Hoyos Maria E, Well Andrew, O'Connor Mario, Mercado Amelia, Reilly Shannon M, Van Diest Heather, Lamari-Fisher Alexandra
Texas Center for Pediatric and Congenital Heart Disease, UT Health Austin & Dell Children's Medical Center, 4900 Barbara Jordan Blvd, Austin, TX, 78723, USA.
Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
Pediatr Cardiol. 2025 May 31. doi: 10.1007/s00246-025-03905-6.
OBJECTIVE(S): Mental health concerns (MHCs) are prevalent in caregivers of children with congenital heart disease (CHD) and fluctuate throughout the CHD care journey. The period leading up to congenital heart surgery (CHS) consultation presents a potentially heightened timepoint for MHCs. This study aims to evaluate MHC prevalence among caregivers at the time of CHS consultation.
This single-center retrospective review analyzed CHS consultations from 1/1/2019 to 10/31/2022. The Depression Anxiety Stress Scale-21 (DASS-21) was administered to caregivers attending CHS consultations. DASS-21 subscale scores for depression, anxiety, and stress were categorized as "no concerns" vs. "any concerns." Sociodemographic and clinical characteristics were collected. Univariate and multivariable analyses were performed.
A total of 373 caregiver DASS-21 assessments were identified. The median patient age was 45.6 months [IQR: 7.0-129.0], with 160 (42.8%) female and 219 (58.7%) covered by private insurance. Clinically, 47 (12.6%) patients had single-ventricle (SV) diagnoses, and 191 (51.2%) had a syndrome or chromosomal abnormality. MHC prevalence was notable among caregivers: 17.4% for depression, 29.2% for anxiety, and 34.9% for stress. Caregivers of uninsured children and those of patients with SV diagnoses had elevated odds of MHCs, especially in stress (OR 7.77;CI 1.60-37.58, p = 0.010). Higher number of previous surgeries in SV also correlated with increased caregiver stress (OR 1.35; CI 1.07-1.70, p = 0.010).
CONCLUSION(S): MHCs are common in caregivers at CHS consultation and are associated with both clinical and sociodemographic factors. Early identification of caregiver MHCs at CHS consultation may provide an opportunity for timely intervention and support prior to surgery.
心理健康问题（MHCs）在先天性心脏病（CHD）患儿的照料者中普遍存在，且在CHD的治疗过程中会有所波动。先天性心脏手术（CHS）咨询前的这段时间，MHCs出现的可能性可能会更高。本研究旨在评估CHS咨询时照料者中MHCs的患病率。
这项单中心回顾性研究分析了2019年1月1日至2022年10月31日期间的CHS咨询情况。对参加CHS咨询的照料者进行了抑郁焦虑压力量表-21（DASS-21）测评。DASS-21抑郁、焦虑和压力分量表得分被分为“无问题”和“有任何问题”两类。收集了社会人口学和临床特征数据，并进行了单变量和多变量分析。
共确定了373名照料者的DASS-21测评结果。患者的中位年龄为45.6个月[四分位间距：7.0 - 129.0]，其中160名（42.8%）为女性，219名（58.7%）有私人保险。临床上，47名（12.6%）患者被诊断为单心室（SV），191名（51.2%）患有综合征或染色体异常。照料者中MHCs的患病率较高：抑郁为17.4%，焦虑为29.2%，压力为34.9%。未参保儿童的照料者以及SV诊断患者的照料者出现MHCs的几率更高，尤其是在压力方面（比值比7.77；置信区间1.60 - 37.58，p = 0.010）。SV患者既往手术次数较多也与照料者压力增加相关（比值比1.35；置信区间1.07 - 1.70，p = 0.010）。
在CHS咨询时，照料者中MHCs很常见，且与临床和社会人口学因素有关。在CHS咨询时尽早识别照料者的MHCs，可能为手术前的及时干预和支持提供机会。
