title: Education, and obtaining of informed consent, using multimedia before adults with congenitally malformed hearts are submitted to transcatheter interventions.
abstract: BACKGROUND
  Multimedia programmes relating to education and consents may be useful for decreasing anxiety during catheter-based repair in patients with congenitally malformed hearts.
  
  
  OBJECTIVE
  Our study was aimed at evaluating the impact of multimedia protocols for education of a population of consecutive patients with congenitally malformed hearts prior to transcatheter repair.
  
  
  METHODS
  Between September, 2006, and May, 2008, we enrolled 100 consecutive patients, with a mean age of 45 +/- 19 years, of whom 69 were female, for catheter-based repair of their congenitally malformed hearts. In the first 50 patients, we used a written form for informed consent sent to the patients 15 days before the procedure, coupled with a personal interview of 30 minutes. In the subsequent 50 patients, we used multimedia protocol for education, comprising a booklet of 4 pages containing a simple and brief explanation of the intervention, and a digital film of 4 minutes showing the transcatheter procedure with a commentary provided by the referring physician, prior to obtaining the signature for informed consent. We then compared the scores for anxiety, the pre-operative heart rate, the frequency of vaso-vagal episodes, and the need for conscious sedation between the two groups.
  
  
  RESULTS
  Patients who underwent preconditioning using the multimedia programme were significantly less anxious, and had significantly lower heart rates. Vaso-vagal episodes were also significantly less in this group, with no episodes compared to 14% in those providing standard informed consent. Conscious sedation was needed more frequently in those providing standard informed consent.
  
  
  CONCLUSIONS
  Our brief study suggests that a comprehensive multimedia programme of preparation increases the tolerability, and decrease the emotional state, of adults about to undergo catheter-based interventions for congenital cardiac disease.
authors.affiliation: Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy. jackyheart@libero.it
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rigatelli
authors.forename: Beatrice
authors.initials: B
authors.lastname: Magro
authors.forename: Susanna
authors.initials: S
authors.lastname: Ferro
authors.forename: Emiliano
authors.initials: E
authors.lastname: Bedendo
authors.forename: Sandra
authors.initials: S
authors.lastname: Cominato
authors.forename: Riccardo
authors.initials: R
authors.lastname: Mantovan
authors.forename: Laura
authors.initials: L
authors.lastname: Oliva
authors.forename: Massimo
authors.initials: M
authors.lastname: Giordan
authors.forename: Fabio
authors.initials: F
authors.lastname: Dell'Avvocata
authors.forename: Paolo
authors.initials: P
authors.lastname: Cardaioli
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D016292:Procedural Sedation; D004452:Echocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000523:psychology / Q000628:therapy*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D019212:Multimedia; D010353:Patient Education as Topic