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 MindTM (PHMTM), 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, 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 PHMTM group, n = 17 control). Complete retention of 37 (67 %) parents included 29 (76 %) in the PHMTM 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 PHMTM 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 PHMTM 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.

Automated summary

This study tested the impact of a nurse-guided mHealth care program on the emotional distress of parents following prenatal diagnosis of critical congenital heart disease. The results showed that this approach is feasible and can significantly reduce parents' symptoms of depression, anxiety, and trauma.