 attitudin factor congenit heart diseas studi consid behavior implic congenit heart diseas pediatr patient sibl parent effect diseas child sibl parent interplai individu explor impact physician's diagnosi illustr induc chang famili attitud diseas sever child incapac poorer adjust anxieti cardiac child highli matern anxieti pamper degre incapac matern protect pamper greater cardiac normal group highest cyanot group best predictor matern protect matern anxieti addit variabl incapac child depend fail improv predict matern anxieti presenc sever heart condit 