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Evaluation of a Video-Based Education Intervention for Parents of Children Undergoing Fontan Surgery: A Cluster
Julie K Rehman1,2, Gwen R Rempel2, Elina Williams3
1Stollery Children's Hospital, Edmonton, Alberta, Canada.
Insights
A pre-Fontan video intervention for parents did not reduce anxiety or behavioral issues in children after surgery. However, parents found the videos helpful for standardizing information.
Area of Science:
- Pediatric Cardiology
- Surgical Intervention
- Psychological Support
Background:
- Fontan surgery is a critical third surgical step for children with univentricular hearts, typically performed between 2-4 years of age.
- Key challenges post-Fontan surgery include parental psychological distress, prolonged pleural drainage, and the necessity of postoperative anticoagulation.
- Existing interventions lack focus on preparing parents for these specific post-surgical challenges.
Purpose of the Study:
- To evaluate the efficacy of a pre-Fontan video-based educational intervention for parents.
- To assess the intervention's impact on parental psychological distress and child behavioral outcomes.
- To gather parental feedback on the utility and timing of video education.
Main Methods:
- A single-center, mixed-methods cluster randomized controlled trial was conducted.
- The intervention involved 3 brief whiteboard videos accessible online from preadmission to 1 month postoperatively.
- Parental anxiety (State Trait Anxiety Inventory) and child behavior (Post Hospital Behaviour Questionnaire) were measured at 1 week and 1 month post-surgery, supplemented by semistructured interviews.
Main Results:
- No significant differences in parental anxiety or child behavioral scores were observed between the intervention and control groups at 1 week or 1 month postoperatively.
- Child behavior scores remained in the maladaptive range for both groups.
- Parents reported that the videos were helpful for standardizing information but ideally should be provided earlier in the preoperative process.
Conclusions:
- A pre-Fontan video-based educational intervention did not significantly alter parental anxiety or child behavioral outcomes.
- Despite not meeting primary outcome measures, parents found the video intervention to be a valuable tool for information delivery.
- The findings suggest a need for earlier integration of such educational resources into the preoperative care pathway.
Background:
Fontan surgery is performed at 2-4 years of age and is the third planned surgical intervention for children with a univentricular heart. Major challenges for children and parents after Fontan include (a) psychological distress, (b) prolonged pleural drainage, and (c) the need for postoperative anticoagulation. The aim of this study was to evaluate a pre-Fontan video-based intervention for parents to address these challenges.
Methods:
This study is a single-centre mixed-methods cluster randomized controlled trial. The intervention consisted of 3 brief whiteboard videos offered online from preadmission clinic to 1 month postoperatively. The parent's State Trait Anxiety Inventory score and the child's Post Hospital Behaviour Questionnaire score were measured 1 week and 1 month postoperatively. Semistructured interviews were conducted to obtain parental feedback on the videos.
Results:
We enrolled 26 children (13 female patients; 16 intervention group) and 1 parent per child. Mean State Trait Anxiety Inventory scores were similar between groups at both 1 week (52.8 vs 55.5, P = 0.25) and 1 month postoperatively (50.9 vs 53.9, P = 0.25). Post Hospital Behaviour Questionnaire scores were in the maladaptive range but did not differ between groups. Parents agreed or strongly agreed that the videos were helpful but should be provided earlier in the preoperative process. The main value of the videos was recognized as being a method for standardizing information provided to parents.
Conclusions:
A video-based education intervention did not impact State Trait Anxiety Inventory or Post Hospital Behaviour Questionnaire scores. However, the majority of parents agreed that the videos were helpful.
