Parental mobile health adherence to symptom home monitoring for infants with congenital heart disease during the single ventricle interstage period: A concept analysis

Abstract

Purpose: Single ventricle heart disease is fraught with risk for infant mortality and morbidity. During the interstage period, or the time between palliative cardiac surgeries, mobile health (mHealth) technology improves the ability of registered nurse coordinators to monitor infant symptoms through parental monitoring and reporting. The concept of parental mHealth adherence to symptom home monitoring of infants with single ventricle congenital heart disease has not been defined, despite increasing use of mHealth technology. Methods: Rodger's concept analysis method was used to derive a unified definition of parental mHealth adherence to symptom home monitoring of infants with congenital heart disease during the single ventricle interstage period. A literature review included a search of databases for studies that addressed interstage home mHealth monitoring. Thematic analysis was applied to selected articles to derive a unified definition based on attributes, antecedents, consequences, related terms, and an illustrative case example. Sixteen publications were selected. Attributes, antecedents, and consequences of the concept were derived from the literature leading to a definition of parental mHealth adherence for infants with congenital heart disease during the single ventricle interstage period. The definition is the degree of adherence to which parents' transfer mHealth data for their infant meet healthcare providers' recommendations for symptom home monitoring. Consequences were improved infant symptom home monitoring through parental mHealth adherence measured by initiation, implementation, and discontinuation. Conclusion: The unified definition of the concept will provide a firmer ground for research in mHealth and interstage pediatric care and a guide for clinicians in developing new mHealth interventions for symptom home monitoring. Practice Implications: This concept analysis hypothesizes that infants with a single ventricle during the interstage period, whose parents are mHealth symptom home monitoring adherent, will have timelier symptom identification with resultant superior outcomes compared with infants with a single ventricle during the interstage period whose parents are not mHealth adherent.

Acceptability of an interstage home monitoring mobile application for caregivers of children with single ventricle physiology: Toward technology‐integrated family management

“…There has been an increased attention in home monitoring technology and mobile applications over the past several years that have demonstrated promising results (Bingler et al, 2018;Erickson et al, 2020;Foster et al, 2021;Medoff Cooper et al, 2020;Nkoy et al, 2019). There is a need to continue to push the state of the science beyond the advantages in home monitoring to the implementation science aspects of ( 1 There are several limitations of this study.…”

“…There has been an increased attention in home monitoring technology and mobile applications over the past several years that have demonstrated promising results (Bingler et al, 2018; Erickson et al, 2020; Foster et al, 2021; Medoff Cooper et al, 2020; Nkoy et al, 2019). There is a need to continue to push the state of the science beyond the advantages in home monitoring to the implementation science aspects of (1) determining the best way to design home monitoring systems that allow caregivers and patients to actively participate in their data entry and communication with providers, (2) implementation of technology‐enhanced home monitoring that promotes adherence to data entry, and (3) assessment of how technology‐enhanced home monitoring can contribute to clinical‐decision making of providers by responding to changes in patient situations based on established algorithms and nuanced trends in clinical data.…”

Acceptability and Initial Adoption of the Heart Observation App for Infants With Congenital Heart Disease: Qualitative Study

“…This may promote successful integration into existing services and thereby the adoption among health care professionals [ 13 ]. For parents of the most vulnerable infants, awareness of symptoms might not be enough and the infant’s cardiologist should recommend extending assessments over time [ 32 ]. Whether parents maintain the ability to detect deterioration even if they do not use the app regularly is currently uncertain.…”

Advancing Wearable Biosensors for Congenital Heart Disease: Patient and Clinician Perspectives: A Science Advisory From the American Heart Association

“…For example, Knight and Baber 25 linked comfort and wearability through a 6-dimension scale encompassing emotion, attachment, harm, perceived change, movement, and anxiety. Adherence studies would have greater effect if researchers reported hours per day, days per week, the percent of total possible time wearing the sensor, how the wearable was prescribed for use, 26 wearable technical details, and stakeholder perspectives. 27 Studies specifically assessing wearability in congenital heart disease remain a critical unmet need for technologies intended for at-home use.…”