Maternal Understanding of Infective Endocarditis After Hospitalization: Assessing the Knowledge of Mothers of Children with Congenital Heart Disease and the Practical Implications

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.

Clinical Characteristics of Infective Endocarditis in Children

“…therapeutic interventions, it is likely that further improvement in IE outcome has to focus on different prevention measures, as also included in the 2015 actualized ESC IE guidelines (21,41). Studies evaluating the knowledge on IE in CHD patients or parents show a striking lack of understanding IE, dental hygiene and awareness of symptoms requiring an adequate medical investigation and no self-treatment (42)(43)(44). Therefore, a structured education of physicians and patients seems to be a necessary major target in daily practice to improve knowledge and thereby contributing to a decrease in diagnostic delay of IE, which still represents an important burden of the disease.…”

Determination of oral-dental health status in children with heart disease and level of awareness of infective endocarditis in their parents

“…12,13 Kalp hastalığı olan çocuklarda İE'in önlenmesinde ebeveynlerin bu konudaki bilinç düzeyi ve çocukların ağız hijyeninin antibiyotik profilaksisinden çok daha etkili olduğu bilinmektedir. [14][15][16][17] Çalışma ve kontrol grubu DMFT-dmft indeksine göre karşılaştırıldığında; çalışma grubunun indeks ortalaması 5.2 (±2.9) iken kontrol grubunda bu değer 4.6 (±3.6) idi ve her iki grup arasında istatistiksel olarak anlamlı bir fark saptanmadı (p:0.262) (Tablo 4).…”

Maternal factors and preoperative nutrition in children with mild cases of congenital heart disease

“…The mother's perception of the disease also was important. For example, if the parents of children with CHD knew the correct preventive measures for infective endocarditis, they would take or instruct their children to take preventive measures and then episodes of infective endocarditis could be avoided (Knochelmann, Geyer, & Grosser, ). However, the correlation between the accuracy of the maternal perceptions of childhood CHD, maternal characteristics, maternal psychological variables, and the growth of the children prior to surgery for SR CHD has been underreported.…”