When it comes to the role of the clinical psychology in the cardiac settings, or psychocardiology, there is often a focus on acquired cardiac illnesses in the rehabilitation settings. However, the increase of adults with congenital heart disease due to technological advances in cardiology and cardiac surgery have created a new emergency. It is thus necessary to reflect upon the elements of psychocardiology adapting them to this new population, also when it comes to interventional hospital settings of cardiology and cardiac surgery. This perspective article is an effort in this direction.
The population of adults with congenital heart disease is increasing due to advancements in cardiology and cardiac surgery. Many patients face medical complications and psychosocial difficulties; however, it is not yet clear whether there is a direct relationship between medical status and the psychological functioning of these patients. This systematic review of the relevant literature is an attempt to: provide a comparison between the population of adults with congenital heart disease, the healthy reference population and similar cardiac populations when it comes to psychological functioning; explore the relationship between medical status/cardiac condition and psychological functioning; and identify the predictors of psychological distress in this population.
This study shows that the perception of cardiac disease severity, and not the medical parameters in congenital heart disease, is related to the patients' pre-operative psychological state. Thus, more importance needs to be given to assessing the patients' pre-operative perception and psychological state independently of cardiac severity. Targeted interventions with regard to the cardiac condition are recommended.
Many adults with congenital heart disease (ACHD) have to face considerable psychosocial difficulties. The aim of this study was to explore the life experiences of ACHD patients, from when they become aware of having a condition, till after the open heart surgery they underwent. The study was conducted with the use of unstructured, in-depth interviews, performed on 11 patients (age ranging: 20 -56 y) after they recovered from open heart surgery and a focus group, which included 16 participants (age ranging: 22 -46 y). Both the interviews and the focus group were recorded, transcribed and analyzed according to Grounded Theory procedures. Our findings show that the condition of diversity is the core of the emotional experiences connected to ACHD. Feeling different and being perceived as being different are clearly interlinked and coping strategies adopted resulted as being influenced by this perception. This study also clearly outlines the importance of having an adequate perception of one's condition and the link between maladaptive coping strategies and an incorrect perception of one's heart condition. Results are discussed in order to promote psychosocial interventions within and outside of the hospital setting in order to improve the patients' emotional wellbeing.
RiassuntoIl presente lavoro si colloca nell'ambito della Psicocardiologia e si propone di indagare un nuovo progetto di intervento presso il reparto di Cardiologia pediatrica e del congenito adulto dell'IRCSS di San Donato Milanese. A partire dalla rilevazione delle numerose problematiche che affliggono il bambino e l'adolescente ospedalizzato, fino ad arrivare al peso che lo stato emotivo del genitore ha sulla buona salute del figlio, è stato individuato un forte bisogno di "prendersi cura", oltre il mero "curare", ossia un bisogno di attenzione sul versante emotivo oltre che fisico. L'arteterapia può essere una risposta a tale bisogno: recenti studi hanno dimostrato la sua efficacia in ambito ospedaliero, tenendo conto anche della predisposizione maggiore che bambini e adolescenti hanno alla creatività. Attraverso la somministrazione e l'analisi di 10 disegni di giovani pazienti con cardiopatia congenita ricoverati, si riscontra come questo intervento offra loro la possibilità di esprimere paure e sentimenti relativi all'intervento chirurgico e al vissuto di malattia, in una modalità più libera ed immediata. Inoltre, la creazione di un prodotto tangibile dà agli psicologi l'occasione per poter meglio considerare il disagio psicologico dei giovani pazienti e poter quindi attuare interventi di supporto più specifici e mirati ad essi e ai loro genitori.Questo studio si occupa di valutare le percezioni che i genitori hanno di questo nuovo intervento terapeutico proposto presso il reparto di Cardiologia e Cardiochirurgia Pediatrica, confermandone l'utilità per gli attori coinvolti nel "prendersi cura" dei giovani pazienti affetti da CHD.
AbstractThe current work is the presentation of a new project at the IRC-SS San Donato Milanese University hospital, in the sphere of Psychocardiology. Hospitalised children and adolescents often face psychosocial difficulties and the psychological condition of their parents frequently has an impact on their wellbeing. A strong need to take care, beyond the mere cure, is necessary in the hospital settings -that is a need to pay attention also to psychological aspects apart from the medical ones. Art therapy could be an answer for this need: the literature has outlined its efficacy in hospital, also due to the higher inclination of children and adolescents toward creativity. By providing and analysing the drawings of 10 young patients with congenital heart disease (CHD), this study outlines how the art therapy program gives these patients the opportunity to freely and directly express fears and anxieties about medical procedures and their disease. Moreover, through the creation of a tangible product, psychologists can better evaluate the psychological troubles of young patients and provide them and their parents with more focused and personalized support.
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