Caregiver Experiences Using Orthotic Treatment Options for Developmental Dysplasia of the Hip in Children.
Journal
Journal of pediatric orthopedics
ISSN: 1539-2570
Titre abrégé: J Pediatr Orthop
Pays: United States
ID NLM: 8109053
Informations de publication
Date de publication:
01 Feb 2023
01 Feb 2023
Historique:
entrez:
6
1
2023
pubmed:
7
1
2023
medline:
11
1
2023
Statut:
ppublish
Résumé
Developmental dysplasia of the hip (DDH) is a common condition affecting 5 in 1000 newborns. The standard first line of treatment is the use of an orthotic, which has generally high success rates, but can pose substantial difficulties and put undue burden on caregivers. The general experience of caregivers using these orthotics has not been well documented on an orthotic-specific basis. The purpose of this study was to investigate caregiver experience using prescribed DDH orthotics to identify challenges, differences between treatment options, and areas of improvement. A survey assessing treatment prescription, respondent demographics, and caregiver experience was distributed online to caregivers whose child/children were treated for DDH with an orthotic. Seven-point positively phrased Likert scale statements and open-ended questions were included to assess caregiver experience. The results were analyzed using summary statistics and orthotics with more than 30 responses were selected for more in-depth analysis. A total of 530 survey responses were collected with 63% (334/530) of respondents using a Pavlik harness, 45% (236/530) a Rhino brace, and 13% (67/530) a Denis Browne Bar. The overall weighted average score across all Likert Scale statements was positive for the Pavlik harness, Rhino brace, and Denis Browne Bar at 4.19 (95% CI, 3.83 to 4.54), 4.63 (95% CI, 4.27 to 4.99) and 4.91 (95% CI, 4.58 to 5.24), respectively. In the open-ended responses, all 3 orthotics were perceived as easy to use and not hindering child-caregiver bonding, but raised concerns of discomfort and skin irritation, as well as preventing the ability to cuddle their child the way they desired. The Pavlik harness respondents consistently brought up concerns regarding cleanability. The results show that the DDH orthotics analyzed are generally easy to use and perceived positively by caregivers, but have orthotic-specific challenges that should be a focus of future improvement work. This study evaluated opinions and attitudes of caregivers for children being treated with DDH orthotics, revealing experiences, concerns, and challenges associated with the use of commonly prescribed options.
Sections du résumé
BACKGROUND
BACKGROUND
Developmental dysplasia of the hip (DDH) is a common condition affecting 5 in 1000 newborns. The standard first line of treatment is the use of an orthotic, which has generally high success rates, but can pose substantial difficulties and put undue burden on caregivers. The general experience of caregivers using these orthotics has not been well documented on an orthotic-specific basis. The purpose of this study was to investigate caregiver experience using prescribed DDH orthotics to identify challenges, differences between treatment options, and areas of improvement.
METHODS
METHODS
A survey assessing treatment prescription, respondent demographics, and caregiver experience was distributed online to caregivers whose child/children were treated for DDH with an orthotic. Seven-point positively phrased Likert scale statements and open-ended questions were included to assess caregiver experience. The results were analyzed using summary statistics and orthotics with more than 30 responses were selected for more in-depth analysis.
RESULTS
RESULTS
A total of 530 survey responses were collected with 63% (334/530) of respondents using a Pavlik harness, 45% (236/530) a Rhino brace, and 13% (67/530) a Denis Browne Bar. The overall weighted average score across all Likert Scale statements was positive for the Pavlik harness, Rhino brace, and Denis Browne Bar at 4.19 (95% CI, 3.83 to 4.54), 4.63 (95% CI, 4.27 to 4.99) and 4.91 (95% CI, 4.58 to 5.24), respectively. In the open-ended responses, all 3 orthotics were perceived as easy to use and not hindering child-caregiver bonding, but raised concerns of discomfort and skin irritation, as well as preventing the ability to cuddle their child the way they desired. The Pavlik harness respondents consistently brought up concerns regarding cleanability.
CONCLUSIONS
CONCLUSIONS
The results show that the DDH orthotics analyzed are generally easy to use and perceived positively by caregivers, but have orthotic-specific challenges that should be a focus of future improvement work.
CLINICAL RELEVANCE
CONCLUSIONS
This study evaluated opinions and attitudes of caregivers for children being treated with DDH orthotics, revealing experiences, concerns, and challenges associated with the use of commonly prescribed options.
Identifiants
pubmed: 36607922
doi: 10.1097/BPO.0000000000002312
pii: 01241398-202302000-00015
pmc: PMC9812410
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
105-110Informations de copyright
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
K.M. receives funding support from the I’m a HIPpy Foundation, the Peterson Fund for Global Hip Health, IHDI, BC Children’s Hospital Foundation, the Canadian Orthopaedic Foundation, POSNA, Divi’s Foundation for Gifted Children, Johnson & Johnson, Pega Medical and OrthoPediatrics. The remaining authors declare no conflicts of interest.
Références
Woodacre T, Ball T, Cox P. Epidemiology of developmental dysplasia of the hip within the UK: refining the risk factors. J Child Orthop. 2016;10:633–642.
Aronsson DD, Goldberg MJ, Kling TF, et al. Developmental dysplasia of the hip. Pediatrics. 1994;94:201–209.
Malvitz TA, Weinstein SL. Closed reduction for congenital dysplasia of the hip. Functional and radiographic results after an average of thirty years. J Bone Joint Surg Am. 1994;76:1777–1792.
Muller GM, Seddon HJ. Late results of treatment of congenital dislocation of the hip. J Bone Joint Surg Br. 1953;35(B(3)):342–362.
Heeres RHM, Witbreuk MMEH, van der Sluijs JA. Diagnosis and treatment of developmental dysplasia of the hip in the Netherlands: national questionnaire of paediatric orthopaedic surgeons on current practice in children less than 1 year old. J Child Orthop. 2011;5:267–271.
Mubarak S, Garfin S, Vance R, et al. Pitfalls in the use of the Pavlik harness for treatment of congenital hip dysplasia, subluxation, and dislocation of the hip. J Bone Joint Surg Am. 1981;63:1239–1248.
McHale K, Corbett D. Parental noncompliance with Pavlik harness treatment of infantile hip problems. J Pediatr Orthop. 1989;9:649–652.
Hassan FA. Compliance of parents with regard to Pavlik harness treatment in developmental dysplasia of the hip. J Pediatr Ortho B. 2009;18:111–115.
Chao M, Chiang VC. Impact on and coping behaviours of a Chinese mother with a child suffering from developmental dysplasia of the hip. J Orthop Nurs. 2003;7:176–183.
Elander G. Breast feeding of infants diagnosed as having congenital hip joint dislocation and treated in the von Rosen splint. Midwifery. 1986;2:147–151.
Poole C. exploring the experiences of parents caring for their infant with developmental dysplasia of the hip (DDH): an interpretative phenomenological analysis doctoral dissertation. Edinburgh Napier University; 2019.
Jennings HJ, Gooney M, O’Beirne J, et al. Exploring the experiences of parents caring for infants with developmental dysplasia of the hip attending a dedicated clinic. Int J Orthop Trauma Nurs. 2017;25:48–53.
Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–381.
Harris PA, Taylor R, Minor BL, et al. The REDCap consortium: building an international community of software partners. J Biomed Inform. 2019;95:103208.
NVivo Qualitative Data Analysis Software [computer program] Version 12. QSR International Pty Ltd; 2018.
Wakely L, Easey P, Leys J, et al. Exploring the lived experience of parenting a child with developmental dysplasia of the hip. Phys Occup Ther Pediatr. 2021;8:1–12.
Gardner F, Dezateux C, Elbourne D, et al. The hip trial: psychosocial consequences for mothers of using ultrasound to manage infants with developmental hip dysplasia. Arch Dis Child Fetal Neonatal Ed. 2005;90:F17–F24.
Chyung SY, Barkin JR, Shamsy JA. Evidence-based survey design: the use of negatively worded items in surveys. Perform Improv. 2018;57:16–25.