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Counselling strategies for parents of infants with congential herat disease

Published online by Cambridge University Press:  19 August 2008

Samula Menahem*
Affiliation:
Head, Paediatri Cardiology Unit, Monasb Medical Centre, Consultant Cardiologist, Department of Cardiology, Royal Children's Hosptial, Melbourne, Australia
*
Professor S. Menahem, MD, MEd, MPM, FRACP, FACC, Department of Paediatrics, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, 3168, Australia. Tel: +61-3-9550-2242, Fax: +61-3-9550-2239. Article presented in part at the Second World Congress of Paediatric Cardiology and Cardiac Surgery, May 1997.

Abstract

Congenital herat disease is a significant cause of morbidity and mortality in the newborn. Its diagnosis may lead to a crisis in the affercted families; there are the percerived implications of having an abnormality of so vital on organ. To that may be added the assumed guilt or blame, grief and at times anger, frequently experienced by parents of abnormal infants. It often befalls the paediatric cardiologist to initiate counselling while providing the expert information concerning the abnormality and its optimum management

Such counselling differs from that needed for minor lesions as compared for more complex abnormalities where a fatal outcome may ensure. While it is important to provide an accurate diagnosis and management plan to the parents, early detailed information is often confusing and may not be assimilated at a time of great stress. The parents seem more concerned as to whether the infant will survive, what the long term outlook will be, whether he or she will attend school, play, work and so on. With the more severe cardiac abnormalities, especially where there is a family history, one need be aware of the often perceived guilt of the parents. At times, it may be necessary to help the parents retain sufficient ‘self-control’, delaying the grieving process to enable them to contribute to the decision making. Where the infant has died, a follow-up appointment can facilitate grieving and help deal with unresolved issues

Through skilled counselling, the cardiologist in addition to his/her diagnostic and management skills, may meaningfully influence the ongoing care of the infant. They may help avoid the development of unrealistic fears or an over-optimistic outlook, thereby fostering the normal development of the child

Type
Continuing Medical Education
Copyright
Copyright © Cambridge University Press 1998

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References

1.Benson, BA, Gross, AMThe effect of a congenitall handicapped child upon the marital dyad: A review of the literature. clin psychol Rev 1989; 9: 747756.CrossRefGoogle Scholar
2.Garson, SL, Baer, PE. Psychological aspects of heart disease in childhood. In Garson, A Jr, Bricker, JT, McNamra, DG. The Science and Practice of Pediatric Cardiology. Philadelphia: Lea and Febiger, 1990 25192527.Google Scholar
3.Darke, PR, Goldberg, S. Father-infant interaction and parent stress with healthy and medically compromised infants, Infant Behav Develop 1994; 17: 314.CrossRefGoogle Scholar
4.campis, LB, DeMaso, DR, Twente, AW. The role of maternal factors in the adaptation of children eith creniofacial disfigurement. Cleft Palate Cranioface J 1995; 32: 5561.CrossRefGoogle Scholar
5. Consulartative Councill on Obsterric and Paediartic Mortality and Morbidity Annual Report for the year 1995. Melbourne 1996; 22.Google Scholar
6.Kewley, GD. Trends in paediatric care. Aust paediatr J 1986; 16: 46.Google Scholar
7.Young, PCThe morbidity of cardiac non-disease revisited. Is there lingering concern associated with the innocent murmur? Am J Disease child 1993; 147: 975977.Google Scholar
8.Judkin, SSix children with coughs: The second diagnosis. Lancet 1961; 2: 561563.Google Scholar
9.Menahen, S. Teaching students of medicine to listen – the missed diagnosis from a hidden agenda. J Roy soc Med 1987; 80: 343346.CrossRefGoogle Scholar
10.Shinebourne, EA, Carvalho, JSEthics of fetal echocardiography. Cardiol Young 1996; 6: 261263.CrossRefGoogle Scholar
11.Van, Riper M, Pridham, K, Ryff, C. Symbolic interactionism: a perspective for understanding parent-nurse interactions following the birth of a child with Down syndrome. Matern child Nurs J 1992; 20: 2139.Google Scholar
12.Bradbury, ET, Kay, SP, Tighe, C, Hewison, J, Decision-making by parents and children in paediatric hand surgery. Br J plast Surg 1994; 47: 324330.CrossRefGoogle ScholarPubMed
13.Garson, A Jr, Benson, RS, Ivler, L, Patton, C. Parental reactions to children with congenital heart disease. Child Psychiatry Hum Dev 1978; 9: 8694.CrossRefGoogle ScholarPubMed
14.Manahem, S, Lipton, GL, Caplan, GThe psychologically orientated paediatrician and the provisions of psychoanalytic psychotherapy. Child Psychiatry Hum Dev 1989; 12: 6781.CrossRefGoogle Scholar
15.Bando, K, Turrentine, MW, Sun, K, Sharp, TG, Caldwell, RL, Darragh, PK, Ensing, GJ, Corders, TM, Flaspohler, T, Brown, JW. Surgical management of hypoplastic left heart syndrome. Annals Thorac Surg 1996; 62: 7076.CrossRefGoogle ScholarPubMed
16.schrey, C, schreay, M. A parents' perspective: our needs and our maessage. crit Care Nurs clin North Am 1994; 6: 113119.CrossRefGoogle Scholar
17.Lobo, ML. Parent-infant interaction during feeding when the infant has congenital heart disease. J Pediat Nurs 1992; 7: 97105.Google ScholarPubMed
18.Helfer, RE. An objective comparison of th pediatric interviewing skills of freshman and senior medical studiens. pediatriis 1970; 45: 623627.CrossRefGoogle Scholar
19.Linde, Lmpsychiatric aspects of congenital heart disese. Psychiatr Clin North Am 1982; 5: 399406.CrossRefGoogle Scholar
20.Young, PC, Shyr, Y, Schork, MA. The rolr of the primary care physican in the care of childern with serious heart disease. Pediatrice 1994; 94: 284290.CrossRefGoogle Scholar
21.Manahem, S. The onset of murmurs in congenital heart disease. Excepta Medica Communiactions 1996; 17: 78.Google Scholar
22.Romanoff, BDWhen a child dies: Special considerations for providing mental health counselling for bereaved parents. J Mental Health Counsel 1993; 15: 384393.Google Scholar