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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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