Efficacy of CBT on Depression among Parents with Children Undergoing Complex Congenital Heart Surgery & Prolong ICU Stay
Background - Parents, especially mothers whose children are born with complex congenital heart disease (CCHD) requiring complex corrective cardiac surgery, experience extreme stress further leading to depression, especially when their child’s recovery progress is poor in Pediatric cardiac intensive unit (PICU) following cardiac surgery.
Method - This prospective study included 50 biological parents of children admitted to a PICU who had undergone cardiac surgery for CCHD. Both qualitative (observation and interview) and quantitative (questionnaires) methods were used to collect data. Parents, including single mothers and children demographics and responses to Beck’s depression inventory (BDI) and Hospital anxiety depression scale (HADS) were collected. The level of depression was scaled based on the responses from these questionnaires and 12 sessions of cognitive behavioural therapy (CBT) was given to the participants, after which depression level was screened again using HADS and BDI. Pre CBT and post CBT scores were measured.
Results - The association between PICU stay and depression was found significant. Single mothers had higher level of depression when compared to couple parents. The association between area, age, other demographic variables and depression was found Insignificant. Towards the end of 12 sessions of CBT, the post test scores were normal among the participants.
Conclusion- CBT intervention significantly reduces stress, anxiety and depression. Parents feel more stressful and depressed when their child is in PICU for longer period, they need some form of psycho-therapy like CBT, which appears to be appropriate and effective to motivate them fight out their depression during their child’s prolong PICU stay. A larger randomised control trial needs to be conducted to facilitate these findings and implement CBT in every hospital set up by establishing a pre-operative counselling centre, during admission of complex open heart surgery children with expected risk of prolong ICU stay.
Keywords – Complex Congentital heart surgery (CCHD), depression, stress, Cognitive behavioural therapy (CBT), Parents, Infants, Prolong PICU (pediatric intensive cardiac care) stay.