Department of Child and Adolescent Psychiatry and Behavioral Sciences and Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Division of Behavioral Health, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA.
Child Care Health Dev. 2022 Jan;48(1):129-138. doi: 10.1111/cch.12913. Epub 2021 Oct 1.
Parents of children with congenital heart disease (CHD) exhibit high rates of mental health difficulties, which can influence child developmental and behavioural outcomes. While extensive research has focused on CHD-related stressors that contribute to parental mental health difficulties, few studies have investigated parental coping strategies that may mitigate or heighten risk. This study aimed to identify parental coping strategies following diagnosis of CHD and compare use of coping strategies among different groups (mothers vs. fathers; prenatal vs. postnatal diagnosis).
A diverse sample of 34 parents (20 mothers and 14 fathers) of young children with CHD participated in semistructured interviews focused on their responses to CHD-related stressors. Coping strategies were identified from qualitative data and categorized according to the COPE Inventory, an instrument that assesses common adult responses to stress. Coping strategies deemed as unique to parenting a critically ill child were identified. χ and independent sample t tests evaluated group differences.
Parents described using between 1 and 10 different adaptive and maladaptive strategies measured by the COPE Inventory. Most parents (82.35%) also described coping strategies that may be unique to parenting a critically ill child. Mothers were more likely than fathers to report a focus on and venting of emotions (70% vs. 21.43%) and behavioural disengagement (25% vs. 0%). Compared with parents receiving a postnatal CHD diagnosis, those receiving a prenatal diagnosis described a greater variety of coping strategies (6.23 vs. 4.52) and more often reported positive reinterpretation and growth (69.23% vs. 14.29%), behavioural disengagement (38.46% vs. 0%) and denial (38.46% vs. 0%).
Parents of children with CHD utilize a variety of coping strategies, some of which are maladaptive. Interventions tailored to the needs of mothers and fathers of young children with CHD, including those receiving a postnatal diagnosis, are needed to promote adaptive coping and optimize family psychosocial outcomes.
患有先天性心脏病 (CHD) 的儿童的父母表现出较高的心理健康问题发生率，这可能会影响儿童的发育和行为结果。虽然大量研究集中在导致父母心理健康问题的 CHD 相关压力源上，但很少有研究调查可能减轻或增加风险的父母应对策略。本研究旨在确定 CHD 诊断后父母的应对策略，并比较不同群体（母亲与父亲；产前与产后诊断）使用应对策略的情况。
34 名患有 CHD 的幼儿的父母（20 名母亲和 14 名父亲）参加了半结构化访谈，重点是他们对 CHD 相关压力源的反应。从定性数据中确定应对策略，并根据 COPE 库存进行分类，该库存评估了应对压力的常见成人反应。确定了被认为是照顾重病儿童所特有的应对策略。 χ 和独立样本 t 检验评估了组间差异。
父母描述了使用 COPE 库存测量的 1 到 10 种不同的适应性和不适应性策略。大多数父母（82.35%）还描述了可能是照顾重病儿童所特有的应对策略。与父亲相比，母亲更有可能报告关注和发泄情绪（70% 与 21.43%）和行为脱离（25% 与 0%）。与接受产后 CHD 诊断的父母相比，接受产前诊断的父母描述了更多种类的应对策略（6.23 与 4.52），并且更经常报告积极的重新解释和成长（69.23% 与 14.29%）、行为脱离（38.46% 与 0%）和否认（38.46% 与 0%）。
患有 CHD 的儿童的父母使用了多种应对策略，其中一些是适应性不良的。需要针对患有 CHD 的幼儿的母亲和父亲（包括接受产后诊断的父母）的需求量身定制干预措施，以促进适应性应对并优化家庭的心理社会结果。
