Issues of Concern Before Single Event Multilevel Surgery in Patients With 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 R-2 = 0.281). Conclusions: An understanding of the issues of concern will enhance communication between physicians and parents, which would assist in preoperative discussion.