INFLUENCE OF AGE AT WHICH CHILDREN UNDERGO ELECTIVE CARDIAC SURGERY
OR CARDIAC CATHETER INTERVENTION ON THE COURSE OF PSYCHOLOGICAL
DISTRESS AND COPING OF PARENTS.
Utens E, Versluis-Den Bieman H, Witsenburg M, Bogers A, Hess
J, Verhulst F.
Departrnents of Child and Adolescent Psychiatry, Paediatric Cardiology
Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands, and
Geman Heart Centre
Purpose of the present study was to assess the influence
of age at a cardiac procedure of children who underwent elective
cardiac surgery ("surgery") or cardiac catheter intervention
("intervention") for congenital heart defects between
3 months and seven years of age, on the development of psychological
distress and styles of coping of their parents (both fathers and
Methods: The study sample consisted of parents of a consecutive
series of patients who underwent their first elective open cardiac
surgical procedure or elective catheter intervention, for a non-life
threatening and a, at that moment, non-function-impairing congenital
heart defect, between May 1994-May 1997, in the University
Hospital Rotterdam. Patients who were between 3 months and 7 years
of age at the time of "surgery" or "intervention"
were included. Postoperative measurements were performed between
November 1995-November 1998. Due to the longitudinal nature of the
study, only data of parents who completed questionnaires both pre-and-ostoperative1y
were included. Parents completed questionnaires on average respectively
5 weeks prior to and 18.7 months after the cardiac procedure of
their child. ("Surgery-mothers": N=67, "Surgery-fathers":
N= 60, "Intervention-mothers": N=17, "intervention-fathers":
To assess psychological distress the General Health Questionnaire
was used and to assess coping styles the Utrecht Coping List.
Results: Overall, no significant influence was found of the
age at which children underwent elective cardiac surgery or elective
catheter intervention on the pre-to postprocedural development of
distress and the coping styles of their parents.
Significant effects were found for the type of medical procedure:
across time, parents of operated children reported on average significantly
higher levels of psychological distress than parents of children
who underwent cardiac catheter intervention.
After the procedure, parents of children who underwent either type
of procedure, reported significantly lower levels of psychological
distress than reference groups. Significant differences in coping
styles were found between parents of patients and reference groups
after the procedure had been performed.
Conclusion: Our results do not indicate an optimal age at
which the elective cardiac procedures should be performed, from
the viewpoint of psychological wellbeing of the parents. The practice
of performing an elective catheter intervention in preference above
elective cardiac surgery, when both are applicable, seems also to
be justified from the viewpoint of parental wellbeing. Future studies
should focus on how the overall favourable results of the parents
influence the development of children who underwent these elective
The present study was supported by grants from the Netherlands Heart
Foundation (no. 92.353 and no. 97.044)