Kurz Herbert, Neunteufl Renate, Eichler Florian, Urschitz Michael, Tiefenthaler Monika
G. v. Preyer'sches Kinderspital, Vienna, Austria.
Wien Klin Wochenschr. 2002 Sep 30;114(17-18):801-6.
Home apnea/bradycardia monitoring was widely used in the 80s and 90s in the hope that Sudden Infant Death (SID) could be prevented. As no evidence could be found in favor of this hypothesis, HM today is restricted to symptomatic preterm infants, infants with cardiorespiratory problems and infants after an apparent life threatening event (ALTE). HM can impose substantial stress on families, especially mothers. We introduced an intensive counseling program (IC) for home monitoring and evaluated its effects, using a questionnaire. The control group consisted of families who were using a home monitor before the IC program was instituted, and were instructed according to the standard protocol given by the "Austrian SIDS-Consensus". The IC program consisted of standard monitor instruction as well as instruction in infant cardiopulmonary resuscitation, and was extended by providing intensive support at the beginning and throughout the monitoring period with special regard to the monitor weaning phase.
Fifty-eight percent of the 90 questionnaires of the IC-families and 66% of the 70 questionnaires of the control families were returned. Home monitoring was considered to be reassuring by more than 60% of the families. We found the following differences between the two groups: parents taking part in the IC program liked the instruction better, were less stressed by the monitor and reacted less aggressively to monitor alarms. They used the monitor predominantly during sleeping periods and for a shorter period of time (6 vs. 7 1/2 months). IC could not reduce SID related anxiety or change the feelings associated with the use of the home monitor.
Intensive counseling leads to a better use of home monitoring and reduces parents' stress. Even if home monitoring is used less frequently today, families should still be instructed and counselled intensively.
