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Background: Infants born with single ventricle heart disease require in-home medicalized care during the interstage period (time between the first and second staged heart surgery). These caregivers rely on extended family, friends, and hired caretakers to provide respite time. However, the coronavirus pandemic removed these families’ options due to stay-at-home and social distancing directives. We explored the caregivers’ experiences during the interstage period, including impacts on their lifestyle, as they managed their infants’ critical needs during the coronavirus disease 2019 pandemic. Method: In-person or telephonic interviews of 14 caregivers interviewed once or twice were conducted between November 2019 and July 2020. Constructivist Grounded Theory methodology guided both data collection and analysis for the inductive and abductive exploration of caregivers’ experiences. Results: Data analysis led to the development of 2 concepts: Accepting and adapting to a restrictive home environment and Reconciling what is and what is yet to come. Refinement of the relationship between the 2 concepts led to the development of a theory grounded in the words and experiences of the participants called: A Continuous Process of Compromise. Conclusions: Our findings increase understanding of caregivers’ experiences related to psychosocial and lifestyle impacts and the need for additional support during the interstage period.

Purpose: The aim of this study was to examine the relationship between acculturation, medication adherence, lifestyle behaviors (e.g., physical activity, nutrition, weight control), and blood pressure control among hypertensive Arab Americans. Design: The study utilized a cross-sectional descriptive design. A convenience sample of 126 participants completed questionnaires and had measures of blood pressure, weight, and height. Forty-six participants were hypertensive and were included in the analysis. Results: Only 29.2% of participants reported high medication adherence. High medication adherence was associated with lower diastolic blood pressure, eating a healthy diet, and following lifestyle modifications. Acculturation was significantly associated with physical activity and body mass index. Conclusion: Our study found that acculturated participants were more adherent to medications and physical activity and had better blood pressure control. Further studies are needed to explore how acculturation improves adherence and what factors contribute to better adherence in order to design culturally sensitive interventions. © 2014, SAGE Publications. All rights reserved.

Minimally invasive pediatric cardiac surgery, although still evolving, lacks much of the corporate "thunder" directed to wards the adult patient. Because the majority of pediatric procedures remain "open" requiring cardiopulmonary bypass, innovations and/or modifications of already established tech niques might have important adult medical applications. The care of children born with congenital heart disease at our institution presently incorporates cardioscopy, active venous suction, epidural/spinal anesthesia, and, most recently, robotic video assistance. This mufti-disciplinary combination has not only optimized the cosmetics of the operation and use of hospital resources but also has maintained the safety and reproducibility of the surgical interventions.

The use of regional anesthesia in combination with general anesthesia for children undergoing cardiac surgery is the subject of a growing number of publications and presenta tions. Benefits of regional anesthesia in patients having car diac surgery include attenuation of the neuroendocrine response to surgical stress, improved postoperative pulmo nary function, enhanced cardiovascular stability, and im proved postoperative analgesia. To the extent that regional anesthesia facilitates early tracheal extubation in cardiac surgical patients, complications and costs associated with postoperative mechanical ventilation may be reduced. These benefits must, however, be weighed against the ad verse effects that may accompany the use of regional anes thesia, including hypotension, postoperative respiratory de pression, and epidural hematoma formation. In this article, the benefits and risks of regional anesthesia in infants and children undergoing open heart surgery are reviewed. In addition, specific spinal and epidural techniques currently in use are described, including management of side effects. Copyright © 2001 by W.B. Saunders Company.