Certain congenital anomalies : some psycho-social implications in adulthood

Abstract

This study is an investigation of some psycho-social implications in adulthood of being born with a congenital anomaly. The congenital anomalies - oesophageal atresia, Hirschsprung's disease and high anorectal malformations are surgically corrected at birth, but can be associated with residual problems. These problems could put patients at risk for psycho-social maladjustment. The three anomaly groups were seen to represent varying degrees of severity. The oesophageal atresia respondents represented the no to mild disability/residual problems group. Those who had Hirschsprung's disease represented the moderate disability/residual problem group. The high anorectal malformation respondents' represented the severe disability/residual problem group. The research hypothesis is that the severity of residual problems and psycho-social functioning will be directly proportional to each other, i.e. the more severe the handicap, the poorer the psycho-social functioning. A research study was conducted on 38 adult patients whose congenital anomalies were surgically corrected at The Red Cross War Memorial Children's Hospital. The research methods used were a descriptive survey method and a case-study method. The former involved three self-administered questionnaires. Information obtained concerned demographic, socio-economic, family background, medical and psycho-social problem data. An in-depth case-study was conducted with one respondent from each anomaly group. Information was obtained concerning the effect that residual problems had had on various aspects of patients' lives. Data was analysed descriptively. The findings of the study supported the research hypothesis, the medical prognosis and on the whole agreed with the literature. Severity of residual problems was found to be directly related to psycho-social functioning. Patients with severe disability/residual problems were experiencing the most psycho-social problems, those who had moderate disability/residual problems were found to have some psycho-social disability/residual problems, whereas those with mild disability/residual problems were found to have few or no psycho-social problems. Self-esteem, depression, interpersonal relationships and restricted social functioning were the psycho-social aspects found to be most affected by residual problems. The study revealed gaps in both medical and social work services for these patients in terms of ongoing follow-up services. Recommendation to improve these services have been proposed.