Nurse Practitioner Texas Chidren's Hospital Houston, Texas, United States
Background:
Background: - Pre-and post surgical Adult Congenital Heart Disease (ACHD) patients undergo lifesaving, invasive, painful, and traumatic procedures, which can lead to medical trauma and re-traumatization. Addressing this trauma requires a unique multidisciplinary, collaborative approach which provides high-quality, humanistic clinical patient care.
Methods:
Methods: Literature review, interviewing and observation.
Outcome: The ACHD program at Texas Children’s hospital sees over 3000 patients annually. ACHD patients require highly specialized cardiac care synergized with psychiatric care as they experience long hospitalizations, which present unique medically traumatic and re-traumatizing experiences. These patients undergo multiple procedures such as line insertions, cardiac catheterization procedures, advanced cardiac therapies, surgeries, dehumanization, and loss of control. Integrating mental health into patient care models with a dedicated psychiatrist to address the cognitive and behavioral deficits as well as social challenges that ACHD patients face is key. The mental health team link the congenital heart diagnosis and cognitive and behavioral deficits during adulthood. Evidence has shown that patients who are mentally healthy have better outcomes managing their physical disease. Trauma-informed care delivery recognizes the impact of trauma and ACEs throughout the lifespan on mental health outcomes of affected patients. ACHD patients should be approached with a unique compassion, patience, empathy and an awareness that they have likely experienced lifelong traumatic survival mode at different levels with each hospitalization. Care teams should foster patient and family resilience and engagement while building strong patient and family and clinician relationships to mitigate gaps in follow up care. Clear, open and culturally sensitive prevent miscommunication.
Conclusion: ACHD patients present unique lifelong challenges to the healthcare system. Effective programs include trauma-informed care and recognize the importance of providing dedicated high quality, physical and psychiatric humanistic care to address the lifelong conditions requiring multiple surgeries and interventions with multi system-involvement and higher risks of complications and lifestyle considerations.
