Parents of children with critical congenital heart defects (PCCHDs) may be at high risk for mental health issues.
The systematic review of literature which was published in the Journal of the American Heart Association suggests an urgent need for additional research and interventions that can be feasibly delivered in the context of ongoing paediatric cardiac care.
Parents of children with critical congenital heart defects (PCCHDs) have to deal with their children’s appointments and cardiac procedures, lengthy and repeated hospital stays, digestive and/or feeding problems, and increased risk for serious respiratory illnesses, all of which add up to significant costs for the family in terms of money, time, and emotional resources.
Parental mental health can impact childcare
Most children with CCHDs will have at least one cardiac procedure in the postpartum period, a time when parents, especially mothers, are most vulnerable to mental health problems.
It is commonly known that poor parental mental health can have a negative impact on a parent’s capacity to provide for their child and can cause long-term behavioural, cognitive, and health-related issues in kids if left untreated. According to Abidin’s theoretical model of parenting stress, a parent’s mental health can lead to dysfunctional parent–child relationships, which can then have an impact on parental conduct and produce unfavourable results for children.
30 articles on the mental health of PCCHDs were included in the systematic review the researchers conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria.
Risk for psychological issues in the immediate weeks and months following cardiac surgery
According to the literature, parents of children with serious congenital heart defects are more likely to experience psychological issues, especially in the days, weeks, and months immediately following cardiac surgery. Over 80% of PCCHD patients present with clinically significant trauma symptoms, and up to 30% of PCCHD patients have symptoms that are consistent with a diagnosis of posttraumatic stress disorder. Additionally, 25% to 50% of PCCHD patients reported clinically elevated symptoms of depression and/or anxiety, and 30% to 80% of PCCHD patients reported experiencing severe psychological distress.
Measurements employed to evaluate study outcomes, methodological quality, and sociocultural make-up of the parents included in the investigations were highly variable.
Mothers noted significantly more psychological symptoms than fathers
Two factors stood out more than the rest: the parent’s sex and a measure of the severity of the heart abnormality (such as length of hospital stay or ventricular physiology). Mothers often reported much more psychological symptoms than fathers did, and the degree of mental health symptoms was strongly connected with the severity of the heart abnormality, as was documented throughout the review.
Integration of psychological services into medical clinics
The review’s findings highlight the significance of an integrated model of care that includes screening for and interventions for mental health that are empirically established in the field of paediatric cardiology. Since only 44% of people with serious psychological distress (i.e., clinically significant symptoms of a mental disorder) report using mental health services in the previous year, gathering the affected parents’ information in conjunction with their child’s doctor visits may be a creative way to get them connected to care.
Over the past 10 to 20 years, primary care settings have effectively implemented the integration of psychological services, and it has proven to be a cost-efficient and effective strategy for managing mental health issues in adult cardiac care settings.
Research on the implementation of such a model in a paediatric cardiology setting would connect a high‐risk group to treatment and have great potential to improve the physical, cognitive, and psychological outcomes of the paediatric patients themselves, suggests the researchers.
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