Compliance of parents with regard to Pavlik harness treatment in developmental dysplasia of the hip.
A prospective analysis of the views of 160 parents of children with diagnosis of developmental dysplasia of the hip and treated by the Pavlik harness over 3.5 years to assess parents' compliance. A compliance assessment was carried out by taking into consideration the various factors that may contribute to parental concerns during treatment with a standard orthosis, clinic attendance, information written daily by parents about problems encountered, and the final outcome of treatment. Parents who attended the follow-up appointments in the clinic as advised, had written information about the harness at home and claimed that they followed the physician's instructions exactly (P = <0.0002) comprised 94.37%. Parents who had poor compliance with the harness comprised 5.62%. A significant relationship (P=0.000) was detected between compliance and a willingness to use the harness again in the future or to recommend it to other parents. Seventeen (10.6%) parents reported difficulty in applying the harness in the first week after bathing the child. At the completion of treatment, 96.25% of the parents declared that the harness was easy to use and 3.75% said it was difficult to use. Various problems during use of the harness, such as skin-crease dermatitis, feet slipping from the harness, and difficulty in clothing and carrying the child were reported by 31.9% of the parents, but these problems did not deter maternal commitment to continuing the treatment. There was a statistically significant (P = 0.000) progressive decrease in the difficulty index from the initial application of the harness to the end of treatment. Active maternal participation, under direct supervision of an orthopaedic surgeon, can ensure a satisfactory outcome. Our study indicates maternal compliance with the Pavlik harness, which has not been studied before in detail.
Hassan
Freih Abu
FA
Jordan University, Jordan. freih@ju.edu.jo