Coping with Congenital Heart Disease: Implementation of an Evidence-Based Intervention in a Pediatric Cardiac Intensive Care Unit

Caregivers are exposed to many stressors in the pediatric cardiac intensive care unit (CICU) setting. In caregivers of children diagnosed with congenital heart defects admitted to the CICU, symptoms of psychological distress are prevalent (Doherty et al., 2009). These symptoms include, but are not limited to, feelings of acute and chronic stress, worry, anxiety, and depression. Without intervention, these symptoms can negatively influence the health and behavioral outcomes of the admitted child (Commodari, 2010). Providing support for these caregivers during their child’s admission can reduce the significance of these adverse psychological symptoms and promote both patient and caregiver well-being (Melnyk et al., 2007).

The purpose of this evidence-based practice project was to implement a coping intervention for caregivers of children admitted to the pediatric CICU. The Model for Evidence-Based Practice Change, combined with phases from Lippitt’s Theory of Planned Change, guided this project’s development, implementation, evaluation, and dissemination (Larrabbee, 2009; Lippitt, 1958). Eight caregivers of surgical infants in a single center pediatric CICU were provided a palliative care team intervention preoperatively and postoperatively. The aim was to help caregivers cope with common stressors in the CICU setting. Caregivers rated how stressful specific experiences in the pediatric CICU were to them by completing a modified version of the Parental Stressor Scale (PSS:NICU-16). Mean scores were evaluated before and after providing the caregivers with the palliative care team coping intervention. No statistically significant differences were found from baseline to after the palliative care intervention across three subscales (p= .375, .084, .443). However, there were reductions in the mean scores for stressors related to how their baby looked and behaved and stressors involving the parent relationship with their baby, suggesting clinical significance.

Interventions that support caregivers’ mental health during their infant’s hospitalization can improve patient recovery and resilience. Palliative care teams have beneficial knowledge and skills that make them resourceful in promoting caregiver coping. Implementing a palliative care team intervention in the pediatric CICU setting for caregivers of patients receiving cardiac surgery may improve caregiver coping mechanisms and thereby promote patient healing and recovery.