Confidence is everything

Gerti G. / photocase.com

One child in every hundred is born with a congenital heart defect (CHD). Despite certain physical limitations and health problems, the majority have a good quality of life. Without doubt, medical progress plays a large part in this, but it is not the only factor. The confidence that these youngsters develop in their childhood and adolescence, their belief in their own ability to cope with the challenges of daily living, is equally important. Children and adolescents with congenital heart defects who are able to cultivate this faith in themselves and their environment ultimately experience a greater sense of well-being than those who do not.

Inner confidence improves quality of life

Self-confidence, assurance and joy in living are just some of the things parents try to instil in their offspring as they grow. These qualities are particularly important for children who suffer from chronic medical conditions, because their illness will accompany them throughout their lives and will, in many instances, limit their physical capabilities and cause them health problems. Children and teenagers with CHD are no exception.

“A good quality of life is based on a strong sense of coherence,” says Dr Bruno Neuner of the Institute for Epidemiology and Social Medicine at the University of Münster. This ‘sense of coherence’ is the feeling of confidence in him- or herself that a child develops in the early years, the trust in his or her own ability to cope with the vicissitudes of life. “A strong sense of coherence is vital to good physical and psychological health. It helps children to deal with their illness effectively,” explains Neuner. He and his team established this fact in a study conducted by the Competence Network for Congenital heart Defects and funded by the German Federal Ministry of Education and Research (BMBF).

Scientists questioned young people about their sense of coherence

The study into coherence and quality of life in adolescents with congenital heart defects (the CoalaH study) allowed scientists to collate and evaluate data supplied by 770 young people aged 14 to 17 and living with CHD. The study participants were sent two questionnaires 12 months apart. “We wanted to see if there was any correlation between their sense of coherence at the start of the study and their quality of life a year later,” says Neuner. “It transpired that an individual’s sense of coherence does appear to be an important factor when it comes to their well-being – and that includes children and adolescents with a chronic condition.”

Sport as a contributor to well-being

The study showed that irrespective of medical and social influences, children and teenagers who have a high sense of coherence generally feel better than their peers who score lower down the coherence scale. Sport appears to be particularly good at encouraging a strong sense of coherence: those study participants who played sport between one and five times a week scored highest of all.

“We believe that regular physical activity has a positive impact on both the sense of coherence and the quality of life of children and adolescents with CHD,” states Neuner. “Of course, the chosen sport should reflect the individual’s physical capabilities and should always be practised in consultation with a doctor.”

Prerequisites for a strong sense of coherence

A child will develop a strong sense of coherence provided three primary conditions are met:

• stable emotional and material circumstances,
• the possibility of being involved in decision-making, and
• an environment which demands neither too little nor too much of the youngster.

“Parents, teachers and treating physicians should make every effort to create this optimal environment, particularly for children who are living with chronic conditions,” advises Neuner.