Besley Belinda, Davies Sasha J, Donnelly James
Faculty of Psychology, Counselling, & Psychotherapy, Cairnmillar Institute, Australia.
Faculty of Psychology, Counselling, & Psychotherapy, Cairnmillar Institute, Australia.
J Pediatr Nurs. 2025 Jan-Feb;80:83-90. doi: 10.1016/j.pedn.2024.11.012. Epub 2024 Nov 22.
Infants with a Congenital Heart Defect (CHD) are now surviving longer with more medical treatment available. Many of these infants undergo hospitalisation for life-sustaining procedures in their first seven months. However, barriers to bonding and the psychological burden on parents while caring for an infant during this time can cause issues for the child-parent relationship. This study aimed to assess links among intensive care factors, maternal stress, the Mother-Infant Bond (MIB) and parenting in these mother-infant dyads.
A convenience sample of 148 mothers of CHD children was collected via the Heart Kids Facebook page. An anonymous Qualtrics survey of demographic, hospital experience, MIB, maternal stress and parenting variables was completed retrospectively by mothers of infants with CHD.
The results indicated that MIB and maternal stress were positively and strongly correlated. Hospital experiences of breastfeeding, staff support required for handling the infant, and prolonged separation were associated with both maternal stress and poorer quality MIB. Maternal past experiences of being parented with care was negatively correlated with maternal stress and MIB difficulties. Time of diagnosis and current parenting style were unrelated to any other variable. Testing the effects of barriers to infant contact and the effect of cardiac surgery highlighted some challenges in assessing these features of care.
Results indicated that postpartum mothers living through the traumatic experience of supporting their infant while they received treatment for CHD need more individualised psychological and social support to promote positive psychological outcomes for the mother-infant dyad.
Healthcare providers should prioritise mental health support and create opportunities for mothers of infants with congenital heart disease (CHD) to engage with their babies, even in intensive care settings, to reduce stress and improve mother-child bonding. Given that breastfeeding can unexpectedly increase maternal stress in these environments, flexible feeding alternatives and realistic guidance should be offered. Additionally, reflective parenting education programs should help mothers understand how their own upbringing influences their parenting approaches during this critical period.
患有先天性心脏病（CHD）的婴儿现在通过更多可用的医疗治疗存活时间更长。这些婴儿中的许多人在出生后的前七个月因维持生命的手术而住院。然而，在此期间，亲子关系建立的障碍以及父母照顾婴儿时的心理负担可能会对亲子关系造成问题。本研究旨在评估这些母婴二元组中重症监护因素、母亲压力、母婴联结（MIB）和育儿之间的联系。
通过“心脏儿童”脸书页面收集了148名先天性心脏病儿童母亲的便利样本。患有先天性心脏病婴儿的母亲回顾性地完成了一项关于人口统计学、医院经历、母婴联结、母亲压力和育儿变量的匿名Qualtrics调查。
结果表明，母婴联结和母亲压力呈正相关且相关性很强。母乳喂养的医院经历、处理婴儿所需的工作人员支持以及长时间分离与母亲压力和质量较差的母婴联结均相关。母亲过去被悉心养育的经历与母亲压力和母婴联结困难呈负相关。诊断时间和当前的育儿方式与任何其他变量均无关。测试婴儿接触障碍的影响和心脏手术的影响突出了评估这些护理特征时的一些挑战。
结果表明，在婴儿接受先天性心脏病治疗期间，经历支持婴儿这一创伤性经历的产后母亲需要更多个性化的心理和社会支持，以促进母婴二元组的积极心理结果。
医疗保健提供者应优先提供心理健康支持，并为患有先天性心脏病（CHD）婴儿的母亲创造与婴儿互动的机会，即使是在重症监护环境中，以减轻压力并改善母婴联结。鉴于在这些环境中母乳喂养可能意外增加母亲压力，应提供灵活的喂养替代方案和实际指导。此外，反思性育儿教育项目应帮助母亲了解自己的成长经历如何在这一关键时期影响她们的育儿方式。
