Clinical determinants of parents’ emotional reactions to the disclosure of a diagnosis of congenital anomaly.

Abstract

Objective: To examine the variability of parents’ patterns of emotional reactions (high intensity vs. low intensity) and of the intensity of each emotion when a prenatal or postnatal diagnosis of a congenital anomaly is disclosed, as a function of gender and clinical variables (diagnosis characteristics and obstetric history). Design: Cross-sectional study. Setting: Two urban Portuguese hospitals. Participants: The parents (60 mothers and 50 fathers) of 60 infants prenatally or postnatally diagnosed with a congenital anomaly. Methods: One month after the disclosure of the diagnosis, the parents answered questionnaires regarding sociodemographic and clinical variables and their emotional experience at the disclosure. Results: Gender differences in the parents’ emotional reactions were not found, and intra-couple congruence was frequent. When there was uncertainty regarding the diagnosis, no prior knowledge about the diagnosis (for fathers only), and no history of pregnancy loss (for mothers only), parents presented significantly more frequently with a pattern of high intensity negative emotional reactions to the disclosure. Type of congenital anomaly, timing of diagnosis, and parity were not found to be significantly associated with the patterns of emotional reactions, but differences in the intensity of specific emotions were found for all variables. Conclusion: Both parents’ emotional experience should be acknowledged at the disclosure. Clinical variables were found to define the stressful situation (the diagnosis). When the diagnosis was perceived as more threatening (i.e., more unexpected, less controllable and predictable), parents presented a pattern of high intensity emotional reactions.