Effectiveness of psychosocial interventions for pediatric patients with scoliosis: a systematic review

Abstract

BackgroundPediatric patients affected by scoliosis have complex psychological and social care needs, and may benefit from psychosocial interventions. We therefore aimed to summarize evidence of the efficacy of psychosocial interventions for this patient population.MethodsLiterature was identified by searching Medline, PsycINFO, Embase, EBSCO Cumulated Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Central Register of Controlled Trials (CENTRAL) from database inception to 20 March 2022. Articles that evaluated the effectiveness of psychosocial interventions for pediatric patients diagnosed with scoliosis and reported at least one quantitative outcome were included. Article eligibility, data extraction, and quality assessment (using the Cochrane Collaboration’s Risk of Bias Tool and Methodological Index for Non-Randomized Studies) were performed by two independent researchers. Findings are presented using narrative synthesis.ResultsWe identified ten studies, all of which focused on adolescent idiopathic scoliosis. Studies included a total of 1007 participants, most of whom were female. Three studies focused on patients undergoing bracing, six on patients undergoing spinal surgery, and one on patients broadly. Brace compliance monitoring and counseling were found to significantly improve brace compliance quality and quantity. Proactive mental healthcare delivery by nurses after spinal surgery was similarly found to improve outcomes. Several studies examined the efficacy of brief educational interventions; most did not report clear evidence of their efficacy. The methodological quality of studies was often unclear due to limitations in articles’ reporting quality.ConclusionsResearch on the efficacy of psychosocial interventions for pediatric patients with scoliosis is limited, with interventions involving frequent patient-provider interactions showing the most promise. Future clinical and research efforts should focus on developing and testing psychosocial interventions for this patient population, with emphasis on multidisciplinary teams delivering holistic care.Trial registration numberPROSPERO number CRD42022326957

The Virtual Reality (VR) Based Methodology Examining the Efficacy of Cognitive‐Behavioral Therapy (CBT) Interventions. The Significance for Adolescent Scoliosis Females’ Body Image and Mental Health Before and Following Spinal Fusion

“…Considering psychological interventions for patients undergoing spinal surgery, a systematic review performed by van Nekierk et al [53] revealed six studies focused on patients with AIS undergoing spinal surgery [52][53][54][55][56][57][58][59]. Most of them were randomized clinical trials (RCTs) [55][56][57][58][59][60][61] and excluded patients with psychological, cognitive, and/or developmental conditions [54][55][56][57][58]60,61].…”

“…The first kind of interventions incorporated components such as guided imagery and relaxation training [53][54][55][56][57], specific medical information teaching [56][57][58]60] and music therapy [59]. In general, most studies did not report convincing evidence of brief educational interventions being more efficacious than routine medical care in improving outcomes.…”

“…Referring to efficacy of intensive multidisciplinary care models, the authors reported improvements in patient outcomes, with one focusing on mental health outcomes, pain levels, and satisfaction with care, and the other on length of hospital stay [52][53][54][55][56][57][58][59]. For example, Ying and Fu [61] compared routine nursing care with Rosenthal effect based nursing, where nurses offered proactive mental healthcare post spinal surgery and provided mental health training for family members to monitor patients' mental well-being [61].…”