Parental Acceptance–Rejection and Psychological Adjustment in Young Patients with Congenital Heart Disease: A Comparative Cross-Sectional Study

Abstract

Objectives: To examine the relationship between parental acceptance–rejection and psychological adjustment among young patients with congenital heart disease (CHD) compared to their healthy siblings. Methodology: A comparative cross-sectional study was conducted between 2021 and 2022 in the pediatric cardiology wards and clinics of the Faisalabad Institute of Cardiology (FIC), Allied Hospital Faisalabad, and DHQ Hospital Toba Tek Singh. The study included 240 participants aged 6–17 years, equally divided into CHD patients and same-gender sibling controls. Data were collected using the Parental Acceptance–Rejection Questionnaire (PARQ; mother and father forms) and the Personality Assessment Questionnaire (PAQ) to assess parental behaviors and children’s psychological adjustment. Statistical analyses included Pearson’s correlation and stepwise regression using SPSS v24. Results: Paternal acceptance was positively correlated with emotional stability and responsiveness, while paternal rejection and neglect were associated with hostility, dependency, and negative worldview in both groups. Maternal hostility and neglect significantly predicted emotional instability and low self-esteem among CHD patients. Regression analysis revealed that father neglect, hostility, and rejection were strong predictors of maladjustment in the CHD group (β = .38, –.31, .21), while maternal neglect and rejection also contributed significantly. Conclusion: Parental acceptance–rejection is a critical determinant of psychological adjustment in children with congenital heart disease. These findings highlight the need for family-oriented psychosocial interventions focusing on parental emotional warmth and involvement to foster better psychological outcomes in young CHD patients.