Acceptability and Initial Adoption of the Heart Observation App for Infants With Congenital Heart Disease: Qualitative Study

An individualised mobile app was beneficial for the mothers of infants with severe congenital heart defects

AIM

This national study focused on the individualised Heart Observation (HOBS) mobile phone app, which helps the parents of infants with severe congenital heart disease (CHD) with discharge preparations and decision making at home.

METHODS

We enrolled two groups of parents from 2021 to 2023, during their child's initial hospitalisation at Oslo University Hospital, Norway. Measurements were carried out at baseline and one and four months after discharge. The study examined 73 mothers, who assessed the usefulness and stress-related impact of either printed materials or the HOBS app, as the fathers' responses were insufficient.

RESULTS

The HOBS app was significantly more useful than the printed information, with regard to discharge preparations, follow up at home and ongoing decision making, particularly if the infants had sustained cardiac impairment. The average total usefulness scores were 23.9/35 (95% CI 21.6-26.1) versus 17.0/35 (95% CI 14.1-20.0), respectively. Initial stress significantly decreased from baseline in both groups and elevated awareness of deterioration did not increase stress in the HOBS group.

CONCLUSION

Mothers who used the HOBS app found it significantly more useful than the controls who received printed information, particularly if their infant had sustained cardiac impairment. Elevated awareness of deterioration did not increase stress.

Nurse-guided Mobile Health Care Program to Reduce Emotional Distress Experienced by Parents of Infants Prenatally Diagnosed with Critical Congenital Heart Disease: A Pilot Study

Background

Following prenatal diagnosis of critical congenital heart disease (CCHD), parents encounter emotional distress while facing caregiving challenges. Supportive psycho-educational interventions using mobile health (mHealth) can make care more accessible.

Objectives

We tested a novel nurse-guided mHealth care program, Preparing Heart and Mind™ (PHM™), with the objectives of examining feasibility and estimating the effect of the intervention on parents' emotional distress.

Methods

This pilot study design randomized participants using a 2:1 intervention to control ratio. Analysis involved description of retention, and intervention attendance and engagement, and adjusted linear mixed models to estimate group differences in depressive (CES-D), anxiety (STAI-S), and traumatic stress (IES-r) symptoms.

Results

The sample included 55 parents (n=38 PHM™ group, n=17 control). Complete retention of 37 (67%) parents included 29 (76%) in the PHM™ group and 8 (47%) control. Most attrition was due to infant death (7 parents), transplant referral (2 parents), or postnatal diagnostic ineligibility (4 parents). For the PHM™ group, ≥96% of parents attended pre- and postnatal sessions and most (65%) messaged with the nurse. mHealth engagement was highest prenatally, with handling uncertainty the most viewed topic (average 94% pages viewed). In linear mixed models analyses, the PHM™ group had on average 4.84 points lower depression (95% CI: -10.68-1.04), 6.56 points lower anxiety (-14.04-0.92), and 6.28 points lower trauma (-14.44-1.88) scores by study end.

Conclusion

Findings suggest that a nurse-guided mHealth approach is feasible and may contribute to a clinically important reduction in parents' emotional distress.

A mobile application for postoperative education of caregivers of children with congenital hypospadias: Requirement analysis

Background and Aims

Hypospadias, a congenital anomaly, can have long-term effects on sexual, urinary, and reproductive functions, making proper postoperative care essential for desirable outcomes, which could be facilitated through a mobile application for diseases with long-term complications. The aim of this study was to investigate the data and functional requirements or minimum data set of a postoperative education mobile application for caregivers of children with hypospadias.

Methods

A literature review of papers published until April 2023 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was conducted to determine the data and functional requirements of a mobile application that provides postoperative education to caregivers of children with congenital hypospadias. Based on the results, a questionnaire was prepared, and its content validity and reliability were evaluated by CVI and CVR. Additionally, data was examined by 30 residents, specialists, and subspecialists in pediatric surgery using the Delphi approach.

Results

The study identified 28 data elements in three main categories: demographic data, clinical data, and application function. Functional requirements of the mobile application were suggested for use in designing the application. Also, the most critical data elements included the definition of disease, the importance of treatment, surgical preparation, bandage, hygiene, symptoms and infection, bleeding, and emergency condition.

Conclusion

The study will pave the way for developing postoperative educational applications for caregivers of children with congenital hypospadias. M-Health app developers and clinician specialists can utilize these findings to design practical applications that assist caregivers in managing the care of hypospadias patients.