الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Congenital heart defects are structural problems arising from abnormal formation of the heart or major blood vessels. At least 18 distinct types of congenital heart defects are recognized, with many additional anatomic varitations. Recent progress in diagnosis and treatment (surgery and heart cathereization) makes it possible to fix most defects, even those once thought to be hopeless (American Heart Association, 2016 b).
Aim of the study
The aim of the study was to assess mothers’ adjustment for their children post congenital heart surgery through:
- Assessing knowledge of mothers about congenital heart surgery for their children post hospital discharge.
- Assessing mothers’ care provided to their children post congenital heart surgery post hospital discharge.
- Evaluating mothers’ adjustment toward their children post congenital heart surgery.
Research questions
1- What are the mothers knowledge about congenital heart surgery?
2- How would be the level of mothers’ adjustment post heart surgery?
3- Is there relation between mothers’ socio demographic characteristics and their care given to their children post heart surgery?
4- Is there relation between mothers’ care and their adjustments post hospital discharge after heart surgery?
Research Design
A. Setting:
This study was conducted at outpatient clinics of cardiovascular diseases and surgeries Hospital of Ain Shams University.
B. Subjects:
The total number was 102 mothers have children underwent congenital heart surgery. Those children represent 60% of the mean (170) of the last past three years from 2012 to 2014.
The criteria for recruiting of children in the study were:
- Children were post hospital discharge with congenital heart surgery.
- The children’s age were preschool age from 1 year to 5 years.
Technical design
Tools of data collection:
The data were collected using the following tools:
First tool: An interviewing questionnaire (Appendix I): which included the following parts.
Part (I): This part included questions to assess the mother’s socio –demographic characteristics as regard age, educational level, job, family size, monthly income, past obstetric history, child’s age, sex birth order, and diagnosis.
Part (II): This part included questions for mothers to assess their knowledge about the heart, the congenital heart disease, the immunizations for their child, the complications and the follow up.
Part (III): This part included questions for mothers to assess their knowledge about the health care for child about daily activities, sternal wound care, oral and dental care, balanced diet and medications administrations
Part (IV): This part included adjustment scale rated on from 1-to-3 points. Likert scale to indicate the degree of use (never, sometimes, & always). Whereby ”1” represent never used at all,”2” sometimes used &”3”signifies always used.
The Second tool: This tool included medical analysis record for assessing diagnosis, investigations, and medications of children.
The Third tool: This part included an observation checklist for assessing mother’s activities through the six months which included checklist observation for breast feeling, bottle feeding, measuring auxiliary temperature, about wound care and about mouth care.
The Fourth tool: Physical examination of child growth and development using Denver Developmental Screening Test (Berman, 2012).
Result of studyas the following:
The study shows that 54.9% of the total sample of children post congenital heart surgery were male aged 1-5 years.Regarding the medical diagnosis 47.1% of them diagnosed with VSD and ASD and 13.7 % of them diagnosed with TOF. There was no statistical significant relation between the mothers’ total care practices and their age, family monthly income, residence, and family size, respectively at P>0.05. Meanwhile, there was a statistical significant relation between the mothers’ total care practices and mothers’ job, crowding index, respectively at P<0.05. Also there is a highly statistical significant relation between the mothers’ total care practices and their educational level, at P<0.001.More than two third (69.0%) of mothers were non adaptive compared to third (31%) of them had adaptive level of adjustment with their children post congenital heart surgery. There was a statistical significant relation between the mothers’ adjustment and their total care practices for their children post congenital heart surgery after hospital discharge, at P <0.05. There was a statistical significant relation between the mothers’ total knowledge and their adjustment toward their children post congenital heart surgery, at P>0.05. There was no statistical significant relation between the mothers’ total knowledge and their total practices of care given to their children post congenital heart surgery after hospital discharge, at P >0.05.
The findings of the present study suggest the following recommendations:
Health education and discharge plan should be adovacated for post congenita heart surgery care at home.
Stress on the importance of genetic counseling especially if there is positive family history of CHD for women before becoming pregnant.