Introduction: Congenital heart disease is the most common fetal disease and the second leading cause of death in infants and children. This study aimed to identify the key psychological and biological factors affecting the psychological outcomes of these children.
Methods: This study was correlational. The study’s participants included all children aged 8-12 years with congenital heart disease of cyanosis type and their mothers who referred to Shahid Rajaee Heart Hospital. A random sampling method was considered including 338 children and their parents. The Shallice (1982) Tower of London test, performed on children, and the Nolen-Hoeksema (1999) Rumination Response Scale and the Rutter (1967) Behavioral Scale, were answered by mothers, were used to collect data. The mothers of these children also answered two questions about the mother's perception of the severity of the illness and the severity of the child's physical limitations. The disease information was extracted from children's records. Data analysis was performed in SPSS-25 software using the stepwise multiple regression method.
Results: According to the results, maternal rumination, maternal perception, and severity of physical limitation predicted 16% of the child's anxiety/depression. Mother's rumination and child’s problem solving predicted 13% of the aggression/hyperactivity variable. Rumination and problem solving predicted 10% of antisocial behavior and 7% of child social maladaptation. Rumination predicted 8% of attention deficits and eventually hospitalizations predicted 2% of problem solving. Among these variables, maternal rumination of depression symptoms had the highest predictive power while the number of hospitalizations had the least predictive power.
Conclusion: Psychological factors, especially maternal factors, played a more crucial role in the psychological outcomes of children than the factors related to surgery.