Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
Pediatr Cardiol. 2024 Mar;45(3):605-613. doi: 10.1007/s00246-023-03355-y. Epub 2023 Dec 19.
Although commonly performed, optimal techniques, strategies, and content to achieve the most effective prenatal counseling have not been explored. We investigate the efficacy of prenatal counseling via survey feedback of parents of children with prenatally diagnosed single ventricle. Grades of counseling using a Likert scale (1-5) were solicited to assess: (1) overall impression of quantity of counseling, (2) explanation of the heart defect, (3) preparation for heart surgery, (4) preparation for hospital course and care, (5) preparation for complications and outcomes of a Fontan circulation, and (6) preparation for neurological, school-related, or behavioral problems. Impressions were solicited concerning specific providers. A comprehensive fetal counseling score was calculated for each participant. Burden of care including length of hospitalization was explored as impacting prenatal counseling grades. There were 59 survey respondents. Average age of the children at the time of survey was 4.6 ± 3.3 years (range 1-10 years). Highest grades were for explanation of the heart condition, with lowest grades for preparation for neurological, school-related, or behavioral problems. Cardiac surgeon received the highest with social worker lowest grade for provider. Negative correlation was found between the composite fetal counseling score and parental recollection of length of hospitalization (Pearson r = - 0.357, p < 0.01). Prenatal counseling for neurological, school-related, and behavioral problems in single ventricle is deficient. Further studies analyzing prenatal counseling techniques and content can help improve upon the delivery of this important aspect of prenatal care.
虽然经常进行，但尚未探索出最有效的产前咨询的最佳技术、策略和内容。我们通过对产前诊断出单心室的儿童的父母进行调查反馈来研究产前咨询的效果。使用李克特量表（1-5）征求咨询的等级，以评估：（1）咨询量的总体印象，（2）心脏缺陷的解释，（3）心脏手术的准备，（4）医院过程和护理的准备，（5）并发症和 Fontan 循环结果的准备，以及（6）神经系统、学校相关或行为问题的准备。就特定提供者征求了有关印象的意见。为每位参与者计算了综合胎儿咨询评分。探讨了住院时间长短等护理负担对产前咨询成绩的影响。共有 59 名调查受访者。调查时孩子的平均年龄为 4.6±3.3 岁（范围为 1-10 岁）。心脏状况解释的评分最高，神经系统、学校相关或行为问题的准备评分最低。心脏外科医生的评分最高，而社会工作者的评分最低。复合胎儿咨询评分与父母对住院时间长短的回忆呈负相关（Pearson r=-0.357，p<0.01）。单心室的产前神经、学校相关和行为问题咨询不足。进一步分析产前咨询技术和内容的研究可以帮助改善这一重要产前护理方面的提供。
