Latent profiles and network analysis of emotional behaviors in preschool children after congenital heart disease surgery.

BACKGROUND

Emotional and behavioral problems are prominent and highly heterogeneous among preschool children after congenital heart disease surgery, but their latent subgroup characteristics and core symptoms remain unclear. The associations between the family psychological environment (e.g., parenting stress, family hardiness) and children's emotional and behavioral outcomes also need further clarification.

OBJECTIVE

To identify heterogeneous subgroups and central symptoms of emotional and behavioral problems in preschool children after congenital heart disease surgery, and to examine the associations between parenting stress, family hardiness, and children's emotional and behavioral outcomes.

METHODS

A cross-sectional survey was conducted among 273 mothers of children aged 3-6 years after congenital heart disease surgery. Latent profile analysis was used to identify subgroups, and network analysis was applied to construct association networks of symptoms and related factors.

RESULTS

Two subgroups were identified: the well-adjusted subgroup (82.1%) and the maladjusted subgroup (17.9%). Hyperactivity/inattention was the node with the highest strength centrality in both subgroups. Parenting stress was independently associated with emotional and behavioral problems (OR = 1.086), while family hardiness was independently associated with a lower risk (OR = 0.907). The "challenge" dimension of family hardiness showed the highest centrality in the well-adjusted subgroup, whereas the "control" dimension showed the highest centrality in the maladjusted subgroup.

CONCLUSION

Emotional and behavioral problems in preschool children after congenital heart disease surgery show significant heterogeneity. Different dimensions of family hardiness may serve as candidate targets for future intervention research, and early identification and management of hyperactivity/inattention should be prioritized.