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

Abstract

BackgroundFollowing 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. ObjectivesWe 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. MethodsThis pilot study design randomized participants using a 2:1 intervention to control ratio. Analysis involved description of retention, 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. ResultsThe 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. ConclusionFindings suggest that a nurse-guided mHealth approach is feasible and may contribute to a clinically important reduction in parents' emotional distress.