Congenital malformations and compliance to the treatment: influence of parents’ personal perceptions of the relationship with the medical team

Congenital hand malformations can cause a traumatic stress condition and the trauma is the more severe if could not have been foreseen so that it requires the parents to elaborate strategies on adapting to the malformation experience. This process sometimes does not evolve spontaneously in an adaptive and physiological way both for the parents and the child. Parents personal feelings and their possibility to accept child malformation seem to be very important for child development, for the possibility to form a balanced relationship with parents, for the harmonic development of child personality and for his or her relationship with the social world in an unfamiliar environment, and for parents, and child, for the possibility to comply with the proposed treatment. Child possibility to accept the malformation can be determined by the analysis of parents expectations on the surgery. When a child with a hand malformation is born, parents experience a heavy sense of guilt because they feel they have given life to an "unfinished" child and they consequently want to repair their guilt as soon as possible. If parents can accept the limitations of the surgical procedure, they will accept child malformation. Whenever parents have deep unrealistic expectations and try to ignore what happened, they will inevitably be deluded. It seems very important to achieve a good interaction between the family and the medical team in order to support the parents; in this regard the psychologist is placed between parents' emotions in respect to the malformation and the treatment proposed by the team. The optimal solution is to devise a treatment based on parents and child needs and therefore work as team.