The Children's Hospital of Philadelphia; daggerUniversity of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA.
J Dev Behav Pediatr. 2010 Apr;31(3):202-8. doi: 10.1097/DBP.0b013e3181d3deaa.
This study aimed to identify and compare differences in temperament and maternal stress between infants with complex congenital heart disease and healthy controls at 3 months of age.
Study sample was drawn from an existing longitudinal study examining growth in infants with congenital heart disease when compared with healthy controls. Infant temperament and parental stress were measured in 129 mother-infant dyads. Inclusion criteria for infants with congenital heart disease were > or = 36-week postmenstrual age, > or = 2500 g at birth, surgery in first 6 weeks of life, and no major congenital anomalies or genetic syndromes. The Early Infancy Temperament Questionnaire and Parent Stress Index were the assessment tools used.
Infants with single ventricular (SV) physiology were more negative in mood (F = 7.14, p < .001) and less distractible (F = 5.00, p < .008) than the biventricular physiology or Control (C) infant groups. The demands of care for infants with congenital heart disease were a source of stress when compared with Control infants (p < .05). Five of 6 subscales of the Child Domain were significant sources of stress in the SV group compared with biventricle and Control groups. Negative mood and difficulty to soothe were predictors for Child Domain and Total Life Stress in SV infants.
The demands of parenting an irritable infant with SV physiology put these mothers at risk for high levels of stress. Results suggest the need for predischarge anticipatory guidance for parents to better understand and respond to the behavioral style of their infants, in particular, infants with SV physiology.
本研究旨在比较 3 个月大的患有复杂先天性心脏病婴儿与健康对照婴儿之间的气质和产妇应激的差异。
研究样本取自一项现有的纵向研究,该研究比较了先天性心脏病婴儿与健康对照婴儿的生长情况。129 对母婴对接受了婴儿气质和父母应激的测量。先天性心脏病婴儿的纳入标准为:>或=36 孕周,出生时体重>或=2500g,出生后 6 周内手术,且无重大先天畸形或遗传综合征。使用的评估工具为早期婴儿气质问卷和父母应激指数。
单心室(SV)生理组婴儿的情绪更消极(F = 7.14,p <.001),且更难以分散注意力(F = 5.00,p <.008),与双心室生理组或对照组婴儿相比。与对照组婴儿相比,照顾患有先天性心脏病婴儿的需求是一种应激源(p <.05)。与双心室和对照组婴儿相比,SV 组的儿童域的 6 个分量表中有 5 个是应激的重要来源。消极情绪和难以安抚是 SV 婴儿儿童域和总生活应激的预测因子。
照顾具有 SV 生理的烦躁婴儿的需求使这些母亲面临高压力的风险。结果表明,需要在出院前为父母提供预期指导,以帮助他们更好地理解和应对婴儿的行为方式,特别是具有 SV 生理的婴儿。