Association of Parenting Stress in Early Childhood with Emotional Health and Resilience of Young Adults with Congenital Heart Disease.

Abstract

To describe the association between parenting stress levels during early childhood and subsequent emotional health outcomes and resilience of their children with congenital heart disease (CHD) as young adults. This prospective cohort study included 202 dyads of young adults with CHD and their caregivers. The young adults had undergone surgery with cardiopulmonary bypass at ≤ 6 months of life and were enrolled in a longitudinal study of neurodevelopmental outcomes in CHD. Resilience and general health status of the young adults were evaluated using self-report standardized questionnaires (14-Item Resilience Scale [RS-14] and 36-Item Short-Form Health Survey [SF-36]). Parenting stress in the preschool period was assessed using the Parenting Stress Index (PSI), completed by caregivers. An underlying mental health condition was self-reported by 120 (59%) of the young adults. Median PSI score (PSI total score = 58; interquartile ranges 46.25-71) indicated normal parenting stress levels. Mean SF-36 score (46, SD 11) was just below general population average (50), and mean RS-14 score (77, SD14) was similar to population average (76). Higher parenting stress was associated with lower young adults' resilience, with a unit increase in PSI total score associated with 0.14 (95% CI 0.02 - 0.26) decrease in RS-14 total score. Higher reported parenting stress during early childhood was associated with lower self-reported resilience in young adulthood for patients with CHD. This suggests that identification of an at-risk population early in life is possible and may provide an opportunity for targeted family-based interventions to improve psychosocial development with increased resilience.