Developing patient resources to enable the exchange of healthy lifestyle information between clinicians and families of children with complex heart problems.

BACKGROUND: Healthy active lifestyles are critically important for children with complex heart problems (CHP) that affect heart structure, rhythm or function. They are at increased risk for morbidities such as atherosclerosis, obesity, anxiety and depression. Educating children with CHP and their families about the relevance of healthy lifestyles is an important part of clinical care. DESIGN: This study used a collaborative approach among six patients/family members and 22 health professionals to develop a series of knowledge-to-action tools suitable for counselling children with CHP and their families about their healthy lifestyle needs. METHODS: After development of the knowledge-to-action tools had been completed, one cardiologist and one research assistant implemented one or more of these new resources during each clinic visit as appropriate for each patient. Thirty-nine parents and eight children completed post-clinic interviews to explore their perceptions of the new resources. The nine resources developed included brochures and websites addressing physical activity with a heart condition, body contact restrictions, exercise test results, emotional health, finding community resources, encouragement for asking healthy lifestyle questions and a brief, in-clinic healthy lifestyle assessment. RESULTS: Families found the resources useful and helpful for clarifying their specific concerns. They also provided suggestions to improve the content and delivery of the resources so that they would be suitable for a variety of settings-schools, community and sports. CONCLUSION: Future research is required to evaluate the effectiveness of these resources for raising awareness and knowledge about healthy active lifestyles among children with CHP and the impact of these resources for changing healthy lifestyle behaviours.

Recognition of children's emotional facial expressions among mothers reporting a history of childhood maltreatment.

Several studies have shown that child maltreatment is associated with both positive and negative effects on the recognition of facial emotions. Research has provided little evidence of a relation between maltreatment during childhood and young adults' ability to recognize facial displays of emotion in children, an essential skill for a sensitive parental response. In this study, we examined the consequences of different forms of maltreatment experienced in childhood on emotion recognition during parenthood. Participants included sixty-three mothers of children aged 2 to 5 years. Retrospective self-reports of childhood maltreatment were assessed using the short form of the Childhood Trauma Questionnaire (CTQ). Emotion recognition was measured using a morphed facial emotion identification task of all six basic emotions (anger, disgust, fear, happiness, sadness, and surprise). A Path Analysis via Structural Equation Model revealed that a history of physical abuse is related to a decreased ability to recognize both fear and sadness in children, whereas emotional abuse and sexual abuse are related to a decreased ability to recognize anger in children. In addition, emotional neglect is associated with an increased ability to recognize anger, whereas physical neglect is associated with less accuracy in recognizing happiness in children's facial emotional expressions. These findings have important clinical implications and expand current understanding of the consequences of childhood maltreatment on parents' ability to detect children's needs.

Childhood maltreatment moderates the relationship between emotion recognition and maternal sensitive behaviors.

BACKGROUND: Sensitivity is defined as parents ability to perceive, react and respond to children signals. Having a history of childhood maltreatment changes the way adults perceive visual emotions. These perceptual characteristics could have important consequences on how these parents respond to their children. OBJECTIVE: The current study examines how a history of childhood maltreatment moderates the relationship between maternal emotion recognition in child faces and sensitive behaviors toward their child during free-play and a structured task. PARTICIPANTS AND SETTING: Participants included 58 mothers and their children aged between 2 and 5 years. METHODS: Mothers were exposed to a set of photographs of child faces showing morphed images of the six basic emotional expressions. Mother-child interactions were then coded for sensitive behaviors. Mothers' history of childhood maltreatment was assessed using the Childhood Trauma Questionnaire. RESULTS: Maltreatment severity was related to poorer abilities in emotion recognition. However, the association between emotion recognition and sensitive behavior was moderate by history of childhood maltreatment. For mothers exposed to a severe form of childhood maltreatment, a better emotion recognition was related to less sensitive behaviors toward the child, both during free-play and the structured task. CONCLUSION: This relationship is unique to these mothers and is inconsistent with Ainsworth's definition of sensitivity. These results have important implications as they suggest mothers with a history of severe maltreatment would need tailored interventions which take into account their particular reactions to children's emotions.