A controlled trial of early interventions to promote maternal adjustment and development in infants born with severe congenital heart disease

Abstract

Background Congenital heart disease can have a negative impact on both infant development and maternal adjustment. This study considered the impact of a new programme of early psychosocial interventions on such outcomes, following the birth of a child with severe congenital heart disease. Methods Seventy infants and their mothers were assigned to an intervention or control group based on order of presentation to the unit. Interventions aimed at bolstering mother-infant transactions, through psychoeducation, parent skills training and narrative therapy techniques were implemented. Results Clinically and statistically significant gains were observed at 6-month follow-up on the mental (but not the psychomotor) scale of the Bayleys-II. Positive gains were also manifested on feeding practices, maternal anxiety, worry and appraisal of their situation. Conclusions A programme of generalizable psychosocial interventions is shown to have a positive impact on the infant with severe congenital heart disease and the mother.

Multidisciplinary family-centred psychosocial care for patients with CHD: consensus recommendations from the AEPC Psychosocial Working Group

“…9,10 At present, their protocol for schoolchildren is being further studied in a Dutch randomised control trial, with the aim to improve emotional and school functioning in these children. Moreover, standardised exercise training has been shown to improve the quality of life in children with CHD.…”

Effect of cardiac surgery in young children with congenital heart disease on parenting stress in central South Africa: Initial outcomes

“…(23) Neurodevelopmental outcome, in particular language development, was found to be significantly associated with parenting stress prior to cardiac surgery (p=0.04), as well as at three- that parenting stress negatively impacts on the quality and responsiveness of caregiving, ultimately having a detrimental effect on the child's social-emotional, motor, cognitive and language development. (10,16,38,(46)(47)(48) Findings in developing countries are comparable. (38) Parents' perception of their child's HRQOL was significantly …”

“…(10,16,38,(46)(47)(48) Findings in developing countries are comparable. (38) Parents' perception of their child's HRQOL was significantly …”

“…(5,18,26,40) These interventions may include counselling, parent education, active listening and the provision of anticipatory guidance, teaching of coping skills and developing strategies for accessing social support within parents' families and communities, and parent support groups have all been found to mediate stress and anxiety. (7,15,17,38,39) The PSI-SF has been used in several studies to determine parenting stress in children with CHD, and has been found to be a valid and reliable measure. (19,20,21,23,34,41) The PSI-SF has also been shown to have good test-retest reliability with Pearson correlations of .84 for total stress scores, and .68 -.85 for the subscale scores.…”

“…(25) Accessing and complying with cardiac care is challenged in employed parents who may stand to lose income due to the frequent and sometimes extended periods of time needed off work in order to meet their child's care needs. (25,41,(46)(47)(48) A family's ability to come to terms with their child's cardiac diagnosis, and to then make the necessary lifestyle adjustments it demands, plays an important role in the outcome of the child with CHD, (1,7,15,38,39) currently driving interest into the impact of a child's CHD on parents' psychological health and parenting experiences. (2,5,12,26) The aim of this study was to determine stress in parents of children with CHD who had undergone cardiac surgery in central South Africa.…”