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Psychosocial screening and interventions in congenital heart surgery: optimising patient and family outcomes

Published online by Cambridge University Press:  07 August 2025

Maria E. Hoyos Open the ORCID record for Maria E. Hoyos [Opens in a new window] ,
Andrew Well Open the ORCID record for Andrew Well [Opens in a new window] ,
Mario O’Connor ,
Heather Van Diest ,
Hannah Lopez ,
Carlos M. Mery ,
Charles D. Fraser Jr.  and
Alexandra Lamari-Fisher Open the ORCID record for Alexandra Lamari-Fisher [Opens in a new window]
Maria E. Hoyos*
Affiliation:
Texas Center for Pediatrics and Congenital Heart Disease, Dell Children’s Medical Center at UT Health Austin, Austin, TX, USA Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, TX, USA Value Institute for Health and Care, The University of Texas at Austin Dell Medical School and McCombs School of Business, Austin, TX, USA
Andrew Well
Affiliation:
Texas Center for Pediatrics and Congenital Heart Disease, Dell Children’s Medical Center at UT Health Austin, Austin, TX, USA Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, TX, USA Value Institute for Health and Care, The University of Texas at Austin Dell Medical School and McCombs School of Business, Austin, TX, USA
Mario O’Connor
Affiliation:
Texas Center for Pediatrics and Congenital Heart Disease, Dell Children’s Medical Center at UT Health Austin, Austin, TX, USA Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
Heather Van Diest
Affiliation:
Texas Center for Pediatrics and Congenital Heart Disease, Dell Children’s Medical Center at UT Health Austin, Austin, TX, USA Department of Health Social Work, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
Hannah Lopez
Affiliation:
Texas Center for Pediatrics and Congenital Heart Disease, Dell Children’s Medical Center at UT Health Austin, Austin, TX, USA Department of Health Social Work, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
Carlos M. Mery
Affiliation:
Texas Center for Pediatrics and Congenital Heart Disease, Dell Children’s Medical Center at UT Health Austin, Austin, TX, USA Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
Charles D. Fraser Jr.
Affiliation:
Texas Center for Pediatrics and Congenital Heart Disease, Dell Children’s Medical Center at UT Health Austin, Austin, TX, USA Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
Alexandra Lamari-Fisher
Affiliation:
Texas Center for Pediatrics and Congenital Heart Disease, Dell Children’s Medical Center at UT Health Austin, Austin, TX, USA Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, Austin, TX, USA
*
Corresponding author: Maria Elisa Hoyos; Email: me.hoyos@utexas.edu
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Abstract

Background:

Integrating psychosocial health services into paediatric surgical specialty care is essential for addressing behavioural and psychological aspects of illness and reducing healthcare disparities. This is crucial for patients facing CHD, who are at higher risk for depression, anxiety, and attention-deficit/hyperactivity disorder, which is significantly influenced by their caregivers’ mental well-being.

Methods:

The Pediatric Psychosocial Preventative Health Model framework was utilised by a psychosocial team to assess biopsychosocial needs in CHD patients during their first cardiac surgery evaluations. Patient and family needs were categorised into universal, targeted, and clinical tiers, allowing for responsive interdisciplinary services. Screening tools such as the Psychosocial Assessment Tool, Pediatric Quality of Life Inventory, and Depression, Anxiety, and Stress Scales were used during initial consultations to guide appropriate interventions and referrals.

Results:

Universal-tier patients received comprehensive support focused on preventive measures, resource access, and education to promote resilience. Targeted-tier care involved intensive, collaborative efforts, providing specialized psychological evaluations, and one-on-one time with experts. Clinical-tier families required specialised, intensive interventions such as advanced cognitive behavioural therapy and medication management. The Pediatric Psychosocial Preventative Health Model framework and psychosocial team workflow allow for individualised management strategies, ensuring that each family received timely and appropriate interventions based on their unique needs.

Conclusion:

Integrating psychosocial services into initial surgical evaluations is critical for addressing CHD patients’ psychological and social needs, promoting an interdisciplinary approach that enhances overall family functioning and well-being.

Keywords

Psychosocial screeningCHDsurgical evaluationbehavioural health

Information

Type
Original Article
Information
Cardiology in the Young , Volume 35 , Issue 7 , July 2025 , pp. 1436 - 1442
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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