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Parental Resolution of Infant Congenital Heart Disease and Bonding in the Pediatric Cardiac Intensive Care
Tamar Bernstein1,2, Efrat Sher-Censor1, Uri Pollak2,3
1The School of Psychological Sciences, University of Haifa, Haifa, Israel.
Insights
Parental acceptance of an infant's congenital heart disease (CHD) diagnosis supports parent-infant bonding, even amidst psychological distress. Early psychological support is crucial for families navigating CHD diagnoses.
Area of Science:
- Pediatric Cardiology
- Developmental Psychology
- Clinical Psychology
Background:
- Infants diagnosed with congenital heart disease (CHD) require intensive care, often leading to significant parental psychological distress.
- Parent-infant bonding can be challenged by the medical complexities and emotional toll of a CHD diagnosis during hospitalization.
Purpose of the Study:
- To investigate if parental resolution of an infant's CHD diagnosis enhances parent-infant bonding.
- To assess the impact of resolution beyond psychological distress in a pediatric cardiac intensive care unit (PCICU) setting.
- To explore these factors within the understudied ultra-Orthodox Jewish and Muslim-Arab populations.
Main Methods:
- A cross-sectional study was conducted with 58 parents of 37 infants hospitalized in a PCICU.
- Data collection involved validated questionnaires assessing reaction to diagnosis, bonding, depression, and PTSD symptoms.
- Parents also responded to an open-ended question about the impact of their infant's condition, with responses coded for themes like affect, crisis, growth, faith, and social support.
Main Results:
- Parental resolution of the CHD diagnosis was significantly associated with healthier parent-infant bonding (r = -0.55, p < 0.001).
- Higher levels of depressive and PTSD symptoms correlated with poorer resolution and impaired bonding.
- After controlling for psychological distress and diagnosis timing, resolution remained a significant predictor of healthier bonding (β = -0.35, p = 0.032).
- Themes of less negative affect and personal growth predicted better resolution and bonding, while framing the experience as a crisis or lack of religious faith reference were linked to impaired bonding.
Conclusions:
- Parental resolution of an infant's CHD diagnosis appears to foster nurturing parent-infant relationships.
- The findings underscore the importance of early psychological interventions for families coping with a CHD diagnosis.
- Addressing parental psychological well-being is critical for supporting healthy parent-infant bonding in this population.
Objectives:
To evaluate whether parental resolution of infants' congenital heart disease (CHD) diagnosis contributes to parent-infant bonding above and beyond psychological distress during hospitalization in a pediatric cardiac ICU (PCICU). The study focused on an understudied population of ultra-Orthodox Jews and Muslim-Arabs.
Design:
A cross-sectional study.
Setting:
PCICU; Hadassah University Medical Center, Israel.
Subjects:
Fifty-eight parents (43% fathers; 72% ultra-Orthodox Jewish; 28% Muslim-Arab) of 37 infants (Mdays = 65.22; sd = 84.61) hospitalized after cardiac surgery or catheterization.
Interventions:
None.
Measurements:
Parents completed the Reaction to Diagnosis Questionnaire, the Postpartum Bonding Questionnaire, the Edinburgh Postnatal Depression Scale, and the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and responded to an open-ended question about how infants' birth and medical condition affected their lives. Responses' coding included affect, crisis, growth, religious faith, and social support. Clinical data were extracted from infants' medical records.
Main Results:
Resolution was associated with healthier bonding (r = -0.55; p < 0.001; higher bonding scores indicate impaired bonding). Depressive and PTSD symptoms correlated with poorer resolution (r = -0.47; p < 0.001 and r = -0.51; p < 0.001) and more impaired bonding (r = 0.44; p = 0.001 and r = 0.48; p < 0.001). Controlling for depressive and PTSD symptoms and diagnosis timing (prenatally vs. postpartum), resolution predicted healthier bonding (β = -0.35;i p = 0.032; ΔR2 = 0.08). Parents who expressed less negative affect and addressed personal growth in the open-ended question demonstrated better resolution and healthier bonding (p's < 0.029). Lack of reference to religious faith and framing the experience as a crisis were associated with more impaired bonding (p's < 0.037).
Conclusions:
Parental resolution of infants' CHD diagnosis may contribute to the formation of nurturing parent-infant relationships. Findings highlight the need for early psychological interventions for families facing a CHD diagnosis.
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