title: Opinions of youngsters with congenital below-elbow deficiency, and those of their parents and professionals concerning prosthetic use and rehabilitation treatment.
abstract: BACKGROUND
  Youngsters with unilateral congenital below-elbow deficiency (UCBED) seem to function well with or without a prosthesis. Reasons for rejecting prostheses have been reported earlier, but unfortunately not those of the children themselves. Furthermore, reasons for acceptance are underexplored in the literature.
  
  
  OBJECTIVE
  To investigate opinions of children and early and late adolescents with UCBED, and those of their parents and healthcare professionals, concerning (1) reasons to wear or not to wear prostheses and (2) about rehabilitation care.
  
  
  METHODS
  During one week of online focus group interviews, 42 children of 8-12 y/o, early and late adolescents of 13-16 and 17-20 y/o, 17 parents, and 19 healthcare professionals provided their opinions on various topics. This study addresses prosthetic use or non-use of prosthetics and rehabilitation care. Data were analyzed using the framework approach.
  
  
  RESULTS
  Cosmesis was considered to be the prime factor for choosing and wearing a prosthesis, since this was deemed especially useful in avoiding stares from others. Although participants functioned well without prostheses, they agreed that it was an adjuvant in daily-life activities and sports. Weight and limited functionality constituted rejection reasons for a prosthesis. Children and adolescents who had accepted that they were different no longer needed the prosthesis to avoid being stared at. The majority of participants highly valued the peer-to-peer contact provided by the healthcare professionals.
  
  
  CONCLUSIONS
  For children and adolescents with UCBED, prostheses appeared particularly important for social integration, but much less so for functionality. Peer-to-peer contact seemed to provide support during the process of achieving social integration and should be embedded in the healthcare process.
authors.affiliation: Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. e.golea.vasluian@umcg.nl
authors.forename: Ecaterina
authors.initials: E
authors.lastname: Vasluian
authors.forename: Ingrid G M
authors.initials: IG
authors.lastname: de Jong
authors.forename: Wim G M
authors.initials: WG
authors.lastname: Janssen
authors.forename: Margriet J
authors.initials: MJ
authors.lastname: Poelma
authors.forename: Iris
authors.initials: I
authors.lastname: van Wijk
authors.forename: Heleen A
authors.initials: HA
authors.lastname: Reinders-Messelink
authors.forename: Corry K
authors.initials: CK
authors.lastname: van der Sluis
mesh_terms: D000293:Adolescent; D002648:Child; D058569:Elbow Prosthesis; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D017060:Patient Satisfaction; D016312:Treatment Refusal / Q000523:psychology; D038062:Upper Extremity Deformities, Congenital / Q000523:psychology / Q000534:rehabilitation*; D055815:Young Adult