High self-competence may act as a protective factor against lower quality of life in children with pacemakers

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A low sense of self-competence seems to contribute to decreased quality of life for paediatric patients with pacemakers, according to results of a study recently published in the Journal of Developmental & Behavioral Pediatrics.

“Self-competence may function as a protective factor against lower health-related quality of life in children with pacemakers,” write Ana M Gutierrez-Colina, University of Georgia, Athens, USA, and colleagues. They suggest that the growing number of young patients with pacemakers might benefit from interventions to help them feel more confident in social interactions and other areas of life.


The researchers administered a self-competence questionnaire to 27 children and adolescents with pacemakers. The patients, average age 13.5 years. Self-competence was defined as “how well an individual believes he or she generally functions” in various areas, such as academics and social life. The patients also completed evaluations of health-related quality of life, psychosocial adaptation, and behavioural and emotional problems.


Scores for self-competence were decreased for children with pacemakers, compared to healthy children. The patients had relatively large reductions in scores on all four questionnaire subscales: cognitive, social, physical, and general self-competence.


As the researchers hypothesised, patients with lower self-competence also had lower health-related quality of life. Low perceptions of social competence seemed particularly important, linked to lower scores in physical, social, psychosocial, and overall quality of life.


Gutierrez-Colina also found that self-competence was not strongly associated with psychological problems, such as depression or anxiety. Self-competence was also unrelated to behaviour problems.


Based on the study, higher self-competence may act as a “protective factor” against lower quality of life in children with pacemakers. The researchers write, “It is possible that children’s belief in their ability to successfully engage in a variety of activities, including social interactions, prepares them to better cope with the challenges that they may face as a result of their illness.”


Gutierrez-Colina and colleagues suggest that children with pacemakers might benefit from interventions aimed at enhancing their sense of self-competence. Children could be taught problem-solving skills to help them believe in their ability to succeed at school, in social situations, and in managing their health-ideally in a group setting, where they could meet and learn from peers with similar health conditions.

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