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Issues of Concern Before Single Event Multilevel Surgery in Patients With Cerebral Palsy

Park, Moon Seok MD*; Chung, Chin Youb MD*; Lee, Kyoung Min MD*; Lee, Sang Hyeong MD*; Choi, In Ho MD; Cho, Tae-Joon MD; Yoo, Won Joon MD; Kim, Kyung Hwan MD*

Journal of Pediatric Orthopaedics:
doi: 10.1097/BPO.0b013e3181e00c98
Cerebral Palsy
Abstract

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 R2=0.281).

Conclusions: An understanding of the issues of concern will enhance communication between physicians and parents, which would assist in preoperative discussion.

Level of Evidence: Diagnostic level II.

Author Information

*Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Sungnam, Kyungki

Department of Orthopedic Surgery, Seoul National University Children's Hospital, Seoul, Korea

None of the authors received any financial support from the commercial party for this study. This study was supported by the SNUBH research fund (11-2009-016). No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Reprints: Kyoung Min Lee, MD, Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Sungnam, Kyungki 463-707, Korea. E-mail: oasis100@empal.com.

This study was conducted at Seoul National University Bundang Hospital.

© 2010 Lippincott Williams & Wilkins, Inc.