Exploring family functioning through therapeutic conversations in caregivers of young children undergoing open-heart...

Pediatric open-heart surgery poses significant challenges, as surgical risks and postoperative uncertainties profoundly affect families. Caregivers of young children often face anxiety, exhaustion, and helplessness during intensive care, highlighting the need for developmentally and emotionally responsive support.

To explore the impact of therapeutic conversations on the cognitive, emotional, and behavioral domains of family functioning among caregivers of young children undergoing open-heart surgery.

This qualitative study employed content analysis to explore caregiver experiences. Semi-structured therapeutic conversations were conducted with 32 caregivers of young children undergoing open-heart surgery at two key time points: before the postoperative day 1 visit and before the child's transfer from the intensive care unit. Conversations were guided by the circular questioning approach of the Calgary Family Intervention Model (CFIM).

Analysis of therapeutic conversations identified six themes across cognitive, emotional, and behavioral domains. At previsit, caregivers focused on reducing uncertainty, managing stress, and sustaining coping strategies. By pretransfer, themes shifted to adapting caregiving roles, anticipating future challenges, and reorganizing family life.

Caregivers' emotional responses shifted from initial anxiety to increased hope and proactive planning, demonstrating the positive impact of CFIM-guided therapeutic conversations.

Nurses should incorporate targeted, relationship-based emotional support strategies, particularly in intensive care settings, to enhance caregiver well-being and strengthen family functioning during the critical postoperative recovery period.