HOW DOES THE INTERVENTION OF CARDIAC-SURGERY AFFECT THE SELF-PERCEPTION OF CHILDREN WITH CONGENITAL HEART-DISEASE

Background There is little published information about the self-percep tions of children with chronic physical diseases and the ways in which self-perceptions might change as a result of treatment. An innovative measure of self-perception is described, suitable for use by children of widely varying ages as well as by parents. Methods The instrument used assessed eight constructs contributing to self-perception, and al so measured differences between perceptions of actual and ideal self. Children (n = 31; age 5-15 years) with congenital heart disease (CHD) were assessed prior to surgery and 1 year post-operatively. Comparison s were made with children before and 1 year after bone marrow transpla ntation (BMT), and with healthy children. Results There were no differ ences between the groups in ideal self-perceptions, but the CHD childr en rated themselves as weaker, more frightened and more ill than the h ealthy group. Given the differences in symptomatology and illness expe rience of children with cyanotic and acyanotic lesions, surprisingly f ew differences emerged in the self-perceptions of these two groups, al though differences were found among younger and older children assesse d separately. Significant improvements were found in self-perceptions of the CHD and BMT groups following treatment, and at follow-up, no si gnificant differences remained between the CHD and healthy groups. In the latter, self-perception was largely unchanged between the two asse ssments. Conclusions Assessment of self-perception should be an integr al part of the assessment of health outcomes in childhood illness. The study demonstrated the significant improvement in self-perception fol lowing surgery for CHD. The results also support the validity, reliabi lity and sensitivity to change of the assessment measure.