Razavi Journal of Medicine

Razavi Journal of Medicine

The effect of the family-centered care model on the health literacy of family caregivers of pediatric patients after low-risk congenital heart defect surgeries

Articles in Press

Document Type : Original Article

Authors
Mahmood Hosseinzadeh Maleki 1
Vahideh Karimi 2
Mozhdeh Taheri Afshar 3
Amirhossein Nadi 4
Maliheh Eshaghzadeh 5
Mohsen Yaghubi 6
1 Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Department of Pre-Hospital Emergency Care, Abhar School of Nursing, Zanjan University of Medical Sciences, Zanjan, Iran.
3 Student Research Committee, Ramsar Fatemeh Zahra School of Nursing and Midwifery, Health Research Institue, Babol University of Medical Sciences, Babol, Iran.
4 Student Research Committee, Department of Nursing, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
5 Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
6 M.Sc in Extra-Corporal Technology, Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Mashhad, Iran.
10.30483/rjm.2026.254742.1499
Abstract
Background: Family caregivers of infants with congenital heart defects (CHD) require high health literacy to manage complex postoperative care. However, effective interventions to improve their health literacy are underexplored.

Objectives: This study aimed to evaluate the effect of a family-centered care model intervention on the health literacy of family caregivers of pediatric patients following low-risk congenital heart defect surgery.

Methods: This quasi experimental study with a before and after design was conducted from January 2020 to December 2025 at Imam Reza Hospital, Mashhad, Iran. A total of 100 family caregivers of pediatric patients (under 2 years) who underwent RACHS (Risk Adjustment for Congenital Heart Surgery) I II surgeries were allocated into experimental (n=50) and control (n=50) groups using block randomization. The experimental group participated in five weekly multimedia family-centered education sessions, while the control group received routine hospital education. Health literacy was measured using the Health Literacy for Iranian Adults (HELIA) scale at three time points: baseline, immediately post-intervention, and three months’ post-intervention. Data were analyzed using independent t-tests, paired t-tests, and repeated-measures ANOVA in SPSS version 26.0.

Results: A total of 98 caregivers (intervention: n=48, control: n=50) completed the study. The mean age was 39.37±9.15 years in the intervention group and 37.14±10.11 years in the control group. The majority were mothers (72% in intervention, 68% in control). No significant difference was found between groups in baseline health literacy scores (p=0.06). Immediately after the intervention, the mean health literacy score in the experimental group was significantly higher than the control group (58.09±7.24 vs. 31.42±6.56; p<0.001). This significant difference was maintained at the three-month follow-up (57.72±6.12 vs. 34.72±4.98; p<0.001). Repeated measures ANOVA revealed a significant time-by-group interaction (p<0.001), indicating the intervention's effectiveness over time.

Conclusion: The family centered care intervention significantly improved health literacy among caregivers of children after low risk CHD surgery, and this effect was sustained at three months. However, given the limited follow up duration, future studies with longer term follow up (≥12 months) are recommended to confirm the durability of the effect.
Keywords
Health Literacy
Congenital Heart Defects
Cardiac Surgery
Perioperative Care
Caregiver

Acknowledgements: The authors would like to express their gratitude to the cardiac surgery staff at Imam Reza Hospital and to all participants in this study for their invaluable cooperation and support throughout the study.


Availability of data and materials: The data that support the findings of this study are available from the corresponding author upon reasonable request.


Conflicts of interest: The authors have no conflicts of interest to declare.


Consent for publication: Not applicable.


Ethics approval and consent to participate: This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. This study received ethical approval from the Research Ethics Committee of Mashhad University of Medical Sciences, Iran (Code: IR.MUMS.REC.1399.082). Following approval, written informed consent was obtained from the caregivers of all patients. Key ethical principles upheld included confidentiality, patient privacy, no financial burden on participants, and voluntary participation.


Financial disclosure: No financial support was received for this study.


Author contributions: M.H.M. and M.T.A.: Contributed to the conception of the work, revising the draft, approving the final version of the manuscript, and agreeing on all aspects of the work; V.K. and A.N.: Contributed to the conception and design of the study, drafting of the manuscript and critical revision, and approval of final version, M.E. and M.Y.: Contributed to the conception and design of the study, drafting of the manuscript and critical revision, and approval of final version.

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Razavi Journal of Medicine

Articles in Press, Accepted Manuscript
Available Online from 02 August 2026