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[Is psychoprophylaxis a valid approach for heart surgery in children?]
P Pereira Ruschel1, D Pierini Cidade, N S Daudt
1Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia.
Insights
Psychological preparation significantly improved outcomes for children undergoing cardiac surgery. Prepared children showed better acceptance of procedures and coping mechanisms, leading to improved psychological adjustment post-surgery.
Area of Science:
- Pediatric Cardiac Surgery
- Psychological Interventions
- Child Psychology
Background:
- Cardiac surgery in children presents significant psychological challenges.
- Effective interventions are needed to mitigate surgical trauma in pediatric patients.
Purpose of the Study:
- To validate the hypothesis that psychological preparation enhances outcomes for children undergoing cardiac surgery.
- To assess the impact of pre-operative psychological preparation on pediatric patients' post-operative adjustment.
Main Methods:
- A study involving 60 children (ages 3-10) undergoing heart surgery for congenital defects.
- Patients were divided into experimental (psychologically prepared) and control groups.
- Data collected via questionnaire on psychological and clinical aspects.
Main Results:
- Statistically significant improvements observed in the prepared group for: peripheral vein puncture acceptance, calm awakening, physiotherapy cooperation, coping with parental absence, fluid restriction acceptance, and cooperation with stitch/pacemaker removal.
- No significant differences in sedation needs, cooperation during extubation/examination, reintubation rates, or clinical complications.
- Prepared group showed a trend towards fewer postoperative complications (20% vs. 27% in control).
Conclusions:
- Adequate psychological preparation prior to congenital heart defect correction leads to better psychological outcomes.
- Pre-operative psychological preparation positively impacts children's ability to cope with the trauma of cardiac surgery.
Purpose:
To validate the hypothesys that a psycological preparation for children who will undergo cardiac surgery may improve the outcome.
Methods:
Sixty patients, with ages ranging between 3 and 10 years, submitted to heart surgery for treatment of congenital heart defects, were evaluated. They were divided in 2 groups: experimental and control. A questionnaire was designed for collecting data about psychological and clinical aspects of each patient.
Results:
The following data was found to be of statistical significance: acceptance of peripheral vein puncture in the surgical group (chi 2 = 11.59, p < 0.05), calm awakening following general anesthesia (chi 2 = 9.64 p < 0.05), cooperation with the physiotherapy staff (chi 2 = 13.30, p < 0.05), coping with parents absence (chi 2 = 9.64, p < 0.05), acceptance of fluid restriction (chi 2 = 17.78, p < 0.05) and cooperation with removal of stitches and pacemaker electrodes (chi 2 = 19.20, p < 0.05). There was not statistical significance on demand of sedation, cooperation at removal of the orotracheal tube and during examination, necessity of reintubation and occurrence of clinical complications. However, the prepared group showed a slight tendency to have less postoperative complications (20%) than the control (27%).
Conclusion:
It was found that children who had adequated psychologic preparation prior to the correction of congenital heart defects had better psychological results with the imposed trauma.