Impact of pre-operative and perioperative parental preparation on the success of surgery in tunisian children with scoliosis

Background Surgical intervention in a child represents a challenging and overwhelming event for the parents. Studies have shown that parents' preoperative preparation and satisfaction with their child's preoperative care are important components of a better clinical outcome and a stronger healthcare system. Objective To investigate the preoperative and postoperative preparation of parents whose children have scoliosis and have undergone surgery, and its possible association with postoperative clinical outcomes. Methods We conducted a cross-sectional study including children and adolescents who underwent surgery for scoliosis. Disease related characteristics were reported. Successful surgery was defined as a postoperative cobb angle less than or equal to half the initial cobb angle. A questionnaire in the Tunisian dialect consisting of 10 Yes/No questions related to the preoperative and perioperative phase was established. The parents answered the questionnaire by telephone and informed oral consent was obtained. An arbitrary cutoff of 7 positive answers was set to define a well-prepared parent. Results Thirty-six children were included (sex-ratio= 0.38, mean age at surgery = 16.05 ± 2.63 [11–23]). Etiologies of scoliosis were idiopathic (n = 29), neuromuscular (n = 4) and congenital (n = 3). Twenty-two children (61.1%) had successful surgery. Regarding the questionnaire, table 1 reports the parents’ answers to the 10 questions. Question two had the most negative response with 55.5% parents reporting that during the pre-operative phase, the medical staff didn’t mention the possible complications of the surgery. Thirty-three per cent of the parents reported that the doctor didn’t explain more about the operation and the post-operative course during the peri-operative period and about 30% revealed that, on the day of surgery, the doctor didn’t explain to them the induction of anesthesia. Forty-seven per cent of the parents mentioned that the doctor didn’t inform them about the possible restrictions in occupation for their child later. Seventy-two percent of parents had ≥7 positive answers indicating that they were well prepared for the surgery, among them 52% had children in whom surgery was successful, P = 0.14. No correlation was found between a good parental preparation and age at surgery (P = 0.736). A significant association was found between success of surgery and a positive response to Q9, P = 0.032. Conclusion In our series, the lack of information about the possible complications of the surgery, during the peri-operative phase and about the induction of anesthesia was noted. Interestingly, receiving sufficient information on how to provide postoperative care at home was significantly associated with a success of surgery.