Issues of concern before single event multilevel surgery in patients with cerebral palsy

J Pediatr Orthop. 2010 Jul-Aug;30(5):489-95. doi: 10.1097/BPO.0b013e3181e00c98.

Abstract

Background: This study was performed to identify the issues of concern of parents of patients with cerebral palsy before single event multilevel surgery (SEMS).

Methods: The parental concerns of 64 patients [34 males, 30 females, mean age 15 y and 5 mo (SD 8 y and 10 mo)] with cerebral palsy were obtained using a questionnaire preoperatively. The issues of parental concern were evaluated using 59 items specifically designed for this study. The individual items were scored using a 5-point Likert scale (1 to 5).

Results: The top 5 issues of concern were as follows: postoperative rehabilitation, duration of rehabilitation, immediate postoperative pain, general anesthesia, and medical cost. Sporting activities and poor compliance to wearing orthosis were included in the top 5 issues of parental concern in patients with unilateral involvement. The overall parental concern in patients with unilateral involvement was lower than that in bilateral involvement (P=0.054). Parents of younger patients showed significantly higher concern score than those of older patients (P=0.020). There was no significant difference in the overall concern score between the parents of patients scheduled for bony procedures and those of patients scheduled for soft tissue procedures (P=0.298). Multiple regression analysis revealed the patient's age (P=0.018) and responding parent (father vs. mother, P=0.025) to be the factors that significantly affected the overall concern score (adjusted R(2)=0.281).

Conclusions: An understanding of the issues of concern will enhance communication between physicians and parents, which would assist in preoperative discussion.

Level of evidence: Diagnostic level II.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cerebral Palsy / diagnosis
  • Cerebral Palsy / surgery*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Multivariate Analysis
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / methods*
  • Pain, Postoperative / physiopathology
  • Parent-Child Relations
  • Parents / psychology*
  • Postoperative Complications / physiopathology
  • Preoperative Care / methods
  • Quality of Life*
  • Regression Analysis
  • Reoperation / methods
  • Surveys and Questionnaires*
  • Treatment Outcome