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Long-Term Satisfaction and Parental Decision Making About Treatment of Deformational Plagiocephaly

Naidoo, Sybill D. PhD, RN*; Cheng, An-Lin PhD

Journal of Craniofacial Surgery: January 2014 - Volume 25 - Issue 1 - p 160–165
doi: 10.1097/SCS.0000000000000383
Original Articles

The incidence of deformational plagiocephaly (DP) has increased greatly during the last 2 decades since the recommendation of supine sleeping. Currently, there are 2 treatment options for DP, helmet therapy and repositioning therapy. This research investigated factors that influenced parental decision making about treatment choice and long-term satisfaction with head shape. A retrospective chart review identified 1660 children, now aged 2 to 10 years, seen in the DP clinic meeting inclusion criteria. Questionnaires were mailed to all eligible families. Four-hundred fifty-six completed questionnaires were returned. The questionnaires evaluated demographics of the family, factors that influenced treatment choice, and satisfaction with current head shape. Most of the respondents had white (93%) and male (70%) children. The mothers’ mean age at the time of childbirth was 31 years; most of the mothers had a college degree or higher (77%) and household incomes of more than $76,000 (52.6%). Fifteen factors were used to evaluate which ones were significant in influencing parental treatment choice. Severity of the DP and time off work for follow-up appointments were the only 2 factors identified that significantly affected treatment choice. More parents who used helmet therapy reported that they were satisfied with their child’s long-term head shape and would choose the same treatment again (P = 0.002) compared with those who used repositioning therapy.

From the *Cleft Palate-Craniofacial Institute, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis Children’s Hospital, St Louis, Missouri; and †University of Missouri–Kansas City, School of Nursing and Health Studies, Kansas City, Missouri.

Received March 6, 2013.

Accepted for publication August 24, 2013.

Address correspondence and reprint requests to Sybill D. Naidoo, RN, CPNP, PhD(c), Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8238, St Louis, MO 63110; E-mail:

The authors report no conflicts of interest.

© 2014 by Mutaz B. Habal, MD.