Table 1: Guiding principles for developing multifaceted interventions.

Phases of Parenting under Pressure
FacetsAdjusting to the inconceivableGrowing increasingly attachedAccommodating to the unexpectedEncountering new challenges

Survival parentingValidate emotional responsesFacilitate development of appropriate vigilanceCoach parent to provide situation-appropriate vigilanceEncourage respite
Expert parentingOffer information to facilitate parental decision-making following diagnosisFacilitate increasing knowledge about baby’s condition while in the hospitalFacilitate process of parent becoming the expert including their use of a weigh scale and oximeterTranslate relevant and comprehensive knowledge regarding care of child with CHD to parents over time
“Hands-Off” parentingAdvocate for parents to have even a brief time with their newborn in the delivery room before transfer to pediatric centreCoach parents to advocate for themselves to be as “hands-on” as possible even in critical care settingsRespect and utilize parental expert knowledge and role when child returns to hospital for subsequent procedures and surgeriesValue parent involvement
Supported parentingIdentify and mobilize supportEncourage parents to involve extended family during hospitalizationFacilitate parent process of drawing forth support, both formal and informalSupport parents in navigating the system
Uncertain parentingDetermine appropriate timing of interventionFacilitate expression of grief responses through the telling of illness narratives (i.e., events around time of diagnosis)Encourage parent-to-parent supportSupporting parents overtime