title: Presurgical Concerns of Primary Family Caregivers of Children With Cerebral Palsy.
abstract: BACKGROUND
  Primary family caregivers (PFCs) of children with cerebral palsy have many worries and concerns when their children face orthopedic surgery. Levels of PFC stress about the upcoming surgery is related to the child's level of gross motor function as well as the support they receive from medical professionals.
  
  
  OBJECTIVE
  The purposes of the present study were to (1) explore the levels of concern about orthopedic surgery; and (2) explore the predictive factors associated with concerns about orthopedic surgery among PFCs of children with cerebral palsy during the preoperative period.
  
  
  METHODS
  A cross-sectional, correlational study was conducted. Primary family caregivers were assessed preoperatively using the Single-event Multilevel Surgery Scale, Social Support Scale, Gross Motor Function Classification System-Expanded and Revised, and background information form. Primary family caregivers were recruited from the outpatient department of orthopedic surgery and pediatric rehabilitation of a medical center in northern Taiwan. Data were analyzed by descriptive analysis, Pearson product-moment correlation, and multiple regression analysis.
  
  
  RESULTS
  A total of 63 eligible subjects were enrolled in this study. Primary family caregivers had moderate levels of concern and mild-to-moderate levels of social support. The higher severity of motor function impairment in children with cerebral palsy, prior caregiving by PFCs for another family member, and PFCs' lower level of social support from healthcare providers were associated with higher levels of PFC concern.
  
  
  CONCLUSIONS
  Concerns about orthopedic surgery is an overlooked issue that needs more attention from healthcare providers. This study determined that PFCs who perceived a lack of social support from their healthcare providers and those with children who had limited gross motor function were more concerned and anxious about their children's upcoming orthopedic surgery. Health professionals should provide adequate health education and counseling to help PFCs of children with cerebral palsy in the decision-making process prior to orthopedic surgery.
authors.affiliation: Li-Chun Yu, BS, BN, Assistant Head Nurse, Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. Li-Chin Chen, MSN, RN, Deputy Director, Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, and Lecturer, Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan. Hsiu-Chen Lin, MSN, RN, Supervisor, Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, and Lecturer, Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan. Yueh-E. Lin, MSN, RN, Supervisor, Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, and Lecturer, Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan. Chia-Hsieh Chang, BS, MD, Director, Department of Pediatric Orthopedic, Bone and Joint Research Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, and Associate Professor, Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Shu-Ching Chen, PhD, RN, Professor, Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan, and Nursing Consultant, Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Li-Chun
authors.initials: LC
authors.lastname: Yu
authors.forename: Li-Chin
authors.initials: LC
authors.lastname: Chen
authors.forename: Hsiu-Chen
authors.initials: HC
authors.lastname: Lin
authors.forename: Yueh-E
authors.initials: YE
authors.lastname: Lin
authors.forename: Chia-Hsieh
authors.initials: CH
authors.lastname: Chang
authors.forename: Shu-Ching
authors.initials: SC
authors.lastname: Chen
mesh_terms: D000328:Adult; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D002547:Cerebral Palsy / Q000601:surgery*; D002648:Child; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology*; D013502:General Surgery; D006801:Humans; D009985:Orthopedics; D057234:Preoperative Period; D012720:Severity of Illness Index; D012944:Social Support; D013624:Taiwan