Antenatal diagnosis of diaphragmatic hernia: parents’ emotional and cognitive reactions

Presented at the 50th Annual Congress of the British Association of Paediatric Surgeons, Estoril, Portugal, July 15–18, 2003.
https://doi.org/10.1016/j.jpedsurg.2003.10.010Get rights and content

Abstract

Purpose

The aim of this study was to assess parent’s emotional and cognitive reactions to the prenatal diagnosis of diaphragmatic hernia in their prospective children.

Methods

A survey was conducted by means of a questionnaire. In the period ranging from 1997 to 2002, 40 couples in whom an established diagnosis of diaphragmatic hernia was made in their fetus were seen for prenatal consultation at a tertiary referral center.

Results

Overall response rate was 93% (37 couples). Mean period since diagnosis for compilation of the questionnaire was 2 weeks. Mean gestational age at diagnosis was 25 weeks (range, 16 to 35 weeks). All parents lacked prediagnostic knowledge of diaphragmatic hernia and consider a single consultation with the paediatric surgeon inadequate to have a clear understanding of the anomaly. Only 1 mother and 1 father reported they understood all the information given by the surgeon. The most frequent (75%) feeling during and after the consultation was fear. Most parents (70%) referred to the intense emotions as the factor that made it difficult to follow the surgeon’s explanations as well as to ask questions.

Conclusions

Because of the incompatibility of emotional distress and optimum learning, impairment of early comprehension of information about diaphragmatic hernia is unavoidable. Therefore, we believe that follow-up antenatal consultations and provision of written and visual illustration are extremely important to facilitate informed choices.

Section snippets

Materials and methods

In the period ranging from 1997 to 2002, all couples seen for prenatal consultation at a tertiary referral center, in which an established diagnosis of diaphragmatic hernia was made in the fetus, were asked to participate in a psychological study.

Couples fulfilled the following criteria: (1) Communication of diagnosis was done by the same team; (2) no associated anomalies were detected; and (3) no language problems existed.

A pair of identical questionnaires were given to each member of the

Results

Forty couples met the aforementioned criteria and formed the object of this study. Completed questionnaires were received from 37 couples with an overall response rate of 93%. Mean period for returning the questionnaire was 2 weeks (range, 1 to 3 weeks). Mean gestational age at diagnosis was 25 weeks (range, 16 to 37 weeks). Mean maternal and paternal age was 29 years and 31 years, respectively. Educational level ranged from high school (27 mothers; 31 fathers) to graduate (10 mothers, 6

Discussion

Numerous studies have considered the emotional distress of the parents after the diagnosis of a severe fetal malformation.6, 7, 8, 9 Few of these studies have considered the potential cognitive impairment to the prospective parents by the initial communication of the diagnosis of a fetal anomaly. Hunfeld et al10 has assessed to what extent prospective parents recall information given about their unborn baby’s anomaly. Kohler et al5 considered parents’ recollection of the initial communication

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