Abstract 19104: The Relationship of Parent Well-Being, Family Management, and Service Utilization in Families of Children With Hypoplastic Left Heart Syndrome From the Perspective of Mothers and Fathers

Abstract

Background: Given the prevelance of neurodevelopmental impairments in children with hypoplastic left heart syndrome (HLHS), and recommendations that they have early intervention, parents’ patterns of service utilization for their at-risk child warrants investigation. The purpose of this study was to (1) delineate parent, child, and family needs from the perspective of parents, and (2) identify the services and resources used and needed by parents to support themselves, their children, and their family. Method: Descriptive study employing the Family Management Measure (FaMM), Connor-Davison Resilience Scale (CD-RISC), Parenting Stress Index (PSI), Vineland Adaptive Behaviour Scales (VABS) and Education and Rehabilitation Services Questionnaire (ERSQ). Findings: Questionnaires were sent to 64 families. Thirty-four parents, 21 mothers and 13 fathers, from 22 families returned questionnaires ( 38% response rate). Mean age of the children was 4.81 years (range 13 months to 15 years). There was no significant difference between the resilience of mothers and fathers, with 5/32 (19%) scoring in the post-traumatic stress category. For parenting stress, 10 of 30 (33%) of parents scored in the clinically significant range. Ten of 24 (41%) parents fell into the problematic family management category. Half of the children on the Vineland had typical or above average mean scores. Four of the 22 children living with severe morbidities were receiving education and rehabilitation services. Children with mild to moderate morbidities, including inattention, learning and behavior difficulties, progressive hearing loss and sensory issues, were not receiving adequate services. Minimal community-based services for parents were reported. Conclusion: The presence of an impairment such as HLHS does not predict service needs or outcomes from a functional perspective. Rather, persistent comorbidities have distinct meaning for each child, parent, and family. Therefore, when considering intervention for both the child and the parent, it is important to consider parents’ perceptions the child’s limitations and community participation and how these perceptions influence their parenting processes, especially related to service utilization.