Psychological Distress and Its Associated Factors Among Parents of Children With Congenital Heart Disease: A Cross-Sectional Mixed Method Study at the National Cardiothoracic Center, Ghana

Abstract

Background The aim of this study was to examine the prevalence and factors associated with psychological distress among parents of children with congenital heart disease (PCCHD) receiving treatment at the National Cardiothoracic Centre (NCTC), Accra. Methods A cross-sectional mixed method study involving 248 parents of children with congenital heart disese receiving treatment at the NCTC was employed. Systematic sampling was used to select participants. The outcome variables were depression, anxiety, and somatization, assessed using the brief symptom inventory. A semistructured interview guide was used to understand the contextual factors that contribute to parents’ psychological distress. Poisson regression and inductive thematic analyses were employed for quantitative and qualitative data, respectively. Results The prevalence of depression, anxiety, and somatization was 42.9% [95%CI = 36.7-49.3], 42.4% [95%CI = 36.3-48.9], and 41.2% [95%CI = 35.1-47.6] respectively. Parents who were divorced [aPR (95%CI) = 1.60(1.02-2.51)], hadonly basic level education [aPR (95%CI) = 2.13(1.34-3.39)], were without a religious affiliation [aPR (95%CI)= 2.24(1.58-3.19)], and in the low asset quintile significantly increased the likelihood of psychological distress. Delay/postponement of scheduled surgery, worsening state of child's condition, feeling a sense of helplessness, societal stigma, and lack of funding or health insurance for the treatment of the condition were contextual factors that contributed to increased psychological distress among parents. Conclusion The prevalence of psychological distress was quite high among parents of children with congenital heart disease in Ghana and was associated with both parent and patient factors. Psychosocial care should be integrated into the clinical health services of this group of patients and their parents to improve psychological health outcomes.