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Psychological functioning in parents of children undergoing elective cardiac surgery

Published online by Cambridge University Press:  20 January 2005

Jo Wray
Affiliation:
Paediatric Surgical Unit, Harefield Hospital, Harefield, Middlesex and Imperial College London, West Middlesex University Hospital, Isleworth, Middlesex, UK
Tom Sensky
Affiliation:
Paediatric Surgical Unit, Harefield Hospital, Harefield, Middlesex and Imperial College London, West Middlesex University Hospital, Isleworth, Middlesex, UK

Abstract

Purpose: To assess levels of distress, the marital relationship, and styles of coping of parents of children with congenital heart disease, to evaluate any change in these parameters following elective cardiac surgery for their child, and to compare these parents with parents of children undergoing another form of hospital treatment, and with parents of healthy children. Design: A prospective study in which parents were assessed the day before the surgical procedure being undergone by their child, and 12 months afterwards. Participants: We assessed three groups of parents of 75 children, aged from birth to 16.9 years. The first was a group whose children were undergoing surgery because of congenital heart disease, the second was a group whose children were undergoing transplantation of bone marrow, and the third was a group whose children were healthy. Measures used for assessment included the General Health Questionnaire, the Dyadic adjustment scale, and the Utrecht coping list. Results: Parents in both groups of children undergoing surgery had significantly higher rates of distress prior to the surgical procedures than did the parents of the healthy children, but within those whose children were undergoing cardiac surgery, there were no differences between parents of children with cyanotic and acyanotic lesions. Following treatment, there was a significant reduction in the levels of distress in both groups whose children had undergone surgery. There were few differences between any of the groups on the other parameters, and the evaluated indexes showed stability over time. Conclusion: Despite elevated levels of psychological distress prior to surgical procedures, which had fallen after one year, the stability of other parameters of parental functioning over time suggests that the surgical interventions are of less significance than either factors attributable to the presence of chronic illness, or the individual characteristics of the parents.

Type
Original Article
Copyright
© 2004 Cambridge University Press

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References

Bouma R, Schweitzer R. The impact of chronic childhood illness on family stress: a comparison between autism and cystic fibrosis. J Clin Psychol 1990; 46: 722730.Google Scholar
Goldberg S, Morris P, Simmons RJ, Fowler RS, Levison H. Chronic illness in infancy and parenting stress: a comparison of three groups of parents. J Pediatr Psychol 1990; 15: 347358.Google Scholar
Wray J, Sensky T. How does the intervention of cardiac surgery affect the self perception of children with congenital heart disease? Child Care, Health and Development 1998; 24: 5772.Google Scholar
Emery JL. Families with congenital heart disease. Arch Dis Child 1989; 64: 150154.Google Scholar
Cohn JK. An Empirical Study of Parents’ Reaction to the Diagnosis of Congenital Heart Disease in Infants. Social Work in Health Care 1996; 23: 6779.Google Scholar
Gardner FV, Freeman NH, Black AMS, Angelini GD. Disturbed mother–infant interaction in association with congenital heart disease. Heart 1996; 76: 5659.Google Scholar
Sparacino PSA, Tong EM, Messias DKH, Foote D, Chesla CA, Gilliss CL. The dilemmas of parents of adolescents and young adults with congenital heart disease. Heart Lung 1997; 26: 187195.Google Scholar
Clark SM, Miles MS. Conflicting responses: the experiences of fathers of infants diagnosed with severe congenital heart disease. J Soc Pediatr Nurs 1999; 4: 714.Google Scholar
Utens EM, Versluis-Den Bieman HJ, Verhulst FC, Witsenburg AJJC. Psychological distress and styles of coping in parents of children awaiting elective cardiac surgery. Cardiol Young 2000; 10: 239244.Google Scholar
Davies CC, Brown RT, Bakeman R, Campbell R. Psychological adaptation and adjustment of mothers of children with congenital heart disease: stress, coping, and family functioning. J Pediatr Psychol 1998; 23: 219228.Google Scholar
DeMaso DR, Campis LK, Wypij D, Bertram S, Lipshitz M, Freed M. The impact of maternal perceptions and medical severity on the adjustment of children with congenital heart disease. J Pediatr Psychol 1991; 16: 137149.Google Scholar
Thompson RJ, Gustafson KE, Hamlett KW, Spock A. Stress, coping and family functioning in the psychological adjustment of mothers of children and adolescents with cystic fibrosis. J Pediatr Psychol 1992; 17: 573585.Google Scholar
Thompson RJ, Gil KM, Burbach DJ, Keith BR, Kinney TR. Psychological adjustment of mothers of children and adolescents with sickle cell disease: the role of stress, coping methods and family functioning. J Pediatr Psychol 1993; 18: 549559.Google Scholar
Finley JP, Putherbough C, Cook D, Netley C, Rowe RD. Effect of congenital heart disease on the family: divorce, separation and stability in families of children with Tetralogy of Fallot. Pediatr Cardiol 1979; 1: 913.Google Scholar
Silbert AR, Newburger JW, Fyler DC. Marital stability and congenital heart disease. Pediatrics 1982; 69: 747750.Google Scholar
Fowler MG, Johnson MP, Welshimer KJ, Atkinson SS, Loda FA. Factors related to school absence among children with cardiac conditions. Am J Dis Child 1987; 141: 13171320.Google Scholar
Goldberg D. The Detection of Psychiatric Illness by Questionnaire. Maudsley monographs, 21. Oxford University Press, London, 1972.
Goldberg D. Manual of the General Health Questionnaire. NFER-Nelson, Windsor, 1978.
Spanier GB. Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family 1976; 38: 1528.Google Scholar
Spanier GB, Thompson L. A confirmatory analysis of the Dyadic Adjustment scale. Journal of Marriage and the Family 1982; 44: 731738.Google Scholar
Antill JK, Cotton S. Spanier’s dyadic adjustment scale: some confirmatory analyses. Australian Psychologist 1982; 17: 181189.Google Scholar
Sharpley CF, Cross DG. A psychometric evaluation of the Spanier dyadic adjustment scale. Journal of Marriage and the Family 1982; 44: 739741.Google Scholar
Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychological Monographs 1966; 80 (No. 609): 128.Google Scholar
Van der Ploeg JD. The Environment in Orthopedagogical Perspective. Rotterdam: Samsom, 1983.
Schreurs PJG, Tellegen B, Van de Willige G. Health, stress and coping: The development of the Utrecht Coping Scale. Gedrag 1984; 12: 101117.Google Scholar
Schreurs PJG, Van de Willige G, Tellegen B, Brosschot JF. The Utrecht Coping List. Utrecht: Swets & Zeitlinger, 1988.
Utens EM, Versluis-Den Bieman HJ, Witsenburg M, Bogers AJ, Hess J, Verhulst FC. Does age at the time of elective cardiac surgery or catheter intervention in children influence the longitudinal development of psychological distress and styles of coping of parents? Cardiol Young 2002; 12: 524530.Google Scholar
Kitchen LW. Psychological factors in congenital heart disease in children. J Fam Pract 1978; 6: 777783.Google Scholar
Wallander JL, Varni JW, Babani L, DeHaan CB, Wilcox KT, Banis HT. The social environment and the adaptation of mothers of physically handicapped children. J Pediatr Psychol 1989; 14: 371387.Google Scholar
Hughes PM, Lieberman S. Troubled parents: vulnerability and stress in childhood cancer. Br J Med Psychol 1990; 63: 5364.Google Scholar
Bradford R. Children with liver disease: maternal reports of their adjustment and the influence of disease severity on outcomes. Child Care Health Dev 1994; 20: 393407.Google Scholar
Barbarin OA, Hughes D, Chesler MA. Stress, coping and marital functioning among parents of children with cancer. Journal of Marriage and the Family 1985; 5: 473480.Google Scholar
Dahlquist LM, Czyzewski DI, Copeland KG, Jones CL, Yaub E, Vaughan JK. Parents of children newly diagnosed with cancer: anxiety, coping and marital distress. J Pediatr Psychol 1993; 18: 365376.Google Scholar
Pless IB, Satterwhite BB. Family functioning and family problems. In: Haggerty RJ, Roghmann KJ, Pless IB (eds). Child Health and the Community. John Wiley & Sons, London, 1975, pp 4154.
Vance JC, Fazan LE, Satterwhite B, Pless IB. Effects of nephrotic syndrome on the family: a controlled study. Pediatrics 1980; 65: 948955.Google Scholar
Sanger MS, Copeland DR, Davidson ER. Psychosocial adjustment among pediatric cancer patients: a multidimensional assessment. J Pediatr Psychol 1991; 16: 463474.Google Scholar
Sloper T, Larcombe IJ, Charlton A. Psychosocial adjustment of five-year survivors of childhood cancer. J Cancer Educ 1994; 9: 163169.Google Scholar
Eiser C, Havermans T. Mothers’ and fathers’ coping with chronic childhood disease. Psychol Health 1992; 7: 249257.Google Scholar
Thompson RJ, Gil KM, Gustafson KE, George LK, Keith BR, Spock A, Kinney TR. Stability and change in the psychological adjustment of mothers of children and adolescents with cystic fibrosis and sickle cell disease. J Pediatr Psychol 1994; 19: 171188.Google Scholar