Open Access

ARTICLE

Parental anxiety before invasive cardiac procedure in children with congenital heart disease: Contributing factors and consequences

Oscar Werner¹, Fedoua El Louali², Virginie Fouilloux³, Pascal Amedro^1,4, Caroline Ovaert^2,5

1 Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, University Hospital, Montpellier, France
2 Pediatric and Congenital Cardiology, M3C Regional Reference CHD Centre, University Hospital, Marseille, France
3 Pediatric and Congenital Cardiac Surgery, University Hospital, Marseille, France
4 PHYMEDEXP, CNRS, INSERM, University of Montpellier, Montpellier, France
5 Marseille Medical Genetics, INSERM UMR 1251, Aix Marseille University, Marseille, France

* Corresponding Author: Oscar Werner, Pediatric and Congenital Cardiology Department, Montpellier University Hospital, 371 Avenue du Doyen Giraud, 34295 Montpellier, France. Email:

Congenital Heart Disease 2019, 14(5), 778-784. https://doi.org/10.1111/chd.12777

Abstract

Objective: Medical information provided to parents of a child with a congenital heart disease can induce major stress. Visual analog scales have been validated to assess anxiety in the adult population. The aim of this study was to analyze parental anxiety using a visual analog scale and to explore the influencing factors.
Design: This prospective cross‐sectional study.
Setting: Tertiary care regional referral center for congenital heart disease of Marseille—La Timone university hospital.
Patients: Parents of children with a congenital heart disease, as defined by the ACC‐ CHD classification, referred for cardiac surgery or interventional cardiac catheterization, were offered to participate.
Intervention and outcome measure: The parental level of anxiety was assessed using a visual analog scale (0‐10) before intervention and after complete information given by the cardiologist, the surgeon or the anesthetists.
Results: Seventy‐three children [7 days‐13 years], represented by 49 fathers and 71 mothers, were included in the study. A total of 42 children required cardiac surgery and 31 children underwent interventional cardiac catheterization. The mean score of maternal anxiety was significantly higher than the paternal anxiety (8.2 vs 6.3, P < .01). A high level of maternal anxiety (visual analog scale > 8) was associated with paternal anxiety (P = .02), the child's comorbidity (P = .03), the distance between home and referral center (P = .04), and the level of risk adjustment for congenital heart surgery (P = .01). In multivariate analysis, maternal anxiety was associated with paternal anxiety (OR = 4.9; 95% confidence interval [1.1‐19.2]), and the level of risk adjustment for congenital heart surgery (OR = 11.4; 95% confidence interval [1.2‐116.2]). No significant association was found between parental anxiety and prenatal diagnosis.
Conclusion: This study highlighted several factors associated with the parental anxiety. Identifying the parents at risk of high stress can be useful to set up psychological support during hospitalization.

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