Quality of life is a multidimensional concept. The World Health Organization defines it as being based on the individual's value system, cultural background and one's own subjective feelings about life, and affected by the individual's expectations, standards, goals, and attention [9]. In the "Research on the Quality of Life of Special Populations", the research on the quality of life of children is ranked fifth [10]. The quality of life of children with CHD is determined in a variety of ways, including the children's psychological, life and social function status. Unlike the quality of life assessment methods for adults, because the growth and cognitive abilities of younger children are not yet perfect [11], medical staff can only make scientific and objective assessments of their physiological conditions, but parents can make extensive observations of their children's activities, which are more effective in evaluating their emotional and thinking conditions [12].
Children with CHD have poor blood transport efficiency due to cardiac insufficiency [13], resulting in weak gastrointestinal function and inadequate nutritional intake. In addition, such children have high energy consumption [14] and the nutritional demand is greater than the supply, leading to lagging growth and development and affecting their appearance. The study of Argent showed that the growth and development of children with CHD significantly lagged behind that of normal children [15]. The better the children’s development level, the better the quality of life. Therefore, it is necessary to increase postoperative nutritional support for children to improve their growth and development and to improve their quality of life.
Surgery is considered to be the most effective modality in the treatment of CHD [16]. After surgical treatment, Children with CHD have improved cardiac function and quality of life [17]. The results of this study showed that the parent-reported health-related quality of life scores and child self-rated quality of life scores of children in different age groups significantly improved after surgery, suggesting the success of surgical treatment. It also showed that the prognosis of children after surgical treatment was ideal, and the quality of life was improved.
In this study, there were no significant differences in the self-rated quality of life scores of children in different age groups, but the scores were slightly higher in the 5–7 years old group than in the 8–12 years old group. The reason is that there is a certain correlation between the quality of life and the level of children's growth and development [18]. 8–12 year olds have increased analytical and comprehension skills and have made significant psychological transitions during this period. Children's self-awareness increases with age [19], and they have higher quality of life requirements, so the self-rated quality of life scores are lower than in the lower age groups. In addition, the surgical level of surgeons is also one of the factors that affect the score [20]. Surgical techniques are advancing and aggressive surgical treatment in the early stages of the disease can lead to a higher quality of life [21]. At the same time, the quality of life is also affected by social and parental factors. The prognosis of children with a family income that can afford good treatment conditions and provide good nutritional conditions and a comfortable and safe living environment is better [22, 23]. Access to good social health maintenance services is also an important factor in improving the quality of life of children after surgery [24].
In adults, increasing the amount of exercise can improve their quality of life after CHD surgery [25]. Therefore, it is possible to explore the relationship between increased exercise and the quality of life of children with CHD after surgery [26, 27]. We should pay attention to the life, study, and work situation of this population, and promptly and effectively interventions with the children and their parents after the operation should be implemented to strengthen the children's coping ability and improve their quality of life.
With the continuous development of science, technology and medicine, more and more children with CHD will survive after surgery. At present, we have a basic understanding of the current situation of quality of life of postoperative children with CHD, but the lack of long-term follow-up observation makes the research results not deep and comprehensive. Therefore, it is necessary to carry out a long-term follow-up of the children and investigate the current situation of the children's life at different time periods after surgery in order to truly reflect the quality of life and its change process after surgery [28]. Meanwhile, we should strengthen the multicenter and multidisciplinary cooperation, and strive to improve the quality of life of children with CHD after surgery, so that they can better face various challenges in the future.
This study has some shortcomings. First of all, it was a retrospective study rather than a randomized controlled study. Therefore, the cases had certain deviations, but the results still have certain clinical significance. Secondly, this was a single-center study with a relatively small sample size and a follow-up time of only 6 months. Finally, this study was limited to specific patients who underwent surgery for CHD, other patients may have different results. Therefore, a multicenter, prospective and long-term study will be conducted in the future to determine the results of the study.