Management strategies for children with congenital health diseases (CHDs) should encompass more than just the medical aspect of the disease and consider how heart diseases affect their everyday activities and, subsequently, their quality of life (QoL). Global studies witnessed a greater emphasis on studying the QoL associated with CHD. However, there is still a great lag in such data in the Arab region. The purpose of this study was to evaluate QoL in children with CHD using an Arab sample from Jordan. The specific objectives were twofold: (1) to contrast the assessments of children’s QoL reported by their parents with those reported by the children themselves, and (2) to assess the factors that influence the QoL of children with CHD.Dardas LA, Pan W, Hamdan AI, Abu Jabeh RAH, Eid Ashakhanba A, Sami Abdelhai O, et al. (2024) Quality of life in Arab children with congenital heart disease. PLoS ONE 19(1): e0290306. https://doi.org/10.1371/journal. pone.0290306
Multiple linear regression analysis was conducted to examine influencing factors of childrens QoL. Combined analysis for all ages was conducted to maximize predictive power. Besides age in years, the age group was also included in the model to account for the variation of QoL scores among age groups. In addition, the following variables were used as potential predictors: gender, disease type (cyanotic or not), disease severity, presence of learning difficulties, and parental education. Those predictors were selected based on the literature [22,23]. The regression analysis was conducted using two separate models: one for QoL scores reported by children (N = 62) and another for QoL scores reported by parents (N = 79).
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The results revealed that the children model could significantly predict children reported QoL scores (F(8, 53) = 4.96, p < .001), explaining 42.8% of the variance in the outcome (QoL scores). The second model using parent-reported QoL scores was also significant (F(8, 70) = PLOS ONE | January 18, 2024 7 / 13 PLOS ONE QoL in Arab children with CHD Fig 1. Self-reported and Parent-reported QoL scores for children with CHD. 3.31, p < .003) and could explain 27.4% of the variance in the outcome. Table 3 presents the estimated regression coefficients () with their standard errors (SE), p-values, and model fit statistics for the predictors of QoL scores reported by children and parents.
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Considering the individual betas, the results revealed that the childs age was negatively associated with QoL scores, although the effect was significant only for children-reported scores (p < .019) but not for parents-reported scores (p = .238). Being female was associated with lower QoL scores. The effect was also significant for children (p < .043) but not for parents (p = .183). Neither the presence of cyanosis nor disease severity showed a significant association with QoL scores reported by either children or parents. Having learning difficulties was associated with lower QoL scores. The effect was significant for both children-reported scores (p < .001) and parents-reported scores (p < .027). Fathers and mothers education Table 3. Estimated determinants of QoL from regression analysis. Estimate QoL Scores by Children (N = 62) QoL Scores by Parents (N = 79) SE p SE p
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Intercept 118.73 9.29 < .001 77.58 10.39 < .001 Age group (ordinal) Age (yrs) Gender (female vs. male) Cyanosis (yes vs. no) Severe disease (yes vs. no) Learning difficulties (yes vs. no) Fathers education (level) Mothers education (level) 18.00 2.95 6.26 1.14 3.64 14.34 .82 5.20 1.22 3.02 3.62 3.53 3.68 2.10 .001 .019 .043 .753 .308 < .001 .698 8.44 1.82 5.18 7.37 1.59 10.51 1.28 5.56 1.53 3.85 4.92 4.73 4.66 2.60 .134 .238 .183 .139 .739 .027 .623 1.14 1.83 .537 3.11 2.43 .205 Model fit (F, p; R2) F(8, 53) = 4.96, p < .001; 42.8% F(8, 70) = 3.31, p < .003; 27.4% PLOS ONE | January 18, 2024 8 / 13 PLOS ONE QoL in Arab children with CHD levels did not show significant associations with QoL scores reported by either children or parents.
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