揭示儿童机会和医疗因素对学龄期危重先天性心脏病患者神经心理结局的影响。

IF 1.9 3区 心理学 Q3 CLINICAL NEUROLOGY
Kirsty L Coulter, Samantha van Terheyden, Rachel Richie, Mary T Donofrio, Jacqueline Sanz
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引用次数: 0

摘要

我们研究了病史和健康的社会决定因素在预测严重先天性心脏病(cCHD)儿童学龄智力(IQ)和执行功能(EF)中的作用。这是一项回顾性观察性研究,通过心脏神经发育项目参加神经心理学评估的197例cCHD患者(5-18岁)。以儿童机会指数(coi3.0)衡量的病史和健康的社会决定因素(SDOH)通过图表回顾获得。COI是学龄期IQ和EF的显著预测因子。癫痫发作史和遗传状况是IQ的预测因子;纳入COI改进了模型,预测了额外14%的方差。COI的教育子域反映了社区一级的教育资源,推动了这一效应。主动脉阻塞和癫痫发作史是父母报告EF的显著预测因素;纳入COI提供了适度的改善。只有COI被确定为基于绩效的EF的预测因子。健康的社会决定因素是cCHD儿童学龄功能的重要预测因素,在这一人群中促进积极的神经发育结果的努力必须考虑SDOH。学龄儿童智商与社区教育资源有关。这表明,在资源匮乏的社区,增加cCHD患者的教育机会可能会促进积极的神经发育并减少差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Unraveling the impact of child opportunity and medical factors on neuropsychological outcomes in school-age patients with critical congenital heart disease.

We examine the role that medical history and social determinants of health play in predicting school-age intellectual (IQ) and executive functioning (EF) in children with critical congenital heart disease (cCHD). This is a retrospective observational study of 197 patients with cCHD (age 5-18 years) who attended a neuropsychological evaluation through the Cardiac Neurodevelopmental Program. Medical history and social determinants of health (SDOH), measured by the Childhood Opportunity Index (COI 3.0), were obtained via chart review. COI was a significant predictor of school-age IQ and EF. Seizure history and genetic condition were predictors of IQ; inclusion of COI improved the model, predicting an additional 14% of the variance. The Education subdomain of COI, reflecting neighborhood-level educational resources, drove this effect. Aortic obstruction and seizure history were significant predictors of parent-reported EF; inclusion of COI provided modest improvement. Only COI was identified as a predictor of performance-based EF. Social determinants of health are important predictors of school-age functioning in children with cCHD, and efforts to promote positive neurodevelopmental outcomes in this population must consider SDOH. IQ at school-age is related to neighborhood educational resources. This suggests that enhancing educational opportunities in patients with cCHD in lower-resourced communities may promote positive neurodevelopment and reduce disparities.

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来源期刊
Child Neuropsychology
Child Neuropsychology 医学-临床神经学
CiteScore
4.10
自引率
9.10%
发文量
71
审稿时长
>12 weeks
期刊介绍: The purposes of Child Neuropsychology are to: publish research on the neuropsychological effects of disorders which affect brain functioning in children and adolescents, publish research on the neuropsychological dimensions of development in childhood and adolescence and promote the integration of theory, method and research findings in child/developmental neuropsychology. The primary emphasis of Child Neuropsychology is to publish original empirical research. Theoretical and methodological papers and theoretically relevant case studies are welcome. Critical reviews of topics pertinent to child/developmental neuropsychology are encouraged. Emphases of interest include the following: information processing mechanisms; the impact of injury or disease on neuropsychological functioning; behavioral cognitive and pharmacological approaches to treatment/intervention; psychosocial correlates of neuropsychological dysfunction; definitive normative, reliability, and validity studies of psychometric and other procedures used in the neuropsychological assessment of children and adolescents. Articles on both normal and dysfunctional development that are relevant to the aforementioned dimensions are welcome. Multiple approaches (e.g., basic, applied, clinical) and multiple methodologies (e.g., cross-sectional, longitudinal, experimental, multivariate, correlational) are appropriate. Books, media, and software reviews will be published.
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