Hearps Simone J, McCarthy Maria C, Muscara Frank, Hearps Stephen J C, Burke Kylie, Jones Bryn, Anderson Vicki A
1Critical Care and Neurosciences,Murdoch Children's Research Institute,Melbourne,Australia.
5The Parenting Research Centre,Melbourne,Australia.
Cardiol Young. 2014 Aug;24(4):632-9. doi: 10.1017/S1047951113000760. Epub 2013 Jun 27.
The aim of this study was to explore the acute psychosocial risk in families with infants undergoing surgery for a congenital heart disease and, secondarily, to explore the psychosocial impact of antenatal versus post-natal diagnoses.
The study sample comprised 39 caregivers (28 mothers) of 29 children diagnosed with a congenital heart disease and requiring surgery within the first 4 weeks of life. Psychosocial risk was measured using the Psychosocial Assessment Tool, which was adapted to include four novel items examining infant risk factors, namely, sleeping, feeding, crying, and bonding difficulties. Parents' psychosocial risk was measured within 4 weeks after their child's surgery and stratified into a three-tiered framework: Universal, Targeted, and Clinical risk.
Of the total sample, 61.5% of parents were classified as Universal, that is, at lowest risk; 35.9% as Targeted, and 2.6% as Clinical. The within-family parent total Psychosocial Assessment Tool score correlations were non-significant, and there were no differences between families of infants who received post-natal versus antenatal diagnosis or single ventricle versus biventricular repair. Linear regression found that a higher parent education significantly predicted a lower total Psychosocial Assessment Tool score.
Findings indicate that, although the majority of parents adapt to the acute stress of surgery for a serious cardiac illness in their infant, the remaining 38.5% report an increased psychosocial risk associated with higher rates of emotional distress, which may impact on the parental quality of life and capacity for optimal parenting. The distribution of psychosocial risk in parents of children undergoing surgery for a congenital heart disease is consistent with that described for parents of children with other serious paediatric diagnoses.
本研究旨在探讨患有先天性心脏病且正在接受手术的婴儿家庭中的急性心理社会风险,其次是探讨产前诊断与产后诊断的心理社会影响。
研究样本包括29名被诊断患有先天性心脏病且在出生后4周内需要手术的儿童的39名照料者(28名母亲)。使用心理社会评估工具来测量心理社会风险,该工具经过改编,纳入了四个用于检查婴儿风险因素的新项目,即睡眠、喂养、哭闹和建立情感联系困难。在孩子手术后4周内测量父母的心理社会风险,并将其分为三层框架:普遍风险、针对性风险和临床风险。
在总样本中,61.5%的父母被归类为普遍风险,即风险最低;35.9%为针对性风险,2.6%为临床风险。家庭内部父母的心理社会评估工具总分相关性不显著,接受产后诊断与产前诊断的婴儿家庭之间以及单心室修复与双心室修复的婴儿家庭之间没有差异。线性回归发现,父母受教育程度较高显著预测心理社会评估工具总分较低。
研究结果表明,尽管大多数父母能够适应婴儿严重心脏病手术带来的急性压力,但其余38.5%的父母报告心理社会风险增加,情绪困扰发生率更高,这可能会影响父母的生活质量和最佳育儿能力。患有先天性心脏病且正在接受手术的儿童父母的心理社会风险分布与其他患有严重儿科疾病的儿童父母的情况一致。