Abstract
This study aimed to examine the knowledge of mothers of children with congenital heart disease as well as the association of cardiological factors and maternal characteristics with maternal understanding. Mothers of 135 children (≤2 years old) were interviewed to assess maternal knowledge of infective endocarditis (IE) using the Hannover Inventory of Parental Knowledge of Congenital Heart Disease. Two subscales, endocarditis and risk factors, were used. Cardiological data as well as maternal characteristics were collected. Two-thirds of the mothers achieved only low scores, answering 0–20 % of the questions correctly (endocarditis = 64.4 %; risk factors = 71.1 %). Mothers with higher education recalled the correct definition of IE (P = 0.001) and the importance of dental hygiene (P = 0.004) more often. Mothers with only one child were more likely to know the most typical symptom (P = 0.007). The severity of the heart disease and the requirement of endocarditis prophylaxis did not influence maternal understanding. Yet, mothers assessing the heart disease as severe showed better knowledge (typical symptom P = 0.021; importance of dental hygiene P = 0.007). If mothers learned the diagnosis before their child’s birth, they remembered relevant information more often. Mothers receiving information by the medical staff and from the Internet showed better knowledge (definition P = 0.014; importance of dental hygiene P = 0.001). Due to low levels of knowledge, more efforts must be put into the education of mothers. Educational programs should take maternal characteristics into account, providing written material and thereby keeping the instruction of lower-educated persons in mind. Furthermore, education should be focused on mothers of children requiring IE prophylaxis.
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Tornos P, Gonzalez-Alujas T, Thuny F, Habib G (2011) Infective endocarditis: the European viewpoint. Curr Probl Cardiol 36:175–222
Nomura A, Omata F, Furukawa K (2010) Risk factors of mid-term mortality of patients with infective endocarditis. Eur J Clin Microbiol Infect Dis 29:1355–1360
Plicht B, Erbel R (2010) Diagnostik und therapie der endokarditis. Aktuelle ESC-Leitlinie. Herz 35:542–549
Rostagno C, Rosso G, Puggelli F, Gelsomino S, Braconi L, Montesi GF et al (2010) Active infective endocarditis: clinical characteristics and factors related to hospital mortality. Cardiol J 17:566–573
Naber CK, Horstkotte D, Moritz A (2009) ESC pocket guidelines. Infektiöse Endokarditis. http://leitlinien.dgk.org/images/pdf/leitlinien_pocket/2010_pll_16.pdf. Accessed 14 Nov 2012
Murdoch DR, Corey GR, Hoen B, Miró JM, Fowler VG Jr et al (2009) Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century. Arch Intern Med 169:463–473
Tleyjeh IM, Abdel-Latif A, Rahbi H, Scott CG, Bailey KR, Steckelberg JM (2007) A systematic review of population-based studies of infective endocarditis. Chest 132:1025–1035
Moreillon P, Que Y (2004) Infective endocarditis. Lancet 363:139–149
Hoen B, Alla F, Selton-Suty C, Béguinot I, Bouvet A, Briançon S, For the Association pour l’Etude et la Prévention de l’Endocardite Infectieuse (AEPEI) Study Group et al (2002) Changing profile of infective endocarditis. JAMA 288:75–81
Math RS, Sharma G, Kothari SS, Kalaivani M, Saxena A, Kumar AS et al (2011) Prospective study of infective endocarditis from a developing country. Am Heart J 162:633–638
Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I et al (2009) Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009). The task force on the prevention, diagnosis, and treatment of infective endocarditis of the European Society of Cardiology (ESC). Eur Heart J 30:2369–2413
Dzupova O, Machala L, Baloun R, Maly M, Benes J (2011) Incidence, predisposing factors, and aetiology of infective endocarditis in the Czech Republic. Scand J Infect Dis 44:250–255
Fedeli U, Schievano E, Buonfrate D, Pellizzer G, Spolaore P (2011) Increasing incidence and mortality of infective endocarditis: a population-based study through a record-linkage system. BMC Infect Dis 11:48
Mokhles MM, Ciampichetti I, Head SJ, Takkenberg JJM, Bogers AJ (2011) Survival of surgically treated infective endocarditis: a comparison with the general Dutch population. Ann Thorac Surg 91:1407–1413
Botelho-Nevers E, Thuny F, Casalta JP, Richet H, Gouriet F, Collart F et al (2009) Dramatic reduction in infective endocarditis-related mortality with a management-based approach. Arch Intern Med 169:1290–1298
Delahaye F, Alla F, Béguinot I, Bruneval P, DocoLecompte T, Lacassin F et al (2007) In-hospital mortality of infective endocarditis: prognostic factors and evolution over an 8-year period. Scand J Infect Dis 39:849–857
Kiefer T, Park L, Tribouilloy C, Cortes C, Casillo R, Chu V et al (2011) Association between valvular surgery and mortality among patients with infective endocarditis complicated by heart failure. JAMA 306:2239–2247
Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M et al (2007) Prevention of infective endocarditis. Guidelines from the American Heart Association. A Guideline From the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 116:1736–1754
Al-Nawas B, Block M, Ertl G, Franzen D, Gohlke-Bärwolf C, Herrmann M et al (2010) Kommentierte Zusammenfassung der Leitlinien der European Society of Cardiology zur Infektiösen Endokarditis (Neuauflage 2009). Kardiologe 4:285–294
Vittinghoff M, Gutmann A, Messerer B, Nagl B, Toller W (2010) Endokarditisprophylaxe bei Kindern und Jugendlichen. Umsetzung der aktuellen Leitlinien an der Universitätsklinik für Kinderchirurgie in Graz. Anesthetist 5:427–432
Fortún J, Centella T, Martín-Dávila P, Lamas MJ, Pérez-Caballero C, Fernández-Pineda L et al (2012) Infective endocarditis in congenital heart disease: a frequent community-acquired complication. Infection 41:167–174
Verheugt CL, Uiterwaal CSPM, van der Velde ET, Meijboom FJ, Pieper PG, van Dijk APJ et al (2010) Mortality in adult congenital heart disease. Eur Heart J 31:1220–1229
Day MD, Gauvreau K, Shulman S, Newburger JW (2009) Characteristics of children hospitalized with infective endocarditis. Circulation 119:865–870
Alshammary A, Hervas-Malo M, Robinson JL (2008) Pediatric infective endocarditis: has Staphylococcus aureus overtaken viridans group streptococci as the predominant etiological agent? Can J Infect Dis Med Microbiol 19:63–68
Kramer H (2002) Die bakterielle Endokarditis im Kindes- und Jugendalter. Deutsche Herzstiftung. http://www.herzstiftung.de/pdf/SD%20Nr.%202.pdf. Accessed 14 Nov 2012
Thuny F, Habib G (2010) When should we operate on patients with acute infective endocarditis? Heart 96:892–897
Haag F, Casonato S, Varela F, Firpo C (2011) Parents’ knowledge of infective endocarditis in children with congenital heart disease. Rev Bras Cir Cardiovasc 26:413–418
Rai K, Supriya S, Hegde A (2009) Oral health status of children with congenital heart disease and the awareness, attitude and knowledge of their parents. J Clin Pediatr Dent 33:315–318
Saunders CP, Roberts GJ (2008) Dental attitudes, knowledge, and health practices of parents of children with congenital heart disease. Arch Dis Child 76:539–540
Agbelusi GA, Okoromah CN, Nwhator SO (2005) Oral health knowledge: attitudes and practices of parents of children with congenital heart disease. Nig Q J Hosp Med 15:34–37
Chessa M, De Rosa G, Perdeo M, Negura DG, Butera G, Giamberti A et al (2005) What do parents know about the malformations afflicting the hearts of their children? Cardiol Young 15:125–129
Al-Jarallah AS, Lradhi AA, Hassan AA (2004) Endocarditis prophylaxis in children with congenital heart disease. A parent’s awareness. Saudi Med J 25:182–185
Cheuk DKL, Wong SMY, Choi YP, Chau AKT, Cheung YF (2004) Parents’ understanding of their child’s congenital heart disease. Heart 90:435–439
Bulat DC, Kantoch MJ (2003) How much do parents know about their children’s heart condition and prophylaxis against endocarditis? Can J Cardiol 19:501–506
Moons P, De Volder E, Budts W, De Geest S, Elen J, Waeytens K et al (2001) What do adult patients with congenital heart disease know about their disease, treatment, and prevention of complications? A call for structured patient education. Heart 86:74–80
Löbel A, Geyer S, Grosser U, Wessel A (2012) Knowledge of congenital heart disease of mothers: presentation of a standardized questionnaire and first results. Congenit Heart Dis 7:31–40
Perloff JK (1998) Historical perspective. In: Perloff JK, Child JS (eds) Congenital heart disease in adults. W. B. Saunders, Philadelphia, pp 3–8
Corporation Stata (2007) Stata statistical software as follows: Release 10. StataCorp LP, College Station
Negarandeh R, Mahmoodi H, Noktehdan H, Heshmat R, Shakibazadeh E (2012) Teach back and pictorial image educational strategies on knowledge about diabetes and medication/dietary adherence among low health literate patients with type 2 diabetes. Prim Care Diabetes
Houts PS, Doak CC, Doak LG, Loscalzo MJ (2006) The role of pictures in improving health communication: a review of research on attention, comprehension, recall, and adherence. Patient Educ Couns 61:173–190
Acknowledgments
We owe thanks to our colleagues at the Clinic for Pediatric Cardiology and Pediatric Intensive Care for their support for conducting this study. The study was funded by the German Research Association (Deutsche Forschungsgemeinschaft) under grants GE 1167/5-1 and WE2670/3-1 to Siegfried Geyer and Armin Wessel, respectively.
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Knöchelmann, A., Geyer, S. & Grosser, U. Maternal Understanding of Infective Endocarditis After Hospitalization: Assessing the Knowledge of Mothers of Children with Congenital Heart Disease and the Practical Implications. Pediatr Cardiol 35, 223–231 (2014). https://doi.org/10.1007/s00246-013-0763-8
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DOI: https://doi.org/10.1007/s00246-013-0763-8