Abstract
Background;
Parents of premature infants engage in shared decision making regarding the care of
their infant. The process of prenatal counseling typically involves a verbal conversation
with a neonatal provider during hospitalization. Support people may not be available
and the pregnant person's memory is impaired by medications, pain, and stress. The
American Academy of Pediatrics, American College of Obstetricians and Gynecologists,
and the National Institute of Child Health and Human Development have called for improvements
to this process, including the development of educational aids.
Objective;
We hypothesized that a multimedia tablet would be more effective than a paper handout
to supplement verbal clinician counseling during preterm birth hospitalization.
Study Design;
Design: Randomized controlled trial. Inclusions: ≥ 18 years old English-speaking pregnant people hospitalized 22 through 33 weeks
gestational age for preterm birth. Exclusions: known fetal or chromosomal anomaly, delivery before study completion. Intervention: Pregnant people received either multimedia tablet or paper handout before verbal
clinician counseling. Pre-intervention assessment: demographics and State-Trait Anxiety Inventory. Post-intervention assessment: The Parent Knowledge of Premature Birth Questionnaire and State-Trait Anxiety Inventory.
Statistical analysis: Continuous variables were analyzed by t-test and categorical variables by Fisher's
exact test.
Results;
122 pregnant people referred for counseling were screened, 76 were randomized, and
59 completed the study. Demographics were similar between groups, except that pregnant
people in the handout group were older, mean 32 years v 29 years, p=0.03. The multimedia
tablet group (n=32) was less likely to report reviewing all the educational material
than the paper handout group (n=27); 41% vs.72%, p=0.037. Both groups correctly answered
a similar number of knowledge items, p=0.088. Post-intervention state-anxiety decreased
in both groups, p<0.0001, with no difference between groups. Computerized tracking
showed the multimedia group spent a median of 37 minutes reviewing the tablet.
Conclusions;
Contrary to our hypothesis, a paper handout and multimedia tablet were equally effective
in the labor unit to supplement verbal preterm birth counseling and decrease parental
anxiety.
Keywords
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Article info
Publication history
Accepted:
January 14,
2023
Received in revised form:
January 13,
2023
Received:
November 7,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
