with the age-matched reference group. ...
... Studies assessing children who have different levels of condition severity reported that severity and presence of associated anomalies contributed to the lower scores in some domains of self-reported QoL, 33,34,38 which is in agreement with a previous review. 1 We observed a lack of consistency in the reviewed studies in relation to QoL in children with congenital conditions, with some reporting comparable 36,38,39 or even better 40 subjective QoL than control children, whereas others reported lower total or domain-specific scores. This inconsistency cannot be fully attributed to the type of condition, QoL measure used, or age differences, as some studies explored children of the same age groups with the same condition using the same instrument but reported discrepant findings. ...
Article
Context: There is little consistency in the use of instruments for measuring self-reported quality of life (QoL) in young children. Objective: To systematically review studies of self-reported QoL in children aged <12 years with congenital health conditions, and to examine the agreement between self- and proxy-reports. Data sources: Literature databases (MEDLINE, EMBASE, Web of Science, PsychINFO) were systematically searched, reference lists of eligible studies were scanned. Study selection: We included studies published in English between January 1989 and June 2013 which used validated instruments to assess self-reported QoL in children aged <12 years with a distinct congenital health condition identified in early infancy. Data extraction: We extracted data on study design, objective, sample characteristics, QoL assessment instrument, statistical techniques and results. Results: From 403 full-text articles assessed for eligibility, 50 studies underwent detailed review, and 37 were included in a narrative synthesis. Children's self-reported QoL was assessed by using a variety of generic and/or condition-specific instruments, with the Pediatric Quality of Life Inventory being the most frequently used (25% [9 studies]). Regardless of the condition or the instrument used, children often reported QoL similar to the reference population, except for lower scores in the physical functioning/health domain. There were differences between younger and older age groups according to QoL domain. The child's perception of QoL differed from that of his or her parents, in particular for subjective domains such as emotional functioning, and these differences were age related. The main limitation of the review resulted from the lack of published studies on self-reported QoL in young children, in particular, lacking both self-reports and proxy reports. Existing studies demonstrated wide variability in the QoL instruments used and approaches to statistical analyses, lack of information about the formation of the study sample (response rate; comparison of responders and nonresponders) and low sample sizes in the age group of interest. Conclusions: The reviewed studies demonstrated that, even for younger children, both child and parent perspectives are essential to understanding the impact of a condition on a child's QoL.
... Previous research has demonstrated that adolescents with pediatric heart disease are at risk for behavioral problems (Hovels-Gurich et al., 2007;Shillingford & Wernovsky, 2004), reduced social skills (Bellinger, 2008;McCrindle et al., 2006), altered self-perception (Chen, Li, & Wang, 2005;Karsdorp, Kindt, Rietveld, Everaerd, & Mulder, 2007;Rietveld et al., 2002;Salzer-Muhar et al., 2002), and reduced quality of life (Mussatto & Tweddell, 2005;Rose et al., 2005;Uzark et al., 2008). In one of the few studies focusing on adolescent self-report, subjects with severe heart disease reported lower self-esteem, more depression, and reduced HRQOL compared to healthy adolescents and participants with mild or moderate pediatric heart disease. ...
... The results for global self-worth and the domain-specific competence scales of the Self-Perception Profile for this sample of adolescents with heart disease were found to be similar to a healthy reference sample. These findings are consistent with those of Chen et al. (2005) in children with heart disease. The finding that perceptions of global self-worth were preserved despite more internalizing behavior problems and a lower HRQOL suggests that these adolescents were able to distinguish between their overall satisfaction with themselves and other aspects of adjustment. ...
Article
This study examined the importance of self-perceptions as determinants of psychosocial adjustment reported by adolescents with heart disease and compared adolescents with heart disease to healthy norms. Ninety-two adolescents with heart disease from a single Midwestern institution provided reports of self-perceptions (health, self-worth, competence, and importance), internalizing behavior problems (IPs; e.g., anxiety and depression) and externalizing behavior problems (EPs; e.g., attention problems and aggression), and health-related quality of life (HRQOL). Hierarchical linear regression was used to assess the impact of self-perceptions, as well as clinical factors (e.g., illness severity, time since last hospitalization, and medications) and demographic characteristics on outcomes. Self-perceptions explained the most variance in behavioral and HRQOL outcomes (R(2)adj = 0.34 for IP, 0.24 for EP, and 0.33 for HRQOL, p < .001). Male gender and lower household income were associated with more behavior problems. Clinical variables were only related to HRQOL. Compared with healthy norms, IPs were significantly more common in male adolescents and HRQOL was lower (p < .001). Adolescents with heart disease are at risk for internalizing behavior problems and reduced HRQOL; however, positive self-perceptions appear to be protective. Self-perceptions are critical and should be addressed by clinicians.
... 21 Adolescents with CHD indicated that support from others and enhanced perceptions of mastery facilitated their participation. 21 In order to guide health promotion strategies, the importance of adolescents' preferences, mastery motivation, and diminished self-concept, 22,23 as determinants of participation in leisure activities requires clarification. Environmental factors such as social, peer, and family support should also be considered as potential determinants. ...
Article
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Aim To describe leisure participation in adolescents with congenital heart defects (CHD) and identify factors associated with intensity of participation. Method Eighty adolescents with CHD were recruited (39 males, 41 females; mean age [SD] 15y 8mo [1y 8mo] range 11y 5mo–19y 11mo) of whom 78 completed the Children’s Assessment of Participation and Enjoyment (CAPE) outcome measure of leisure participation. The measure has five subscales: recreational, active‐physical, social, skill‐based, and self‐improvement. Associations between the CAPE and age, sex, and development were examined. Motor ability (Movement Assessment Battery for Children, Second Edition), cognition (Leiter International Performance Scale‐Revised), behavior (Strengths and Difficulties Questionnaire), and motivation (Dimensions of Mastery Questionnaire) were assessed. Results Participants exhibited impaired motor (43.5%), behavioral (23.7%), and cognitive (29.9%) development. The most intense participation was in social (mean [SD] 3.3 [0.99]) and recreational (2.9 [0.80]) activity types on the CAPE. Male sex (p<0.05) and younger age were associated with greater physical activity (<15y: 1.87; ≥15y: 1.31, p<0.05). Greater engagement in social activities was related to better cognition (r=0.28, p<0.05), higher motor function (r=0.30–0.36, p<0.01), and fewer behavioral difficulties (r=−0.32 to −0.47, p<0.01). Cognitive ability (r=0.27, p<0.05), dexterity and aiming/catching (r=0.27–0.33, p<0.05), and behavior problems (r=0.38–0.49, p=0.001) were correlated with physical activity participation. Persistence in tasks, an aspect of motivation, correlated with physical (r=0.45, p<0.001) and social activity involvement (r=0.28, p<0.05). Interpretation Ongoing developmental impairments in adolescents with CHD are associated with decreased active‐physical and social engagement, putting them at risk of poor physical and mental health. Health promotion strategies should be considered. What this paper adds Adolescents with congenital heart defects (CHD) have limited engagement in active‐physical leisure activities. Cognitive, motor, and behavioral impairments are associated with decreased participation in leisure in children with CHD. Female sex and older age are associated with less engagement in leisure. Mastery motivation correlates with participation, suggesting an avenue for intervention.
... In this study, self-esteem was also related to QOL, replicating other research [39]. Children with CHD have demonstrated compromised self-esteem [39,40], which warrants attention because positive self-concept has been shown to be associated with resilience across chronic illness conditions [41]. ...
Article
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The purpose of this prospective multi-center cross-sectional study was to identify key biopsychosocial factors that impact quality of life (QOL) of youth with congenital heart disease (CHD). Patient-parent pairs were recruited at a regular hospital follow-up visit. Patient- and parent-proxy-reported QOL were assessed using the Pediatric Cardiac Quality of Life Inventory (PCQLI). Wallander’s and Varni’s disability-stress coping model guided factor selection, which included disease factors, educational impairment, psychosocial stress, child psychological and parent/family factors. Measures utilized for these factors included the Pediatric Inventory for Parents, Self-Perception Profile for Children/Adolescents, Child Behavior Checklist, Revised Children’s Manifest Anxiety Scale, Child PTSD Symptom Scale, State-Trait Anxiety Inventory, and Posttraumatic Diagnostic Scale. Ordinary least squares regression was applied to test the theoretical model, with backwards stepwise elimination process. The models accounted for a substantial amount of variance in QOL (Patient-reported PCQLI R² = 0.58, p < 0.001; Parent-proxy-reported PCQLI R² = 0.60, p < 0.001). For patient-reported QOL, disease factors, educational impairment, poor self-esteem, anxiety, patient posttraumatic stress, and parent posttraumatic stress were associated with lower QOL. For parent-proxy-report QOL, disease factors, educational impairment, greater parental medical stress, poorer child self-esteem, more child internalizing problems, and parent posttraumatic stress were associated with lower QOL. The results highlight that biopsychosocial factors account for over half the variance in QOL in CHD survivors. Assessing and treating psychological issues in the child and the parent may have a significant positive impact on QOL.
... In overall terms, this means that in the school environment, there is a decline in grades in academic skills related to reading and arithmetic (Wray and Sensky 2001). Th e child's psychological development is also aff ected: there are behavioral and emotional problems (insecurity, shyness and low self-esteem, among other problems) ( Chen et al. 2006). Research shows the need to consider the impact of this pathology in the psychological, social and pedagogical fi elds. ...
Article
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Internationalization of higher education is becoming an important topic for studies in educational research. For the most part, these studies have been done in the context of economically developed countries that are traditional exporters of higher education. The present study is different. First of all, it was conducted in a public university in Malaysia, a developing country and a net importer of higher education. Secondly, it focused on the attitudes of the host country students towards their international peers, which has been a less explored area in educational research. The findings of this exploratory study revealed that despite an overwhelmingly positive attitude towards the international students expressed by the respondents, social and academic-related interactions between the local and foreign students were almost non existent. The study gives some recommendations for institutional policy improvement and highlights some directions for future research.
... A moderate-to-vigorous PA (MVPA) which refers to the amount of energy using more than six metabolic equivalents of a task (MET) by the body during PA, has positive effects on physiological improvement and emotional-psychosocial and cognitive development. 4 In children with CHD, MVPA affects emotional-psychosocial-cognitive development by enhancing their perception of self or self-concept 8 , social skills, and academic achievements 9 . In cases of physical inactivity or sedentary behavior, children have high risk of cardiovascular disease and obesity later. 2 Despite the international recommendation of PA, children after having completely corrected CHD are less active than children without CHD. ...
... Einarson & Arthur 2003), Korea (e.g. Tak & McCubbin 2002), Sweden (Morelius et al. 2002), Taiwan (Chen et al. 2004(Chen et al. , 2005, Thailand (Srichantaranit et al. 2010), Turkey (Yildiz et al. 2009) and the USA (e.g. Uzark & Jones 2003, Brosig et al. 2007a, 2007b, Uzark et al. 2008 have identified numerous challenges for children with CHD and their families. ...
Article
Aim: To report a grounded theory study to describe the process of parenting young children who have survived hypoplastic left heart syndrome to inform parent-focused interventions. Background: Technological advances in paediatric cardiology worldwide have improved the survival rates for young children with hypoplastic left heart syndrome who undergo staged surgical palliation. These children, however, are at risk for life-threatening complications and parents are charged with the responsibility to monitor their children at home with minimal support and guidance from healthcare professionals once home. Design: A constructivist grounded theory study. Method: The study was conducted in 2006-2008. Participants were 25 parents (15 mothers, 10 fathers) and 28 grandparents (17 grandmothers, 11 grandfathers) of 15 young children (6 months-4·5 years) who had undergone the Sano surgical approach for hypoplastic left heart syndrome. The 53 interviews were digitally recorded, transcribed and analysed using open and focused coding, constant comparative analysis and memoing. Findings: A process of Parenting under Pressure emerged that was characterized by four overlapping and re-emerging phases: (1) realizing and adjusting to the inconceivable; (2) growing increasingly attached; (3) watching for and accommodating the unexpected; and (4) encountering new challenges. Conclusions: In-depth understanding of the phases of Parenting under Pressure provides direction for nurses to support parents of children who survive hypoplastic left heart syndrome. Interventions that help carers of children with complex health conditions move through the phases of our Parenting under Pressure process may help them safeguard the survival of their children, and their own survival as parents as they manage multiple demands.
... 14 A more recent study confirmed this significantly lower physical self-concept in CHD children compared to healthy children, but found no group differences in family, school, appearance, and emotional and general self-concept. 15 Although these studies resolved many challenges, they do contain some limitations. The medical and surgical treatments used in adolescent and adult patient samples are different from the techniques used at present. ...
Article
We sought to combine parental and child reports in order to describe the behavior, self-perception, and emotional profile of children with a surgically corrected congenital heart disease (CHD). Forty-three children with a surgically corrected CHD were selected and compared to an age- and sex-matched healthy group. The parents of the CHD children completed a behavior rating scale, the Child Behavior Checklist. Children 8 years and older (n = 23) completed a self-report questionnaire concerning perceived competence, their anxiety level, and feelings of depression. Compared to parents of healthy children, those of CHD children report significantly lower school results (p < .01), more school problems in general (p < .01), and a higher percentage of their children repeated a school year (p < .01). They also reported more social (p < .01) and attention problems (p < .01) and more aggressive behavior (p < .05). On self-perception and state anxiety questionnaires, no significant differences were found between the patient group and the healthy group. On a depression scale, however, children with a surgically corrected CHD reported more depressive feelings than healthy controls (p < .01). Parents of children with CHD rate their child's school competence to be weaker than healthy peers, they report more attention and social problems and more aggressive behavior. Children themselves did not report differences on perceived competence or anxiety but they do indicate more depressive symptoms than healthy peers.
Article
Die Operation am offenen Herzen bei Kindern mit einem kongenitalen Herzvitium stellt eine besondere Belastung im Leben betroffener Familien dar. Diese Arbeit untersucht die psychische Anpassung und Lebensqualität bei jenen Kindern anhand eines systematischen Überblicks zu Langzeitstudien nach der Operation an der Herz-Lungenmaschine. Allgemeingültige Schlussfolgerungen des Reviews wurden durch die Vielfalt methodischer Ansätze erschwert. Dennoch zeigt die Analyse ein erhöhtes Risiko für psychische Fehlanpassung, insbesondere internalisierende Verhaltensschwierigkeiten, in dieser Patientenpopulation. Ein zweiter Schwerpunkt dieser Arbeit beruht auf der Untersuchung von Stressreaktionen betroffener Eltern im Zusammenhang mit der Herzoperation ihres Kindes, operationalisiert durch physiologische und psychologische Merkmale. In einer prospektiven Kohortenstudie wurden die Cortisolsekretion und die posttraumatische Belastungssymptomatik vor und nach der Operation untersucht. Bedeutsame Veränderungen wurden für beide Parameter im Zusammenhang mit der Operation beobachtet. Des Weiteren wurden Risikofaktoren für das Entwickeln einer posttraumatischen Belastungssymptomatik identifiziert. Die Ergebnisse der Studie verdeutlichen den dringenden Bedarf für das Angebot einer systematischen psychosoziale Unterstützung, für einen Teil der betroffenen Familien, um das Wohl der Eltern, der Familie und nicht zuletzt die bestmögliche Entwicklung des operierten Kindes zu sichern. The event of open-heart surgery in children to correct for congenital heart defects is a source of great distress to the lives of affected families. The present thesis focussed on the psychological adjustment and the quality of life in these children by systematically reviewing the empirical literature on long-term outcome in children following cardiopulmonary bypass surgery. Final conclusions of the review were hampered by the heterogeneity across methodological approaches. Nevertheless, the increased risk of psychological maladjustment, i.e. in particular for internalising behavioural difficulties, in this patient population emerged from the analysis. A second emphasis of this thesis was placed on the assessment of surgery-related stress reactions in parents of children after open-heart surgery by physiological as well as psychological means. Findings were based on a prospective cohort study evaluating the diurnal cortisol secretion and posttraumatic stress symptoms in parents before and after surgery. Thus, significant changes in response to the surgical event were observed for either parameter. In addition, risk factors for posttraumatic stress symptoms were identified. Altogether, results of the study highlight the urgent need for systematicpsychosocial support to families experiencing heart surgery in their child to benefit long-term parental well being, family functioning and finally, to ensure optimal development of the operated child.
Chapter
More than 25% of children with CHD are overweight [1–3].
Thesis
Door een enorme vooruitgang in de pediatrische hartheelkunde over de laatste 35 jaren, worden we geconfronteerd met een steeds groter wordende groep kinderen met een aangeboren hartafwijking (AHA). Ondanks de toegenomen overlevingskansen, blijft morbiditeit echter een grote zorg. Aangeboren hartafwijkingen worden immers geassocieerd met neurologische tekorten en een ontwikkelingsachterstand. De mid-term functionele status van het kind blijft tot hiertoe echter onbekend. We onderzochten het neuropsychologische profiel, het gedrag, de emotionele beleving en zelfperceptie van kinderen met een chirurgisch gecorrigeerde AHA 6 tot 12 jaar postoperatief door ze te vergelijken met een gezonde controlegroep. We weerhouden bij kinderen met een AHA een neuropsychologisch profiel dat voornamelijk milde motorisch tekorten vertoont alsook discrete taalproblemen. Aandacht -en executief functioneren, mede als het geheugen blijken, hoewel in mindere mate, eveneens betrokken. Ouders van kinderen met een AHA beschrijven hun kinderen als minder schoolbekwaam, ze halen minder goede schoolresultaten en het overdoen van een schooljaar komt meer voor in deze groep. Op een cognitieve klachtenlijst rapporteren de ouders van AHA kinderen meer aandacht- en geheugenproblemen, alsook een minder goede grove motoriek. Op gebied van gedrag vertonen deze kinderen volgens hun ouders meer sociale en aandachtsproblemen, en eveneens meer agressief gedrag. Uit zelfrapportering door de kinderen leiden we af dat er geen verschil is in het zelfconcept van de kinderen met AHA ten opzichte van gezonde controlekinderen op gebied van schoolse vaardigheden, sociale aanvaarding, sportieve vaardigheden en met name motoriek, uiterlijk, gedrag en zelfwaardering. Ze rapporteren geen verhoogde angst, maar wel meer depressieve symptomen dan gezonde controlekinderen. Deze beschrijving van de volledige functionele status van kinderen met een chirurgisch gecorrigeerde AHA 6 tot 12 jaar postoperatief, biedt mogelijkheden om gespecialiseerde interventies op te zetten aangepast aan de noden van het kind en de familie. Op deze manier kan de functionele status van het kind verbeteren. De oorzaak van deze functionele tekorten moet verder worden bestudeerd en moet zowel pre-, peri- als postoperatieve variabelen opnemen. Hoogst waarschijnlijk veroorzaakt een combinatie van factoren negatieve resultaten op langere termijn. De studie bekrachtigt ook het gebruik van ouderlijke vragenlijsten en wijst op de nood aan een multidisciplinaire aanpak van de follow-up van kinderen met een AHA. Enkel op deze manier kunnen problemen vroeg worden geïdentificeerd en aangepakt wat zal leiden tot een verbeterde levenskwaliteit bij kinderen met AHA.
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The objective of this study is to identify the socio-educational needs in childhood with congenital heart disease. Our study was carried out using a multi-method, it combines quantitative and qualitative data collected in Catalonia (Spain). The results obtained from the questionnaires and interviews with education professionals, children with congenital heart disease and their families have enabled us to establish categories. Analysis of these has provided knowledge of their socio educational needs. This article highlights the need to consider this impact as well as its psychosocial and educational effect, and the need to focus school education on improving their quality of life.
Article
Background:Due to medical advances, most children with congenital heart disease (CHD) are expected to survive into adulthood. Establishing adequate physical self-concept and cardiopulmonary tolerance during the adolescent period can primarily enhance overall well-being.Aim:The purpose of this study was to undertake a gender-specific evaluation of the domain of physical self-concept among adolescents with mild CHD, and to examine the relationships between physical self-concept and cardiopulmonary exercise tolerance among adolescents with mild CHD.Methods:Four hundred and thirteen adolescents 12-20 years of age, whose cardiologists had not recommended any limitation of exercise, completed Physical Self-Description Questionnaires and three-minute step tests in two outpatient cardiology departments.Results:The male participants had significantly greater scores in measures of overall physical self-concept, competence in sports, physical appearance, body fat, physical activity, endurance, and strength than did the female participants. More than 80% of the participants had at least an average cardiopulmonary exercise tolerance index. The perception of not being 'too fat' and being more physically active were significant correlates of better cardiopulmonary exercise tolerance for adolescents with mild CHD.Conclusions:The results provided evidence for gender-specific evaluation of domains of physical self-concept among adolescents with mild CHD. The three-minute step test to measure cardiopulmonary exercise tolerance in adolescents with mild CHD may be an appropriate objective measure for use in future research. Continued efforts are needed in early intervention to promote cardiopulmonary exercise tolerance.
Article
This review addresses selected aspects of the functional morbidities observed at school-age and older in children with congenital heart disease. Although intelligence is not severely impaired, these patients are at increased risk of impairments in speech and language (including pragmatic skills), visual–spatial skills, executive functions, attention, and motor skills. Most patients achieve good psychosocial outcomes, although, by parent and teacher ratings, a substantial percentage is at increased risk. There might be sex differences and age-related changes in risk. Patients tend to rate their own behavior as similar to that of controls. Some data suggest that these patients have deficits in social cognition, specifically “theory of mind” skills. In terms of adaptive functioning, some children with congenital heart disease experience difficulties in activities of daily living, including maintaining adequate academic progress. Parents and others tend to rate the patients' quality-of-life less favorably than that of control populations, although the patients themselves often do not. A relatively neglected topic is the impact of a child with congenital heart disease on the well-being of parents and the family.
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The article is a summary of the extensive research into a technical competence and technical profession preference of the senior primary grades. In total 1650 pupils from 6th, 7th and 8th classes of Moravian Silesian Region of the Czech Republic participate on the survey. The standard psychodiagnostic methods were used. In addition, a new method for measurement of technical and practical comprehension was created. Our results show, that there is no differences between girls and boys in intellectual abilities within the frame of single subtests. However statistically significant differences only appear in psychomotor tempo kills and visual perception in favor of girls. Boys have got higher performance in test of the technical and practical understanding.
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This case report described an experience using therapeutic play in the care of a school-age living donor liver transplant recipient. A first intervention employed playing the patient's favorite game in order to create a therapeutic relationship. The author then introduced therapeutic play elements into the game to observe the patient's personal health behaviors, evaluate patient perception of hospitalization and assess the knowledge of self-care protocols. Therapeutic play was then used to raise patient familiarity with daily care specifics. The author found therapeutic play also helpful in persuading the patient to share deep feelings on the anxiety of separation from her parents while in the ICU. During the nursing process, the author recognized therapeutic play as an effective tool to communicate with children and improve treatment protocol compliance. The author recommends that nurses incorporate therapeutic play in clinical practice to reduce children's stress during hospitalization.
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The study aims to describe the clinical profile of the adult Fontan survivor and identify the worries, symptoms, and the impact of cardiac surveillance most commonly experienced. A descriptive, cross-sectional design was used. The study was performed in outpatient adult and pediatric cardiology clinics in university-affiliated and private practice offices. Fifty-four adolescent and adult patients with single ventricle congenital heart disease who have undergone the Fontan procedure participated in the study. The mean age was 26 ± 9 years with 52% female and 63% Caucasian. Demographic and clinical data were obtained by a standard intake form and retrospective chart reviews. The Congenital Heart Disease TNO/AZL Adult Quality Of Life questionnaire was completed to assess worries, symptoms, and the impact of cardiac surveillance. The majority were single (73%), employed or full-time students (93%), with health insurance (94%), had a single left ventricle (78%), the diagnosis of tricuspid atresia or double inlet left ventricle (59%), lateral tunnel Fontan type (44%), history of arrhythmias (76%), left ventricle ejection fraction percentage >50 (66%), oxygen saturations >90% (70%), frequent headaches (50%), scoliosis (22%), varicose veins, ascites, and liver cirrhosis (46%), normal body mass index (59%), and New York Heart Association class I (48%) and II-III (52%). Primary worries related to current health (83%), job/employment (69%), ability to work, (61%) and living independently (54%). The most bothersome symptoms were shortness of breath with ambulation (69%), dizziness (61%), and palpitations (61%). Fontan survivors experience residua and sequelae from multiple surgical procedures and the natural disease course. Our results support the need for ongoing assessment of both physical symptoms and psychosocial concerns, and suggest the need for multiple risk factor intervention strategies that improve physical and emotional health in Fontan survivors.
Article
  The objectives of this study were to evaluate and compare differences in self-concept between male and female adolescents with congenital heart disease, and to compare the self-concepts of these adolescents to that of the general adolescent population using normative data.   A total of 300 adolescents, 143 male and 157 female, from two medical centers in Taiwan completed the Tennessee Self-Concept Scales and the scores of male and female subjects were compared. The scores of adolescents with congenital heart disease were also compared with normative data of healthy Taiwanese adolescents.   Girls with congenital heart disease showed significantly lower mean scores in Physical Self, Social Self, Personal Self, Academic Self and Overall Self domains on the Tennessee Self-Concept Scales when compared to boys with congenital heart disease. When compared to the average value of normative data, adolescent boys with congenital heart disease had significantly higher mean T-scores on Physical Self, Family Self, Social Self, Personal Self, Academic Self and Overall Self, and adolescent girls had significantly higher mean T-scores in Moral-ethical Self, Social Self, Personal Self, Academic Self and Overall Self domains. There were weak negative correlations between severity of congenital heart disease and Physical Self T-scores, and between the number of heart operations and Academic T-scores.   Self-concept in adolescents with congenital heart disease is similar to or even higher than that of their normal counterparts. More holistic views of adolescents with congenital heart disease, including their self-concept, appear warranted, especially for adolescent girls with congenital heart disease.
Article
Obesity among North American youth has risen to epidemic levels and is expected to result in costly and burdensome health problems, most notably type 2 diabetes mellitus and premature coronary artery disease. In the 2001–2002 National Health and Nutrition Examination Survey survey, 31% of children aged 6 to 19 years were overweight, defined as body mass index (BMI) at the 85th to 95th percentile, or obese (BMI ≥95th percentile).1 Recent research indicates that a significant portion of children with congenital heart disease (CHD) are also obese or overweight.2 Although much has been written on obesity prevention and management of children with normal hearts,3 little is known about how children with CHD will be affected. The National Heart, Lung, and Blood Institute convened a Working Group (WG) on obesity and other cardiovascular risk factors in congenital heart disease in May 2009 to address knowledge gaps, challenges, and opportunities related to research, policies, and the clinical care of children born with CHD who also have or are at risk for obesity and other cardiovascular risk factors.4 The WG was composed of individuals with expertise in pediatric obesity and pediatric cardiology with the goals of summarizing the existing evidence on obesity and cardiovascular risk prevention and treatment in the CHD population, raising awareness of missing data, and presenting data from “healthy” children with potential applicability to children with CHD. In this report, we discuss the prevalence of obesity, potential etiological factors, possible sequelae, and obesity and cardiovascular risk management and treatment in patients with CHD. The recommendations of the WG are presented. There are no longitudinal data on weight trends in children with CHD, and only recently have concerns been raised about obesity. In 2005, Stefan et al5 demonstrated that children with CHD whose activities are restricted are …
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This paper examines the hitherto mostly unrecognised relationship between gender, health and children; its significance for nursing practice and how it has been considered in nursing research. Holistic nursing practice with children requires adequate assessment and consideration of all potential influences on children's lives. Socioeconomic disparities have received widespread attention and gender inequalities in adult health have been studied in some depth. The links between gender, health and children, however, have received little consideration. The paper first considers this context in depth; it then applies the context to research in practice. Systematic review. A systematic literature search was undertaken on four mainstream nursing research journals over 38 months up to February 2007. A total of 567 articles met the key word searches. Duplicates, opinion pieces and articles not focusing on children were removed. The remaining 23 nursing studies relevant to child health were examined for their gender sensitivity. Full consideration of gender issues was found largely to be absent in nursing research on children. Eight studies gave specific consideration to gender relevance, where boys and girls may have responded differently to care. Only six studies specifically addressed gender sensitivity. Allowing children a voice, however, was a strength in these studies, with 18 reflecting children's views directly. Major gaps still exist in research and theorisation relating to children, health and gender. These need to be acknowledged and investigated, particularly in relation to how they might impact on nursing care. Nursing practice and research needs to account for all potential health issues, of which gender may often be important.
Article
To measure quality of life in children with hypoplastic left heart syndrome and their families. A questionnaire exploring socioeconomic status, structure and function of networks and psychological well-being was completed by the families of all 18 patients older than 2 years (age range 2.7-10.6). The results were compared with those of 180 healthy Swedish children matched for age and sex. There were no significant differences between the groups in any of the aspects of socioeconomic status. Study group parents had not more available time for their child (p < 0.05) and more separations/divorces (p < 0.01). The patients had lower self-esteem (p < 0.05), more psychosomatic symptoms (p < 0.01) [corrected] and lower peer acceptance (p < 0.01) than control children. With regard to psychological well-being, quality of life was significantly lower in children with hypoplastic left heart syndrome than in healthy controls.
Article
To evaluate and compare the health-promoting behavior of adolescents with congenital heart disease (CHD) to that of adolescents without CHD. Cross-sectional data were collected from pediatric cardiology outpatient departments at two medical centers in Taiwan. A total of 1209 adolescents, including 316 with various forms of CHD and 893 without CHD, completed the Adolescent Health Promotion (AHP) scale. Of those with CHD, 162 were female, and 12-18 years old. The scores of adolescents with CHD were compared with published normative adolescent data. No significant differences were found between those adolescents with CHD and those without in terms of dimensions of the AHP, which consisted of nutrition, social support, health responsibility, life appreciation, exercise, stress management, and overall health-promoting behavior. The three highest and lowest mean scores of scale items between these two groups were identified. Factors among adolescents with CHD, such as age, gender, parental educational level, and cardiac function were significantly associated with at least one dimension of the AHP. Such significant associations were not indicated when comparing body mass index, medical diagnoses, and whether they had undergone heart surgery. Adolescents with CHD practice health-promoting behavior similar to that of their counterparts without CHD. Health-promotion counseling for adolescents with CHD should be encouraged to improve lifestyle habits, especially to ensure that they engage in adequate and vigorous exercise and practice good dental hygiene.
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This study is the first to empirically validate the social self-concept component of the R. J. Shavelson, J. J. Hubner, and G. C. Stanton (1976) model. The primary purpose was to test for each of 3 age groups—preadolescents (Grade 3), early adolescents (Grade 7), and late adolescents (Grade 11)—3 hypotheses bearing on the structure of social self-concept within the context of this model: (a) that it is multidimensional, (b) that it is hierarchically ordered, and (c) that it becomes increasingly differentiated with age. Given evidence of a hierarchical social self-concept structure, a secondary focus of the study was to determine the extent to which this pattern held across age. On the basis of the analysis of covariance structures within the framework of confirmatory factor analysis, results revealed a multidimensional social self-concept structure that becomes increasingly differentiated and a hierarchical ordering that becomes better defined with age. Overall, findings were consistent with both the R. J. Shavelson et al. (1976) conceptualization of self-concept structure and developmental processes that underlie self-concept formation.
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Although the study of self-concept has been a topic of great interest and much study in the social sciences for many decades, it is really only in the past 30 years that any fruitful expansion in knowledge of both its theoretical structure and its related measurement has been forthcoming. From three perspectives-past, present, and future-the author presents abbreviated and selected highlights of important construct validity findings related to this research and postulates possible trends and areas of self-concept research yet to be explored.
Article
Full-text available
This study is the first to empirically validate the social self-concept component of the R. J. Shavelson, J. J. Hubner, and G. C. Stanton (1976) model. The primary purpose was to test for each of 3 age groups--preadolescents (Grade 3), early adolescents (Grade 7), and late adolescents (Grade 11)-3 hypotheses bearing on the structure of social self-concept within the context of this model: (a) that it is multidimensional, (b) that it is hierarchically ordered, and (c) that it becomes increasingly differentiated with age. Given evidence of a hierarchical social self-concept structure, a secondary focus of the study was to determine the extent to which this pattern held across age. On the basis of the analysis of covariance structures within the framework of confirmatory factor analysis, results revealed a multidimensional social self-concept structure that becomes increasingly differentiated and a hierarchical ordering that becomes better defined with age. Overall, findings were consistent with both the R. J. Shavelson et al. (1976) conceptualization of self-concept structure and developmental processes that underlie self-concept formation.
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A sample of children in Shanghai, P.R. China, initially aged 10 and 12 years, participated in this 2-year longitudinal project. Information on academic achievement and indexes of social adjustment, including social competence, aggression, social inhibition, leadership, and peer acceptance, was collected from multiple sources. It was found that academic achievement predicted children's social competence and peer acceptance. In turn, children's social functioning and adjustment, including social competence, aggression-disruption, leadership, and peer acceptance, uniquely contributed to academic achievement. These results generally supported the "reciprocal effects" model concerning the relations between academic achievement and social adjustment (S. P. Hinshaw, 1992).
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This theoretical integration of social psychology's main cognitive and affective constructs was shaped by 3 influences: (a) recent widespread interest in automatic and implicit cognition, (b) development of the Implicit Association Test (IAT; A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz. 1998), and (c) social psychology's consistency theories of the 1950s, especially F. Heider's (1958) balance theory. The balanced identity design is introduced as a method to test correlational predictions of the theory. Data obtained with this method revealed that predicted consistency patterns were strongly apparent in the data for implicit (IAT) measures but not in those for parallel explicit (self-report) measures. Two additional not-yet-tested predictions of the theory are described.
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Cognitive achievement, behavioural problems, and various dimensions of personality were assessed in 48 male and female patients with congenital heart disease (CHD) aged from 12 to 16 years in comparison to a control group. The CHD group showed a lower speed of cognitive processing but seemed to have less state-anxiety and to possess a higher superego strength. Male adolescents with CHD presented with a reduced perceived capacity and self-esteem. This was not true for adolescent girls with CHD. The negative self-concept of boys with CHD may be partly explained by reduced physical ability interfering with peer relationships.
Article
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Theoretical models suggest that 4- and 5-year-old children should be able to differentiate between multiple dimensions of self-concept, but empirical support is limited. A new 38-item Self Description Questionnaire for Preschoolers (SDQP) that measures 6 self-concept factors (Physical, Appearance, Peers, Parents, Verbal, and Math) was developed and tested. Through an individual-interview procedure, young children (4.0-5.6 years) completed the SDQP and achievement tests. The self-concept scales were reliable (.75-.89), first-order and higher order confirmatory factor analysis models fit the data, and factor correlations were mostly moderate (-.03-.73; Mdn = .29). Achievement test scores correlated modestly with academic self-concept factors (rs = .15-40) but were nonsignificantly or significantly negatively related to nonacademic self-concepts. The results contribute to the critical debate about the validity of self-reports for preschool children, who distinguished between multiple dimensions of self-concept at an even younger age than suggested by previous self-concept research.
Article
: Congenital heart disease includes a variety of malformations or defects arising during fetal development that affect the heart and major vessels. Because of improved diagnostics and therapy, infants who would otherwise have died soon after birth are surviving to adulthood and living longer, more productive lives. This growing population requires specialized care from advanced clinical nurses who understand these patients' unique concerns and needs. [Dimens Crit Care Nurs 2000:19(1):2-15]
Article
The goal of this study was to determine the relative impact of family background, parental attitudes, peer support, and adolescents' won attitudes and behaviors on the academic achievement of students from immigrant families. Approximately 1,100 adolescents with Latino, East Asian, Filipino, and European backgrounds reported on their own academic attitudes and behaviors as well as those of their parents and peers. In addition, students' course grades were obtained from their official school records. Results indicated that first and second generation students received higher grades in mathematics and English than their peers from native families. Only a small portion of their success could be attributed to their socioeconomic background; a more significant correlate of their achievement was a strong emphasis on education that was shared by the students, their parents, and their peers. These demographic and psychosocial factors were also important in understanding the variation in academic performance among the immigrant students themselves.
Article
The goal of this study was to determine the relative impact of family background, parental attitudes, peer support, and adolescents' own attitudes and behaviors on the academic achievement of students from immigrant families. Approximately 1,100 adolescents with Latino, East Asian, Filipino, and European backgrounds reported on their own academic attitudes and behaviors as well as those of their parents and peers. In addition, students' course grades were obtained from their official school records. Results indicated that first and second generation students received higher grades in mathematics and English than their peers from native families. Only a small portion of their success could be attributed to their socioeconomic background; a more significant correlate of their achievement was a strong emphasis on education that was shared by the students, their parents, and their peers. These demographic and psychosocial factors were also important in understanding the variation in academic performance among the immigrant students themselves.
Article
A correlational descriptive study was conducted to investigate self-concept and selected influencing factors among hospitalized Chinese school-age children with a chronic illness. The purposive sample was composed of 122 school-age children with chronic illnesses, such as nephrotic syndrome, leukemia, and congenital heart disease, who were admitted to three major teaching hospitals in Shanghai City. The children's medical records, demographic forms, and the Piers-Harris Self-concept Scale (PHSCS) were used to collect the data. Descriptive statistics, and stepwise multiple regression were used to analyze the data utilizing the SPSS program (SPSS Inc, Chicago, IL, USA). The results of this study showed that the majority of hospitalized Chinese school-age children with a chronic illness had at least an average level of self-concept. Academic achievement (grade point average) was a strong predictor of self-concept, as are most of its subconcepts, including social behavior, academic competence, and physical appearance and attributes. Age was a significant predictor of overall self-concept, social behavior, and popularity subconcept. Sex was a significant predictor of self-concept subconcepts such as social behavior, anxiety, and popularity. Duration of illness was a significant predictor of physical appearance and attributes. In addition, the type of illness was a significant predictor of popularity. It can be concluded that the importance of school education should be emphasized by hospital and school nurses for the purpose of helping such children build a positive self-concept concerning their age, sex, academic achievement, type of illness, and duration of illness. Recommendations for further research have been suggested.
Article
Congenital heart disease includes a variety of malformations or defects arising during fetal development that affect the heart and major vessels. Because of improved diagnostics and therapy, infants who would otherwise have died soon after birth are surviving to adulthood and living longer, more productive lives. This growing population requires specialized care from advanced clinical nurses who understand these patients' unique concerns and needs.
Article
This study examined the following: (1) the knowledge children with and without congenital heart disease have about their internal bodies, (2) the relationship of this knowledge with age, disease severity, and previous health care experiences, and (3) how the differences between beliefs about the interior body and the value assigned to specific body parts differed between children with congenital heart disease and their unaffected peers. One hundred participants, 50 with cardiac disease and 50 comparisons, between 5 and 15 years of age, completed the inside the Body Test; the severity of the conditions of the children with cardiac problems was evaluated with the Permanent Impairment Evaluation Guide. Results indicated that there were no differences between the 2 groups on knowledge of body parts, body-part function, nor the values that were assigned. Implications for practice are discussed.
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To investigate the relationship of demographic asthma, family, and child factors with self-concept in children with asthma. Data were collected twice approximately 4 years apart from both the affected children and their mothers (N = 134) via interviews and self-report questionnaire. Children who demonstrated more negative attitudes toward their illness, had less satisfaction with family relationships, and used more negative coping behaviors had the poorest self-concepts. Over time, the greatest improvement in self-concept occurred in children whose attitudes and satisfaction with family relationships improved and whose use of negative coping behaviors decreased. Results suggest that some children with asthma, especially girls with severe asthma, appear to be at risk for poor self-concept.
Article
Although the study of self-concept has been a topic of great interest and much study in the social sciences for many decades, it is really only in the past 30 years that any fruitful expansion in knowledge of both its theoretical structure and its related measurement has been forthcoming. From three perspectives--past, present, and future--the author presents abbreviated and selected highlights of important construct validity findings related to this research and postulates possible trends and areas of self-concept research yet to be explored.
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