Parental Reactions to Perinatal Congenitalanomaly Diagnosis of the Baby: Implications for the Intervention of Health Professionals

Abstract

_________________________________________________________________________________________________________________________________RESUMO: A notícia de um diagnóstico de anomalia congénita do bebé no período perinatal reveste-se de um impacto emocional significativo para os pais, constituindo um desafio para a actuação dos profissionais de saúde. O objectivo deste trabalho é delinear implicações para a intervenção dos profissionais de saúde, tendo por base uma reflexão sobre a investigação existente acerca das reacções parentais ao diagnóstico de anomalia congénita do bebé. A investigação empírica descreve reacções parentais iniciais semelhantes à resposta de luto (choque, tristeza, ansiedade, culpa e raiva), num processo gradual de adaptação, geralmente conducente à restituição do equilíbrio emocional. Verificam-se também algumas especificidades, em função do momento em que o diagnóstico é conhecido. Da reflexão sobre estes resultados, emergem algumas orientações para a actuação dos profissionais de saúde, nomeadamente no que respeita à comunicação do diagnóstico, à necessidade de uma equipa multidisciplinar coordenada que proporcione um contexto seguro de prestação de cuidados e à relevância de intervenções psicossociais com estas famílias. Palavras-chave: Anomalia congénita do bebé; diagnóstico pré-natal; diagnóstico pós-natal; reacções parentais; intervenção dos profissionais de saúde; intervenção psicossocial. _________________________________________________________________________________________________________________________________ PARENTAL REACTIONS TO PERINATAL CONGENITAL ANOMALY DIAGNOSIS OF THE BABY: IMPLICATIONS FOR THE INTERVENTION OF HEALTH PROFESSIONALSABSTRACT: The communication of a congenital anomaly diagnosis of the baby during the perinatal period has a significant emotional impact for parents, being a challenge for the intervention of health professionals. The aim of this paper is to outline implications for the intervention of health professionals, based on a reflection on existing research about parental reactions to the diagnosis of congenital anomaly of the baby. Empirical research describes initial parental reactions similar to mourning response (shock, sadness, anxiety, guilt and anger), in a gradual process of adaptation, often leading to recovery of emotional well-being. There are also some specific features, depending on when the diagnosis is known. From the reflection on the research results presented, some guidelines for different health professionals emerged, particularly as regards the communication of the diagnosis, the need for a coordinated multidisciplinary team that provides a safe context of care, as well as the relevance of psychosocial interventions with these families.

Anxiety of mothers of newborns with congenital malformations in the pre- and postnatal periods

“…For parents, the news of a diagnosis of congenital anomaly in their child can trigger many reactions, which may vary according to, for example, the moment the diagnosis is revealed 20 .…”

Selected predictors of maternal-fetal attachment in pregnancies with congenital disorders, other complications, and in healthy pregnancies

“…My present findings highlight the need to improve the care system for pregnant women, which, in addition to specialized medical assistance, would also include psychological assistance in a broader sense. Although the present research did not show intergroup differences, it is extremely important to train health care professionals particularly as regards the communica-Predictors of maternal-fetal attachment in healthy and high-risk pregnancies 11  tion of the diagnosis (Fonseca & Canavarro, 2010). The possibility of early detection and correction of pregnancy risks allow ample opportunity for educational, preventive and assistance activities addressed to future parents and their families, as well as the specialists taking care of pregnant women.…”

“…The information about the birth defect of a child has an emotional impact on parents. The initial parental reaction to the diagnosis is compared to the mourning process in which gradual adaptation leads to better emotional well-being (Fonseca & Canavarro, 2010). Additionally, the diagnosis of fetus malformations or pregnancy complications could be a major stressor during pregnancy, associated with higher levels of anxiety and depression (Asplin, Wessel, Marions, & Georgsson Öhman, 2015;da Cunha, Pereira, Caldeira, & Carneiro, 2016).…”