Counseling for Prenatal Congenital Heart Disease-Recommendations Based on Empirical Assessment of Counseling Success.

Front Pediatr 2020 26;8:26. Epub 2020 Feb 26.

Department of Pediatric and Congenital Cardiology, Heidelberg University, Hospital, Heidelberg, Germany.

Empirical assessment of parental needs and affecting factors for counseling success after prenatal diagnosis of congenital heart disease (CHD). Counseling success after fetal diagnosis of CHD was assessed by a validated standardized questionnaire. The dependent variable "Effective Counseling" was measured in five created analytical dimensions (1. "Transfer of Medical Knowledge-"; 2. "Trust in Medical Staff-"; 3. "Transparency Regarding the Treatment Process-"; 4. "Coping Resources-"; 5. "Perceived Situational Control-"). Analyses were conducted with regard to influencing factors and correlations. Sixty-one individuals ( = 40 females, = 21 males) were interviewed in a tertiary medical care center. Median gestational age at first parental counseling was 28 + 6 weeks. Parental counseling was performed four times (median), mostly by pediatric cardiologists (83.6%). Overall counseling was successful in 46.3%, satisfying in 51.9%, and unsuccessful in 1.9%. Analyses of the analytical dimensions show that counseling was less successful for TOMK (38.3%) and PSC (39%); success rates were higher if additional written information or links to web sources were provided (60 and 70%, respectively). Length of consultation was positively correlated to counseling success for ToMK ( = 0.458), TrtTP ( = 0.636), PSC ( = 0.341), and TiMS ( = 0.501). Interruptions were negatively correlated to the dimensions TiMS ( = -0.263), and TrtTP ( = -0.210). In the presence of high-risk CHD (37.5%) overall counseling success was lower (26.1%). By cross table analysis and to a low degree of positive correlation in one dimension (ToMK; = 0.202), counseling tends to be less successful for ToMK, TrtTP, and TiMS if parents have not been counseled by cardiologists. Analyses regarding premises show a parental need for a separate counseling room, which significantly impacts ToMK ( = -0,390) and overall counseling success ( = -0.333). A language barrier was associated with lower success rates for ToMK, TiMS, and CR (21.4, 42.9, and 30.8%). Data from this multidisciplinary study indicate that parents after fetal diagnosis of CHD need uninterrupted counseling of adequate duration and quality in a separate counseling room. Providing additional written information or links to adequate web sources after initial counseling seems necessary. High-risk CHD needs more attention for counseling. There is a trend towards more counseling success if provided by cardiologists.

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Source
http://dx.doi.org/10.3389/fped.2020.00026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054339PMC
February 2020

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