title: Improving education and coping of scoliosis patients undergoing surgery, and their families, using e-health.
abstract: OBJECTIVE
  Healthcare providers have limited time to spend with scoliosis patients who are considering surgery and their families. The purpose of this study was to evaluate an e-health strategy to increase knowledge and coping in patients with scoliosis who are surgical candidates and their families.
  
  
  METHODS
  We enrolled patients with scoliosis who were candidates for surgery and their families. Patients and their families completed the scoliosis knowledge questionnaire, meaning of illness questionnaire, social support and coping questionnaires before and after access to a comprehensive evidence-based scoliosis website ( http://www.aboutkidshealth.ca/scoliosis ).
  
  
  RESULTS
  Seventy-four patients and 71 parents completed the evaluation. While both patients and parents improved their knowledge of scoliosis (p = 0.001 and p = 0.003, respectively), the scores of patients were consistently lower than those of the parents both before and after website use (p = 0.0001). Only parents demonstrated a change in the meaning of illness questionnaire, with a small increase in the negative attitude towards illness and a small decrease in the positive attitude towards illness (p = 0002 and p = 0.01, respectively). Of the 12 coping methods examined on the Adolescent Coping Orientation for Problem Experiences (A-COPE) instrument, patients were slightly more likely than parents to use relaxing and solving family problems as tools to cope following website access (p = 0.02 and p = 0.09, respectively). Parents demonstrated no significant changes in the four methods of coping on the Coping Health Inventory for Parents (CHIP) after website exposure. While the majority of patients and parents reported receiving sufficient support, over half of the patients indicated a need for more support in social participation.
  
  
  CONCLUSIONS
  An evidence-based website increased the knowledge of patients and parents but simply providing access to the website had minimal impact on their coping and perceptions of social support. The website, however, provides users with the opportunity to absorb vital information about scoliosis across several media.
authors.affiliation: Division of Orthopedic Surgery, The Hospital for Sick Children (SickKids), 555 University Ave., Toronto, ON, M5G 1X8, Canada.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Lysenko
authors.affiliation: Division of Orthopedic Surgery, The Hospital for Sick Children (SickKids), 555 University Ave., Toronto, ON, M5G 1X8, Canada.
authors.forename: Peggy
authors.initials: P
authors.lastname: Law
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
authors.forename: James
authors.initials: J
authors.lastname: Jarvis
authors.affiliation: Division of Orthopedic Surgery, The Hospital for Sick Children (SickKids), 555 University Ave., Toronto, ON, M5G 1X8, Canada. james.wright@sickkids.ca.|Faculty of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada. james.wright@sickkids.ca.
authors.forename: James G
authors.initials: JG
authors.lastname: Wright
keywords: AIS; E-health; Scoliosis; Scoliosis surgery; Website