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Objective Assessment of Counselling for Fetal Heart Defects: An Interdisciplinary Multicenter Study
Alexander Kovacevic1, Stefan Bär2, Sebastian Starystach2
1Department of Pediatric and Congenital Cardiology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Insights
Parental counseling for fetal heart disease is highly successful and satisfying (>99%). Structured approaches, adequate duration, and written information improve outcomes, while interruptions and lack of language skills hinder success.
Area of Science:
- Medical Genetics
- Pediatric Cardiology
- Psychology
Background:
- Fetal heart disease (FHD) diagnosis requires comprehensive parental counseling.
- Interdisciplinary and multicenter approaches are crucial for effective FHD support.
- Parental understanding and psychological well-being significantly impact management.
Purpose of the Study:
- To analyze parental counseling effectiveness for fetal heart disease.
- To identify factors influencing counseling success in a multicenter setting.
- To assess parental perceived situational control and knowledge transfer.
Main Methods:
- A validated questionnaire assessed medical, sociodemographic, and psychological aspects.
- 168 parents were recruited from pediatric heart centers and obstetrics units.
- Statistical analysis correlated counseling factors with success metrics.
Main Results:
- Counseling success and satisfaction were >99%; only 0.7% dissatisfaction.
- Adequate duration, written/online information improved success.
- Interruptions, lack of private rooms, and language barriers negatively impacted outcomes.
- High-risk congenital heart disease (CHD) correlated with lower success.
- Parental perceived situational control was impaired in 22.6%.
Conclusions:
- Structured counseling, adequate duration, and supplementary materials enhance parental understanding and satisfaction.
- Addressing parental psychological needs, especially perceived control, is vital.
- Cardiologist-led counseling is essential for complex cardiac malformations.
Abstract:
The objective of this study was to analyze parental counselling for fetal heart disease in an interdisciplinary and multicenter setting using a validated questionnaire covering medical, sociodemographic, and psychological aspects. n = 168 individuals were recruited from two pediatric heart centers and two obstetrics units. Overall, counselling was combined successful and satisfying in >99%; only 0.7% of parents were dissatisfied. "Perceived situational control" was impaired in 22.6%. Adequate duration of counselling leads to more overall counselling success (r = 0.368 ***), as well as providing written or online information (57.7% vs. 41.5%), which is also correlated to more "Transfer of Medical Knowledge" (r = 0.261 ***). Interruptions of consultation are negatively correlated to overall counselling success (r = -0.247 **) and to "Transparency regarding the Treatment Process" (r = -0.227 **). Lacking a separate counselling room is associated with lower counselling success for "Transfer of Medical Knowledge" (r = 0.210 ***). High-risk congenital heart disease (CHD) is correlated to lower counselling success (42.7% vs. 71.4% in low-risk CHD). A lack of parental language skills leads to less overall counselling success. There is a trend towards more counselling success for "Transfer of Medical Knowledge" after being counselled solely by cardiologists in one center (r = 0.208). Our results indicate that a structured approach may lead to more counselling success in selected dimensions. For complex cardiac malformations, counselling by cardiologists is essential. Parental "Perceived Situational Control" is often impaired, highlighting the need for further support throughout the pregnancy.
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