An exploration of psychological trauma and positive adaptation in adults with congenital heart disease during the COVID-19 pandemic.

Abstract

Introduction: The growing population of adults with congenital heart disease (CHD) often have lifelong experience of dealing with potentially traumatic health crises and medical uncertainty whilst facing increased vulnerability to post-traumatic stress disorder (PTSD). The COVID-19 pandemic presents additional challenges for this population including increased risk of health complications, shielding and strict social distancing, changes to medical care provision and social stigma. Despite such challenges, adults with CHD have the potential to also experience positive changes, yet little is known as to what helps cultivate positive adaptation and post-traumatic growth (PTG) within this context. Methods: The current study comprised a cross-sectional, anonymous, online study exploring psychosocial measures of traumatic experiences as well as protective factors that mitigate the risks to mental health on the mental health for adults with CHD (n=236) during the pandemic. Closed and open-ended questions and a series of standardised psychosocial measures of traumatic experiences, coping mechanisms, emotional regulation and PTG were measured.Results: Findings suggest the CHD population are at increased risk of PSTD which may be exacerbated by the COVID-19 pandemic. However, positive adaptation may promote post traumatic growth. In particular, health adversity is associated with greater appreciation whilst emotional regulation is associated with post-traumatic growth.Conclusions: We recommend a growth-focused, psychologically and trauma-informed approach to medicine and public health, recognising the importance of supporting mental health and promoting living well with CHD during the COVID-19 pandemic and beyond. These findings are likely generalisable to other lifelong health conditions and shielding populations.

ENACTstudy: What has helped health and social care workers maintain their mental well‐being during theCOVID‐19 pandemic?

“…exacerbation of such difficulties and worsening symptoms (Macedo et al, 2022;Morton et al, 2022). Indeed, this aligns with the National…”

“…The current pandemic has resulted in HSCWs being under both physical and psychological pressure increasing the risk of mental health sequelae (Krishnamoorthy et al, 2020 ). Given the high levels of acute stress found among HSCWs in the current study and the risks of trauma symptoms, the need for trauma informed practices in the workplace is essential in order to help prevent the likelihood of an exacerbation of such difficulties and worsening symptoms (Macedo et al, 2022 ; Morton et al, 2022 ). Indeed, this aligns with the National Trauma Training Programme (NTTP, 2021 ) for Scotland which has the ambition of a trauma informed and responsive workforce.…”