Abstract:
Background: Behavioral disorder is any persistent and repetitive pattern of behavior that violates societal norms or rules, seriously impairs a person’s functioning, or creates distress in others. Rheumatic heart disease (RHD) is a long-term sequel of single or recurrent acute rheumatic fever. Major physical illnesses usually have an impact on the psychological well-being of any individual.There are no studies that assess behavioral problems in children and adoloscents with RHD.
Objective of the Study: To Assess behavioral problems in children and adolescents with RHD at TikurAnbessa Specialized Hospital.
Methods - This observational cross-sectional study used the strengths and difficulties questionnaire (SDQ), a validated Amharic behavioral screening tool. Sociodemographic and clinical data were collected using a structured questionnaire. RHD subjects aged 4-17 years were included. Factors associated with high-difficulty scores were assessed using logistic regression models.
Results - The study included 166 subjects with a median age 15 years[interquartile range (IQR):13-17 years]. One-fourth of the study subjects, 24.7% (95% CI:18.34-31.98), had behavioral problems with a slightly raised, high, or very high total SDQ score. Of these, 46.5%(77) had emotional problems, 35.5%(59) had peer problems,18.1%(30) had conduct problems and 6.6%(11) had hyperactivity problems. Study subjects who had good medication adherence adjusted odds ratio AOR 0.29(95% CI: 0.11-0.94, P 0.040) and with NYHA class I, AOR 0.28(95% CI: 0.10-0.79, P 0.016) had reduced odds for a high total SDQ score with any behavioral problems.
Conclusion and Recommendation- One-fourth of RHD study subjects had behavioral abnormalities. Subjects with NYHA class II and above with poor medication adherence should be assessed for behavioral abnormalities and linked to expert professionals for targeted care..............Thesis available at Addis Continental Institute of Public Health Library