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用于临床实践沟通的先天性心脏病三维打印患者特异性模型:可行性与可接受性

3D-manufactured patient-specific models of congenital heart defects for communication in clinical practice: feasibility and acceptability.

作者信息

Biglino Giovanni, Capelli Claudio, Wray Jo, Schievano Silvia, Leaver Lindsay-Kay, Khambadkone Sachin, Giardini Alessandro, Derrick Graham, Jones Alexander, Taylor Andrew M

机构信息

Centre for Cardiovascular Imaging, Institute of Cardiovascular Science, University College London, London, UK.

Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.

出版信息

BMJ Open. 2015 Apr 30;5(4):e007165. doi: 10.1136/bmjopen-2014-007165.

Abstract

OBJECTIVES

To assess the communication potential of three-dimensional (3D) patient-specific models of congenital heart defects and their acceptability in clinical practice for cardiology consultations.

DESIGN

This was a questionnaire-based study in which participants were randomised into two groups: the 'model group' received a 3D model of the cardiac lesion(s) being discussed during their appointment, while the 'control group' had a routine visit.

SETTING

Outpatient clinic, cardiology follow-up visits.

PARTICIPANTS

103 parents of children with congenital heart disease were recruited (parental age: 43±8 years; patient age: 12±6 years). In order to have a 3D model made, patients needed to have a recent cardiac MRI examination; this was the crucial inclusion criterion.

INTERVENTIONS

Questionnaires were administered to the participants before and after the visits and an additional questionnaire was administered to the attending cardiologist.

MAIN OUTCOME MEASURES

Rating (1-10) for the liking of the 3D model, its usefulness and the clarity of the explanation received were recorded, as well as rating (1-10) of the parental understanding and their engagement according to the cardiologist. Furthermore, parental knowledge was assessed by asking them to mark diagrams, tick keywords and provide free text answers. The duration of consultations was recorded and parent feedback collected.

RESULTS

Parents and cardiologists both found the models to be very useful and helpful in engaging the parents in discussing congenital heart defects. Parental knowledge was not associated with their level of education (p=0.2) and did not improve following their visit. Consultations involving 3D models lasted on average 5 min longer (p=0.02).

CONCLUSIONS

Patient-specific models can enhance engagement with parents and improve communication between cardiologists and parents, potentially impacting on parent and patient psychological adjustment following treatment. However, in the short-term, parental understanding of their child's condition did not improve.

摘要

目的

评估先天性心脏病三维(3D)患者特异性模型的沟通潜力及其在心脏病学会诊临床实践中的可接受性。

设计

这是一项基于问卷的研究,参与者被随机分为两组:“模型组”在预约就诊期间收到正在讨论的心脏病变的3D模型,而“对照组”进行常规就诊。

地点

门诊心脏病学随访诊所。

参与者

招募了103名先天性心脏病患儿的家长(家长年龄:43±8岁;患儿年龄:12±6岁)。为了制作3D模型,患者需要近期进行心脏MRI检查;这是关键的纳入标准。

干预措施

在就诊前后向参与者发放问卷,并向主治心脏病专家发放额外的问卷。

主要观察指标

记录对3D模型的喜爱程度(1 - 10分)、其有用性以及所接受解释的清晰度,以及心脏病专家对家长理解程度和参与度的评分(1 - 10分)。此外,通过要求家长标记图表、勾选关键词并提供自由文本答案来评估家长的知识水平。记录会诊时长并收集家长反馈。

结果

家长和心脏病专家都发现这些模型非常有用,有助于家长参与讨论先天性心脏病。家长的知识水平与他们的教育程度无关(p = 0.2),就诊后也没有提高。涉及3D模型的会诊平均持续时间长5分钟(p = 0.02)。

结论

患者特异性模型可以增强与家长的互动,改善心脏病专家与家长之间的沟通,可能会影响治疗后家长和患者的心理调适。然而,短期内,家长对孩子病情的理解并没有改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52c0/4420970/9e7fa8dee60f/bmjopen2014007165f01.jpg

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