Anxiety, Depression, and Stress in Parents of Children with Congenital Heart Defects During the COVID-19 Pandemic: An Examination of Risk and Protective Factors

Abstract

Little is known about the mental health burden or the risk and protective factors that have impacted mental health outcomes in parents of children with congenital heart defects (CHD) during the COVID-19 pandemic. Exposure to COVID-19 related stressors plus CHD care related stressors may have had an additive effect on this parent population's mental health. The purpose of this study was to examine risk and protective factors associated with anxiety symptoms, depression symptoms, and perceived stress in parents of young children with CHD during the COVID-19 pandemic. The study used a cross-sectional, nonexperimental survey design that focused on parents of children aged newborn to five years with CHD one year into the COVID-19 pandemic. The findings reveal CHD parents experienced significant anxiety, depression, and stress during the COVID-19 pandemic at levels higher than the US general population norms. Regression analyses were conducted to examine associations between COVID-19 stressors, CHD care related factors, parental resilience, external support, and mental health outcomes. Increased levels of anxiety symptoms, depression symptoms, and perceived stress were associated with 1) Exposure to a greater number of COVID-19 related stressors, 2) Distress from family visitation restrictions during healthcare encounters, 3) Worry related to the perceived risk of their CHD child's exposure to COVID-19 during healthcare encounters, and 4) Worry about their CHD child's risk of death or serious illness from COVID-19. Parental resilience, emotional support, and informational support were shown to be key protective factors for anxiety, depression, and stress. However, resilience was remarkably low in CHD parents. Further research is needed to expand our understanding of resilience in CHD parents and to explore strategies that may support resilience in this population.