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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Caregiver anxiety upon discharge for neonates with congenital heart disease
Abigail L Fischer1, Catherine Butz, Lisa Nicholson
1Heart Center, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
Insights
Parents of infants with congenital heart disease (CHD) generally report low anxiety, but higher education levels correlate with increased state anxiety. Further research is needed to support these families during hospitalization.
Area of Science:
- Pediatric Cardiology
- Psychosocial Health
- Neonatal Care
Background:
- Parents of children with congenital heart disease (CHD) face increased risks of psychosocial issues like anxiety and depression.
- Limited understanding exists regarding parental anxiety during the initial hospitalization of neonates with CHD.
Purpose of the Study:
- To assess parental anxiety levels at hospital discharge for neonates with CHD.
- To identify predictors of heightened anxiety among these parents.
Main Methods:
- Recruited caregivers of neonates diagnosed with CHD within the first month of life.
- Administered the Spielberger State-Trait Anxiety Scale before discharge.
- Utilized Spearman correlations to analyze anxiety scores against clinical variables.
Main Results:
- 81% of parents reported no state anxiety, 14% borderline, and 5% significant anxiety.
- 93% reported no trait anxiety, 2% borderline, and 5% significant anxiety.
- Higher education correlated with increased state and trait anxiety scores; more medications correlated with lower trait anxiety.
Conclusions:
- While trait anxiety was generally low, a notable proportion of caregivers experienced state anxiety.
- Elevated education levels were associated with higher anxiety.
- Further investigation is required to develop strategies for mitigating parental anxiety during this critical period.
Introduction:
Parents of children with congenital heart disease (CHD) have been shown to be at an increased risk of having psychosocial morbidities including anxiety, depression, and somatization. Little is known about the anxiety level of these parents during the initial hospital course. The goal of this study was to evaluate the anxiety level of the parents at the time of hospital discharge and to determine if certain characteristics predict higher anxiety levels.
Methods:
Caregivers of neonates admitted with CHD within the first 30 days of life were recruited. Anxiety levels were measured by using the Spielberger State-Trait Anxiety Scale just prior to discharge. Spearman correlations were performed between state and trait scales vs. clinical variables.
Results:
Fifty-nine questionnaires were completed for 38 neonates. Based on state score measure of anxiety, 81% of parents denied anxiety, 14% reported borderline anxiety, and 5% reported significant anxiety. Trait scores of anxiety reflected 93% of parents who denied anxiety, 2% who reported borderline anxiety, and 5% who reported significant anxiety. There was a significant positive correlation between state score and level of education (ρ= 0.30, P < .05) and the trait score and level of education (ρ= 0.23, P < .10). Number of medications was also significantly negatively associated with standard trait score (ρ=-0.37, P < .05).
Conclusion:
In general, anxiety trait scores were low for caregivers of neonates with CHD; however, there was a higher proportion of caregivers that reported anxiety in the state anxiety score. Higher education was associated with a higher level of anxiety. Future studies are needed to determine how to minimize anxiety levels during this stressful time period.
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