{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:09:13Z","timestamp":1785409753174,"version":"3.56.0"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"unspecified","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951126111809_as1\">\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The Family Adaptation study, ancillary to the Single Ventricle Reconstruction Trial, examined the prevalence of anxiety and its associations with stress, psychosocial factors, and quality of life measures in parents of infants who underwent the Norwood procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126111809_as2\">\n                    <jats:title>Materials and methods:<\/jats:title>\n                    <jats:p>Two hundred and fifteen parents (143 mothers and 72 fathers) of 146 infants completed state anxiety (State Anxiety Inventory), stress, psychosocial, and quality of life measures post-Norwood, post-Stage II, and at a final visit (median child age: 14 months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126111809_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A substantial proportion of parents reported severe anxiety symptoms following the Norwood surgery, with 61% of mothers and 43% of fathers affected, decreasing over time to 46% and 33% by the final visit, respectively. Mothers\u2019 average STAI-S scores were significantly higher than fathers\u2019 post-Norwood (47.7 \u00b1 13.2 versus 43.5 \u00b1 11.8,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03), declining to 42.1 \u00b1 13.0 versus 39.0 \u00b1 9.6 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.14) at the final visit. Stress related to parenting a child with a serious illness was a stronger and more consistent predictor of mothers\u2019 anxiety over time (highest\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.49 for emotional distress), whereas insufficient coping and fewer protective factors were greater and more consistent predictors for fathers (highest\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.40 for mastery and health). Quality of life was a consistent predictor of state anxiety for both mothers and fathers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126111809_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Anxiety is elevated in parents of infants who underwent the Norwood procedure and is influenced by a complex interplay of stress, psychosocial factors, and quality of life. Addressing these factors is crucial for improving parents\u2019 mental health, which in turn promotes the well-being of the entire family.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951126111809","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T11:14:57Z","timestamp":1775474097000},"page":"565-579","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Stress, coping, protective factors, and quality of life in parents of infants with CHD: associations with state anxiety"],"prefix":"10.1017","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3870-9651","authenticated-orcid":false,"given":"Jessica","family":"Bainton","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/057q4rt57","id-type":"ROR","asserted-by":"publisher"}],"name":"The Hospital for Sick Children"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia L.","family":"Trachtenberg","sequence":"additional","affiliation":[{"name":"Carelon Research Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u2019Andrea","family":"Freemon","sequence":"additional","affiliation":[{"name":"National Heart Lung and Blood Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8672-6782","authenticated-orcid":false,"given":"Michael A.","family":"Fremed","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center"},{"name":"NewYork-Presbyterian Morgan Stanley Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Klingman","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8572-9874","authenticated-orcid":false,"given":"Linda M.","family":"Lambert","sequence":"additional","affiliation":[{"name":"University of Utah Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2883-4915","authenticated-orcid":false,"given":"Andrew W.","family":"McCrary","sequence":"additional","affiliation":[{"name":"Duke University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian W.","family":"McCrindle","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/057q4rt57","id-type":"ROR","asserted-by":"publisher"}],"name":"The Hospital for Sick Children"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Rathge","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0938-0591","authenticated-orcid":false,"given":"Anjali","family":"Sadhwani","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4599-0522","authenticated-orcid":false,"given":"David E.","family":"Segar","sequence":"additional","affiliation":[{"name":"Children\u2019s Wisconsin Herma Heart Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel J.","family":"Shustak","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8817-4213","authenticated-orcid":false,"given":"Erica","family":"Sood","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7303-7635","authenticated-orcid":false,"given":"Karen","family":"Uzark","sequence":"additional","affiliation":[{"name":"University of Michigan Mott Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodie K.","family":"Votava-Smith","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Woodard Kline","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen A.","family":"Mussatto","sequence":"additional","affiliation":[{"name":"Milwaukee School of Engineering"},{"name":"Children\u2019s Hospital of Wisconsin 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}