{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T02:19:19Z","timestamp":1784341159543,"version":"3.55.0"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC111\u20102635\u2010B\u2010A49\u2010001\u2010"],"award-info":[{"award-number":["NSTC111\u20102635\u2010B\u2010A49\u2010001\u2010"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the relationship between frailty status, family functioning, and quality of life in adolescents with congenital heart disease (CHD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Frailty is a rarely assessed health outcome in adolescents. Despite advances in paediatric CHD treatment, potential complications may cause frailty, affecting family dynamics and quality of life. Family support and early screening are vital to managing the symptoms of frailty associated with CHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>During the period from July 2022 to August 2023, 302 adolescents aged between 12 and 18 who had received a diagnosis of CHD were assessed for frailty using criteria that included slowness, weakness, exhaustion, shrinkage\/body composition, and diminished physical activity. Data were collected from assessments of grip strength, the 6\u2010min walk test, body mass index, triceps skinfold thickness, the PedsQL Multidimensional Fatigue Scale Adolescent, Physical Activity Questionnaire for Adolescents, the Family Adaptability, Partnership, Growth, Affection, and Resolve scale, and the PedsQL 3.0 Cardiac Module. All data were subjected to multiple linear regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Frailty, as measured by exhaustion and diminished physical activity, was significantly more prevalent in adolescents with severe symptoms of CHD than in those without symptoms. Of the participants, 56.6% were prefrail, and 8.3% were frail. Adolescents who were frail and lived in dysfunctional families experienced a worse quality of life than participants with robust health and those with positive family functioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Frailty and family dysfunction negatively affect the quality of life in adolescents with CHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Developing programmes that detect frailty early and improve family functioning for adolescents with CHD is critical. Establishing guidelines for identifying frailty in this population can minimise adverse health effects and enhance familial relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public involvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.16867","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T02:13:36Z","timestamp":1741745616000},"page":"391-402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Associations Between Frailty, Family Functioning, and Quality of Life in Adolescents With Congenital Heart Disease: A Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"82","author":[{"given":"Chen\u2010Yan","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Nursing National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010I","family":"Chen","sequence":"additional","affiliation":[{"name":"College of Nursing National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Department of Nursing, College of Nursing Tzu Chi University  Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6760-8107","authenticated-orcid":false,"given":"Hung\u2010Tao","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Chang Gung Children's Hospital  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6872-4764","authenticated-orcid":false,"given":"Chun\u2010Wei","family":"Lu","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Center &amp; 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