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Parental Post-traumatic Stress and Healthcare Use in Infants with Complex Cardiac Defects
Nadya Golfenshtein1, Alexandra L Hanlon2, Alicia J Lozano2
1Department of Nursing, University of Haifa, Haifa, Israel.
Insights
Parental post-traumatic stress after infant heart surgery is linked to increased infant healthcare use, including emergency department visits and specialist appointments. Early screening and treatment are crucial for parental mental health and reducing healthcare utilization.
Area of Science:
- Pediatric Cardiology
- Parental Mental Health
- Healthcare Utilization
Background:
- Infants with complex congenital heart defects (CHDs) often undergo cardiac surgery.
- Parental post-traumatic stress (PTS) is a significant concern following pediatric cardiac procedures.
- The impact of parental PTS on infant healthcare use requires further investigation.
Purpose of the Study:
- To investigate the association between parental PTS and healthcare utilization for infants with CHDs.
- To determine if changes in parental PTS scores correlate with specific healthcare encounters.
- To identify the relationship between PTS symptom clusters and healthcare use in this population.
Main Methods:
- Secondary data analysis of a randomized controlled trial involving 153 parent-infant dyads.
- Assessment of parental PTS at hospital discharge and 4-month follow-up.
- Poisson regression models to analyze the effect of PTS change scores on emergency department (ED) visits and unscheduled specialist appointments.
Main Results:
- Increased parental PTS over time was associated with higher risks of ED visits and unscheduled cardiologist visits.
- Greater PTS symptom severity predicted more unscheduled cardiologist and pediatrician visits.
- Specific PTS symptom clusters (avoidance, arousal, re-experiencing) were linked to increased ED visits and unscheduled specialist appointments.
Conclusions:
- Parental PTS following infant cardiac surgery is a significant factor associated with increased infant healthcare utilization.
- Findings underscore the importance of screening for and treating parental PTS.
- Intervention for parental PTS can potentially improve parental mental health and reduce adverse healthcare outcomes for infants.
Objective:
To examine the associations between post-traumatic stress of parents of infants with complex congenital heart defects and their healthcare use for their infants during the early months of life.
Study Design:
The current study is a secondary data analysis from a randomized controlled trial in which 216 parent-infant dyads were recruited from 3 cardiac intensive care units of large pediatric centers in Northeastern America. The current sample included 153 dyads with post-traumatic stress data at hospital discharge and at 4-months' follow-up. Poisson regressions were used to estimate the effect of post-traumatic stress change scores on number of emergency department (ED) visits, unscheduled cardiologist visits, and unscheduled pediatrician visits outcomes.
Results:
Infants whose parents gained post-traumatic stress disorder over the study period were at increased risk for ED visits and unscheduled cardiologist visits. Increased symptom severity predicted more unscheduled cardiologist visits and more unscheduled pediatrician visits. Increased symptom clusters (avoidance, arousal, re-experiencing) predicted more ED visits, more unscheduled cardiologist visits, and more unscheduled pediatrician visits.
Conclusions:
Parents of infants with cardiac conditions may experience post-traumatic stress following cardiac surgery, which can be linked to greater healthcare use. Findings highlight the importance of screening and treating post-traumatic stress to preserve parental mental health and prevent adverse outcomes.
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