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Perceived Self-Competence, Psychosocial Adjustment, and Quality of Life in Pediatric Patients with Pacemakers

Gutierrez-Colina, Ana M. BA*; Eaton, Cyd BS*; Cheng, Patricia PhD*; Strieper, Margaret DO†,‡; Frias, Patrick MD†,‡; Gooden, Kevin CTT; Blount, Ronald L. PhD§

Journal of Developmental & Behavioral Pediatrics:
doi: 10.1097/DBP.0000000000000073
Original Article

Objectives: To compare participants' self-competence levels to normative data and examine self-competence as a potential protective factor against poorer health-related quality of life (HRQOL) and psychosocial adjustment in children with pacemakers.

Methods: Twenty-seven children between the ages of 8 and 18 years and their caregivers were recruited from a pediatric pacemaker clinic. Participants completed self-report and parent-proxy measures of children's health-related quality of life (HRQOL), self-competence, and psychosocial functioning, which included externalizing and internalizing symptoms, adaptive skills, and behavioral symptoms.

Results: Participants reported significantly lower levels of self-competence compared to healthy norms. Self-competence was significantly and positively correlated with most HRQOL domains. Few significant correlations emerged between self-competence and various domains of psychosocial functioning.

Conclusion: Self-competence may function as a protective factor against lower HRQOL in children with pacemakers. There was less evidence that self-competence may play a protective role against lower adaptive skills and higher externalizing, internalizing, and behavioral symptoms. Clinical implications of these findings, limitations of the study, and areas for future research are discussed.

Author Information

*Department of Psychology, University of Georgia, Athens, GA;

Sibley Heart Center Cardiology, Children's Healthcare of Atlanta, Atlanta, GA; and

Department of Pediatrics, Emory University School of Medicine, Atlanta, GA;

§Department of Psychology, University of Georgia, Athens, GA.

Address for reprints: Ana M. Gutierrez-Colina, BA, Department of Psychology, University of Georgia, Psychology Building, Athens, GA 30602-3013; e-mail:

This study was supported by the Children's Healthcare of Atlanta Cardiac Research Committee.

Disclosure: The authors declare no conflict of interest.

Received February , 2014

Accepted May , 2014

© 2014 by Lippincott Williams & Wilkins