Efeitos de intervenção educativa para orientação das mães sobre os cuidados pós-transplante cardíaco pediátrico

Abstract

Introduction: An adequate mothers’ preparation for their children post-heart transplant helps in reducing complications and, mainly, in child’s necessary care adherence. The educational booklet is a relevant resource used by nurses in health education activities, in prophylactic dissemination’s measures to maintain the heart graft in transplanted children, also may be associated with a brief motivational interview. Objective: Evaluate na educational intervention effectiveness mediated by the booklet: "My son has a new heart, now what?" Associated with the brief motivational interview to promote mothers’ knowledge and attitude after pediatric heart transplantation. Method: A quasi-experimental study, conducted from January to June 2019 in a reference institution for cardiopulmonary diseases, also Adults and Pediatrics heart transplantation in Fortaleza-CE, Brazil. The sample consisted of 30 mothers of children with heart transplants who were accompanying them in outpatient consultations. At first were applied mothers socioeconomic and demographic characterization instruments; State-Trait Anxiety Inventory; Assessment of mothers' knowledge and attitude about post-pediatric cardiac transplant care, which this last reapplied after seven and thirty days. In addition, after thirty days, the Trait-State Anxiety Inventory was also reapplied. In statistical analysis, the average statistical measures and standard deviations of quantitative variables were calculated. To compare the before and after STAI- Trait/ State average, Student's t test was used for rigged data. The comparison of averages between the three moments of knowledge and attitude was made using Friedman’s test and the multiple comparisons were performed utilising Conover’s test. The analyzes were considered statistically significant when p <0.05. The data were processed using SPSS 20.0 and license number 10101131007. Results: The mothers' age ranged between 18 and 43 years (66.6%) and complete elementary education (56.7%) predominated among the participants. As for the age group of children / adolescents, 73.2% obtained the graft between 7 and 18 years old. On the intervention day, 70% of the children / adolescents already had three years or more of heart transplantation. Concerning the assessment of anxiety, after intervention, the STAI-trait average were lower (39.37, SD = 4.038). After educational intervention using the booklet associated with motivational interview, the participants obtained a correct answers percentage above 70% after 7 and 30 days post-test, with the attitude factor considering 100% as appropriate (p <0.0001). Topics related to rejection symptoms, after heart transplantation and family vaccinations had significant differences in increased knowledge at 30-day post-test. It was verified that, mothers whose followed correctly all the pediatric post-transplant cardiac care was associated with no complications and, mainly, avoiding child's transplant rejection. The presence or absence of complications after pediatric transplantation, age group and mothers’ education did not significantly influenced on mothers’ knowledge and atitude average. After one month of intervention (43.44, SD = 6.002) assessed using the STAI-state, the anxiety levels of mothers whose children had a transplantation before one to two years were lower When anxiety was avaluated by the STAI-trait, the anxiety average were also lower, maintaining similar averages in the group whose children have one to two years of transplantation (39.89, SD = 5.159). Conclusion: The combination of interventions used in nursing consultation raises mothers’ knowledge about pediatric post-heart transplant care and contributes to reducing mothers' anxiety. Furthermore, it prepares mothers whose children are in transplant queue list, helping to reduce complications.