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Title: Understanding psychological processes in determining outcomes for adults with congenital heart disease
Author: Mills, Rónán
ISNI:       0000 0004 6060 0606
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2016
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Neurodevelopmental delay in children with congenital heart disease (CHD) is well established, but the specific outcomes which result in the long term have not been delineated. The first part of this thesis, a systematic review, aimed to outline the known cognitive deficits associated with severe CHD in adolescents and adults. We reviewed 1016 articles, in Web of Science, MEDLINE, CINAHL Plus and Psychlnfo. Reference lists of relevant articles and reviews were hand-searched for additional reports. Reports of patients with chromosomal or genetic abnormalities were excluded. Papers reporting on standardised cognitive assessments in this population were synthesised, of which 18 unique samples were identified that facilitated a series of meta-analyses on 10 cognitive domains Heterogeneity indicated that underlying moderators in severe CHD affect cognitive outcomes and have yet to be elucidated in the literature, but which are likely to be clinically important for sub-groups and individuals. However, cognitive domains of particular concern have been highlighted for those with severe CHD, which may have a functional impact, should concern clinicians and guide future research. Data is lacking on outcomes for this population across the lifespan in domains such as employment, relationships and other psychosocial attainments. The second part of this thesis reports on a survey which evaluated adults with CHD on multiple common measures of attainment, comparing to normative data and comparing between disease subgroups. We also explored the contribution of self-perceptions and executive functioning to those attainment outcomes. Although many outcomes are comparable to norms, adults with CHD deviated from population norms with respect to interpersonal relationships. Findings suggested that neuropsychological factors and self-perceptions, rather than disease severity or psychopathology, predicted psychosocial attainment outcomes. Clinical implications are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psych) Qualification Level: Doctoral
EThOS ID:  DOI: Not available