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Congenital Cardiac Surgery and Parental Perception of Risk: A Quantitative Analysis

Lotto, RR, Jones, I, Seaton, SE, Dhannapuneni, R, Guerrero, R and Lotto, A (2019) Congenital Cardiac Surgery and Parental Perception of Risk: A Quantitative Analysis. World Journal for Pediatric and Congenital Heart Surgery, 10 (6). pp. 669-677. ISSN 2150-1351

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Abstract

Introduction: Interpretation of risk by parents of children undergoing congenital cardiac surgery is poorly documented. The available evidence highlights a dichotomy, where clinicians suggest parents may not grasp the complexity and risk associated with procedures, whilst some parents suggest risk is unnecessarily over-emphasised.
Aim: To quantify how risk is perceived by parents Methods: 106 parents of children undergoing cardiac surgery were recruited and completed a Likert scale from 1 (perceived low-risk) to 6 (perceived high-risk), at five points: arrival at pre-admission; post discussion with anaethetist/surgeon; day of surgery; discharge from intensive care; at outpatient follow up. The surgical sample was stratified according to risk adjustment in congenital heart surgery.
Analysis: Data was analysed using Wilcoxon rank tests for differences in distributions of scores, and Krippendorff's Alpha to examine level of agreement.
Results: Median parental risk scores varied over time, with no consistent risk scores observed. Maternal scores were consistently higher than paternal scores at every time point (p<0.001). Postoperative complications resulted in a persistent rise in risk perception at follow up (p<0.001). Analysis of parental risk scores, and objective measures of surgical risk highlighted poor agreement that was particularly marked at the extremes of risk.
Conclusions: Parents perceived higher risk scores than those reported by the clinical team. Mothers reported statistically significant higher scores than their partners, highlighting potential tensions. In addition, the changing perception of risk over time emphasizes the need for flexible levels of support and information as parents navigate uncertainty.

Item Type: Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RJ Pediatrics
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0440 Study and Teaching. Research
Divisions: Nursing & Allied Health
Publisher: SAGE Publications
Date Deposited: 11 Nov 2019 12:08
Last Modified: 11 Nov 2019 12:08
DOI or Identification number: 10.1177/2150135119872489
URI: http://researchonline.ljmu.ac.uk/id/eprint/11744

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