Emotional and behavioral problems in preschool children after congenital heart disease surgery show significant heterogeneity, with two distinct subgroups identified, hyperactivity/inattention as the central symptom, and parenting stress and family hardiness independently associated with outcomes.
Latent profile analysis identified two distinct subgroups of emotional and behavioral problems among preschool children after congenital heart disease surgery.
Hyperactivity/inattention was the node with the highest strength centrality in network analyses of both the well-adjusted and maladjusted subgroups.
Parenting stress was independently associated with increased risk of emotional and behavioral problems in preschool children after congenital heart disease surgery.
Family hardiness was independently associated with a lower risk of emotional and behavioral problems.
Different dimensions of family hardiness showed different centrality across the two subgroups in network analysis.
Emotional and behavioral problems among preschool children after congenital heart disease surgery were described as prominent and highly heterogeneous.
This research suggests that young children (ages 3–6) who have had surgery for congenital heart disease do not all experience emotional and behavioral difficulties in the same way. By surveying 273 mothers, researchers found two distinct groups: a well-adjusted group (about 82% of children) and a maladjusted group (about 18% of children). Using a statistical method called network analysis, they found that hyperactivity and inattention were the most central or 'hub' symptoms in both groups, meaning these problems were most strongly connected to other emotional and behavioral difficulties regardless of which group a child belonged to. The study also found that the family environment plays an important role in children's outcomes. Mothers who reported higher parenting stress were more likely to have children in the maladjusted group, while families with greater 'hardiness'—a quality related to resilience and coping—were less likely to have children with emotional and behavioral problems. Interestingly, different aspects of family hardiness mattered for different groups: the sense of 'challenge' (viewing difficulties as opportunities) was most prominent in well-adjusted families, while the sense of 'control' (believing one can influence outcomes) was most prominent in the maladjusted group. This research suggests that interventions for this population might benefit from prioritizing early identification and management of hyperactivity and inattention, as these appear to be core symptoms. It also suggests that addressing parenting stress and supporting family resilience could be important targets for future programs designed to help children and families navigate life after congenital heart disease surgery.
Xu Q, Zhang X, Li Y, Liu J, Li M. (2026). Latent profiles and network analysis of emotional behaviors in preschool children after congenital heart disease surgery.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1914221