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


METHODS
Diagnostic level II.
Park
Moon Seok
MS
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Sungnam, Kyungki, Korea.
Chung
Chin Youb
CY
Lee
Kyoung Min
KM
Lee
Sang Hyeong
SH
Choi
In Ho
IH
Cho
Tae-Joon
TJ
Yoo
Won Joon
WJ
Kim
Kyung Hwan
KH
D000293:Adolescent; D002547:Cerebral Palsy / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D010149:Postoperative Pain / Q000503:physiopathology; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011183:Postoperative Complications / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods; D011788:Quality of Life; D012044:Regression Analysis; D012086:Reoperation / Q000379:methods; D011795:Surveys and Questionnaires; D016896:Treatment Outcome