Nemours Cardiac Center & Nemours Center for Healthcare Delivery Science, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Department of Nursing and Clinical Care Services, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.
Cardiol Young. 2021 Jun;31(6):900-914. doi: 10.1017/S1047951121002134. Epub 2021 Jun 4.
Diagnosis of CHD substantially affects parent mental health and family functioning, thereby influencing child neurodevelopmental and psychosocial outcomes. Recognition of the need to proactively support parent mental health and family functioning following cardiac diagnosis to promote psychosocial adaptation has increased substantially over recent years. However, significant gaps in knowledge remain and families continue to report critical unmet psychosocial needs. The Parent Mental Health and Family Functioning Working Group of the Cardiac Neurodevelopmental Outcome Collaborative was formed in 2018 through support from an R13 grant from the National Heart, Lung, and Blood Institute to identify significant knowledge gaps related to parent mental health and family functioning, as well as critical questions that must be answered to further knowledge, policy, care, and outcomes. Conceptually driven investigations are needed to identify parent mental health and family functioning factors with the strongest influence on child outcomes, to obtain a deeper understanding of the biomarkers associated with these factors, and to better understand how parent mental health and family functioning influence child outcomes over time. Investigations are also needed to develop, test, and implement sustainable models of mental health screening and assessment, as well as effective interventions to optimise parent mental health and family functioning to promote psychosocial adaptation. The critical questions and investigations outlined in this paper provide a roadmap for future research to close gaps in knowledge, improve care, and promote positive outcomes for families of children with CHD.
先心病的诊断会对患儿父母的心理健康和家庭功能产生重大影响,进而影响儿童的神经发育和心理社会结局。近年来,人们越来越认识到需要在心脏诊断后积极支持父母的心理健康和家庭功能,以促进心理社会适应。然而,相关知识仍存在显著空白,且家庭仍报告存在关键的未满足的心理社会需求。2018 年,在国家心肺血液研究所 R13 拨款的支持下,成立了先心病患儿神经发育结局协作组的父母心理健康和家庭功能工作组,旨在确定与父母心理健康和家庭功能相关的重大知识空白,以及为进一步的知识、政策、护理和结局,必须回答的关键问题。需要开展概念驱动的研究,以确定对儿童结局影响最大的父母心理健康和家庭功能因素,更深入地了解与这些因素相关的生物标志物,并更好地了解父母心理健康和家庭功能如何随时间影响儿童结局。还需要开展研究来制定、测试和实施可持续的心理健康筛查和评估模式,以及有效的干预措施,以优化父母心理健康和家庭功能,促进心理社会适应。本文概述的关键问题和研究为未来的研究提供了路线图,以缩小知识差距,改善护理,并为先心病患儿的家庭带来积极的结局。