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Parental Mental Health Moderates the Efficacy of Exercise Training on Health-Related Quality of Life in Adolescents with Congenital Heart Disease

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Abstract

To evaluate the moderating influence of parental variables on changes in health-related quality of life (HRQoL) in adolescents with Tetralogy of Fallot (ToF) or a Fontan circulation after participation in standardized exercise training. A multicenter randomized controlled trail in which 56 patients, aged 10–15, were randomly allocated (stratified by age, gender, and congenital heart disease) to a 12-week period with either: (a) 3 times per week standardized exercise training or (b) care-as-usual (randomization ratio 2:1). Adolescents and their parents filled in online questionnaires at baseline and at 12-week follow-up. In this randomized controlled trail, primary analyses involved influence of parental mental health and parental social support for exercise on changes in the TNO/AZL Child Quality of Life Questionnaire Child Form at follow-up. Secondary analyses concerned comparing levels of parental characteristics with normative data. Compared with controls, adolescents in the exercise group reported a decrease in social functioning when their parents had more anxiety/insomnia or severe depression themselves. Adolescents also reported a decrease in social functioning when their parents showed poorer overall mental health themselves. Parents reported comparable or even better mental health compared with normative data. The effect of a standardized exercise program on HRQoL changes in adolescents with ToF or a Fontan circulation is moderated by parental mental health, more specifically by parental anxiety/insomnia and severe depression. The trial registration number of this article is NTR2731 (www.trialregister.nl).

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Acknowledgments

The authors thank the children and their parents for participation in this RCT. K. Dulfer was supported by a research grant from Stichting Rotterdams Kinderrevalidatie Fonds Adriaanstichting. N. Duppen was sponsored by a research grant from Netherlands Heart Foundation (2008B026).

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children’s Hospital, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands

    Karolijn Dulfer, Frank C. Verhulst, Jan Van der Ende & Elisabeth M. W. J. Utens

  2. Department of Paediatrics, Division of Cardiology, Erasmus Medical Center - Sophia Children’s Hospital, Rotterdam, The Netherlands

    Nienke Duppen & Willem A. Helbing

  3. Department of Cardiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

    Arie P. J. Van Dijk

  4. Department of Pediatric Cardiology, Emma Children’s Hospital, Academic Medical Center, Amsterdam, The Netherlands

    Irene M. Kuipers

  5. Department of Cardiology - Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands

    Ron T. Van Domburg

Authors
  1. Karolijn Dulfer
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  2. Nienke Duppen
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  3. Arie P. J. Van Dijk
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  4. Irene M. Kuipers
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  5. Ron T. Van Domburg
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  6. Frank C. Verhulst
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  7. Jan Van der Ende
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  8. Willem A. Helbing
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  9. Elisabeth M. W. J. Utens
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Corresponding author

Correspondence to Elisabeth M. W. J. Utens.

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Dulfer, K., Duppen, N., Van Dijk, A.P.J. et al. Parental Mental Health Moderates the Efficacy of Exercise Training on Health-Related Quality of Life in Adolescents with Congenital Heart Disease. Pediatr Cardiol 36, 33–40 (2015). https://doi.org/10.1007/s00246-014-0961-z

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  • DOI: https://doi.org/10.1007/s00246-014-0961-z

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