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An mHealth, patient engagement approach to understand and address parents' mental health and caregiving needs after prenatal diagnosis of critical congenital heart disease

Year: 2023

Type: article

Abstract: Background: Most infants with critical congenital heart disease (CCHD) are diagnosed prenatally, prompting parents’ strong emotions and needs to manage mental health. Despite evidence that parent mental health relates to infant caregiving quality, effective interventions are lacking for this population.Objective: To use the nurse-guided Preparing Heart and Mind™ (PHMTM) mobile health application (app) to identify issues of parental concern, development of caregiving competencies, and type and timing of frequently-used PHMTM topics. Two case studies further characterize findings.Patient InvolvementUnderpinned by guided participation theory, nurses involved parents to understand and support their needs using innovative patient engagement software of PHMTM.Methods: Mothers/birthing persons (M/BPs) with a fetal CCHD diagnosis and their caregiving partners (CPs) participated in this mixed methods pilot study from the third trimester of pregnancy through 12 weeks postnatally. Nurse fidelity data, parent survey data, and transcripts from nurse-parent video sessions (2 prenatal, 1 postnatal) were descriptively analyzed.Results: The sample included 19 M/BPs and 15 CPs randomized to the intervention group, with mean age=33.5; Asian, Black, or Indigenous=26%; and fetal single ventricle diagnosis=26%. In 49 sessions,mental health/wellbeing (94%) and condition-specific information (86%) were the top issues. Many caregiving competencies were well developed, with M/BPs often focused on feeding (86%). Regulating emotions and co-parenting consistently needed support. PHMTM topics of preparing for hospitalization (41%) and handling uncertainty (38%) were most frequently incorporated into sessions.Discussion: Nurse-parent collaborative understanding of issues emphasized the need for mental health assessments. Prenatal intervention opportunities were further identified through discussions of caregiving and frequently-used PHMTM topics.Practical Value: PHM™ represents a novel approach that holds promise for reaching parents outside the healthcare setting to address mental health needs and bolster caregiving during a concentrated learning time.

Source: PEC Innovation

DOI: 10.1016/j.pecinn.2023.100213