Rehabilitation Goals

According to the WHO charter for children, every child has the right to an appropriate and undisturbed physical, mental, and emotional development. The main goals of rehabilitative measures are to eliminate or minimize impairments, disabilities, and handicaps linked to the disease and to prevent possible secondary effects. Other general rehabilitation goals are:

- Promotion of self-management and self-responsibility in terms of helping to self-help.

- Promotion of equal participation in social life and prevention or counteraction of possible discrimination. In this respect, it is particularly important to ensure and/or reestablish the affected person's integration into school, education, job, family, and society.

- Enhancement of the overall quality of life.

- Reduction of disease-related morbidity.

The specific rehabilitation goals are formulated from the patient's individual situation (age and stage of life,severity of the disease, time-span from the intervention, postoperative sequelae, co-morbidity, family and social situation, etc.). As a consequence of the diversity and complexity of cardiac defects and their effects on the whole life situation, the need for rehabilitation varies substantially, as do the corresponding rehabilitation goals. As an example, the general development of a child's personality is not only affected by medical and therapeutic interventions and/or improvement of physical fitness, but is also significantly influenced by emotional, psychosocial, and cognitive aspects of development. On the other hand, in adolescents education and coping strategies may be the main focus. This may involve providing extensive information about the cardiac defect, a personal history of the disease and its prognosis, past interventions and their consequences for heart and body, requirement for long-term medication, future diagnostic or therapeutic procedures, and the necessity of hospital attendance for regular follow-up. Furthermore, support in terms of planning a future life independent from the parents,job training, choice of employment, sexuality, and family planning can be of great importance. Especially in adolescence, promoting acceptance of the disease can constitute an essential rehabilitation goal, as restricted acceptance may result in inefficient disease management.

A specific rehabilitation goal can also be catching up with family problems caused by the child's disease. Such problems may impact on the child/adolescent's development, their healing process, and/or their disease management. In some circumstances, this may require the integration of the whole family in the rehabilitation process.

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