Parental Knowledge of Appendicitis and Preference for Operative or Non-Operative Treatment at a United Kingdom Children’s Hospital

Abstract

Appendicitis is a common cause of abdominal pain in children, and is the most common reason for children to undergo emergency abdominal surgery. To guide our research program in this field, we aimed to determine parental understanding with regard to appendicitis and its treatment. We also wished to assess parental preference for non-operative or surgical treatment of children with uncomplicated appendicitis. We asked parents attending a children’s outpatient clinic to complete a brief questionnaire that was interspersed with educational content to rectify any knowledge gaps. A total of 396 parents (of 414 approached) agreed to participate. There were gaps in parental knowledge, including not knowing where the appendix is located (one-third of respondents), not knowing what appendicitis is (40% of respondents), and underestimating the incidence of appendicitis. Parents typically overestimated the risks of complications and dying from both uncomplicated and complicated appendicitis. There was no influence of gender, age, or previous experience of appendicitis on these findings. When presented with the scenario of equal effectiveness of non-operative treatment and surgery for uncomplicated appendicitis, 59% of respondents expressed a preference for non-operative treatment over surgery, while 21% expressed a preference for surgery (20% expressed no preference). These findings are important for clinicians and researchers when discussing appendicitis and treatment options with families, and justify ongoing research into the comparative effectiveness of non-operative treatment and surgery.

Parental Knowledge of Appendicitis and Its Management Options Among Children of Makkah Region, Saudi Arabia

“…In this study, almost half of the participants recognized the correct anatomical location of the appendix (48%). These findings were superior to those of a survey conducted in the UK, which revealed that one-third of respondents did not know where the appendix was [ 7 ]. The subsequent research found gaps in parental awareness, such as not knowing what appendicitis is (40% of respondents) and underestimating the incidence of appendicitis, which supports our findings.…”

“…Regarding the treatment of appendicitis, we found that most of the study population was aware of the current treatment for appendicitis, surgery. These results go in line with another study in the UK [ 7 ]. In this study, only 27.2% of participants thought that it is very likely for the appendix to perforate if the child does not have surgery immediately.…”

“…Another prior investigation verified this, revealing that the level of expertise was considerably higher among mothers and subjects who knew at least one friend or relative who had a terrible experience with appendicitis [ 14 ]. However, a study from the UK discovered that gender, age, or previous experience with appendicitis did not affect knowledge [ 7 ]. When we looked at the effect of various characteristics on treatment preference for a child with uncomplicated appendicitis, we discovered that educational level strongly influenced the desire for antibiotic treatment.…”

“…The electronic responses are exported directly from the online survey platform to Microsoft Excel (Microsoft Corporation, Redmond, USA). Before analysis, the questionnaire was inspired by previous studies and adopted in the literature [ 7 ]. Some additional modifications were made to unclear or ambiguous terminology to ensure that the responses provided accurately reflect the answers the participants intended.…”

“…While previous similar work in this field has been undertaken, to the best of our knowledge, there has yet to be any earlier study of KSA [ 7 ]. As there may be differences in knowledge and attitudes based on culture, we aim to conduct a study at the pediatric outpatient department/clinics at the Maternity and Children Hospital (MCH) in Makkah and King Fahad Armed Force Hospital (KFAFH) in Jeddah.…”