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Effectiveness of the Preschool Children eHealth Cardiac Rehabilitation Program After Congenital Heart Surgery: A
Wenyi Luo1,2, Lin Chen2, Xiaoman Cai2
1Department of Nursing, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Insights
A new eHealth cardiac rehabilitation program significantly improved outcomes for preschool children after heart surgery. This digital approach enhances parental engagement and reduces anxiety, offering a scalable solution for pediatric cardiac care.
Area of Science:
- Pediatric Cardiology
- Digital Health Interventions
- Rehabilitation Medicine
Background:
- Congenital heart disease requires long-term management.
- Home-based rehabilitation for preschool children faces challenges in uptake and accessibility.
- Existing pediatric cardiac rehabilitation programs often lack sufficient home-based support.
Purpose of the Study:
- To develop and evaluate an eHealth Cardiac Rehabilitation programme for preschool children post-congenital heart surgery.
- To assess the programme's impact based on the Interaction Model of Client Health Behaviour.
- To improve outcomes and parental engagement in pediatric cardiac rehabilitation.
Main Methods:
- A parallel two-arm randomized controlled trial was conducted with 84 preschool children.
- Participants were assigned to either a 3-month eHealth Cardiac Rehabilitation programme or routine care.
- Outcomes were measured at baseline, 3 months, and 6 months post-baseline.
Main Results:
- The eHealth group showed significantly better outcomes, including lower heart failure risk and improved ejection fraction.
- Participants in the eHealth program exhibited higher vigorous physical activity levels.
- Parents in the eHealth group reported improved knowledge, attitudes, behaviors, trust, and reduced anxiety.
Conclusions:
- The developed eHealth program effectively transforms home-based rehabilitation for children with congenital heart disease.
- This digital framework addresses gaps in accessible, long-term pediatric cardiac rehabilitation.
- The program offers a scalable solution for underserved regions and improves family-centered care.
Aim(S):
To develop the Preschool Children eHealth Cardiac Rehabilitation programme based on the Interaction Model of Client Health Behaviour, and to evaluate its effects on children after congenital heart surgery.
Design:
A parallel two-arm randomised controlled trial was conducted.
Methods:
A total of 84 participants were recruited from July 2022 to June 2023 and randomly assigned to either the intervention group (n = 40) or control group (n = 44). The intervention group participated in a 3-month eHealth Cardiac Rehabilitation programme, while the control group received routine care. Outcomes were measured at baseline, 3 months post baseline (intervention endpoint), and 6 months post baseline. Eighty participants completed the study.
Results:
Compared to the intervention group, the control group demonstrated significantly worse outcomes at both 3 and 6 months, including a higher risk of heart failure, lower left ventricular ejection fraction scores, and shorter 6-min walk distance tests. The intervention group engaged in significantly more vigorous physical activity. Significant between group differences were also observed in parental knowledge, attitudes, behaviours and trust levels. Additionally, the proportion of parents experiencing anxiety decreased significantly more in the intervention group by 6 months post baseline.
Conclusion:
This pioneering eHealth programme transforms home-based rehabilitation for preschool children with congenital heart disease, addressing a critical gap in accessible and long-term paediatric cardiac rehabilitation care.
Implications For The Profession And/Or Patient Care:
The use of eHealth programmes is valuable for improving paediatric cardiac rehabilitation by empowering parents, enhancing care continuity, and reducing barriers to accessing specialised services in paediatric care, especially in areas with limited medical resources.
Impact:
This study establishes the first validated eHealth framework for family-centred cardiac rehabilitation in preschool children following congenital heart surgery, addressing the critically low uptake of previously home-based rehabilitation. It also provides clinicians with a scalable solution for delivering care in underserved regions lacking access to specialised cardiac services.
Reporting Method:
This study adhered to the CONSORT checklist guidelines for reporting randomised controlled trials.
Patient Or Public Contribution:
This study did not include patient or public involvement in its design, conduct, or reporting.
Trial And Protocol Registration:
This study was a randomised controlled clinical trial. The research protocol was registered with the China Clinical Trial Registration Center (registration number: ChiCTR2200062022; https://www.chictr.org.cn/showproj.html?proj=174261).
