Psychological Adjustment, Maternal Distress, and Family Functioning in Children With Obstetrical Brachial Plexus Palsy

Purpose To determine the impact on families of children with brachial plexus injuries in order to best meet their clinical and social needs. Methods Our cross-sectional study included families with children between the ages of 1 and 18 with birth or non-neonatal brachial plexus injuries (BPI). The consenting parent or guardian completed a demographic questionnaire and the validated Impact on Family Scale during a single assessment. Total scores can range from 0-100, with the higher the score indicating a higher impact on the family. Factor analysis and item-total correlations were used to examine structure, individual items, and dimensions of family impact. Results One hundred two caregivers participated. Overall, families perceived various dimensions of impact on having a child with a BPI. Total family impact was 43. The 2 individual items correlating most strongly with the overall total score were from the financial dimension of the Impact on Family Scale. The strongest demographic relationship was traveling nationally for care and treatment of the BPI. Severity of injury was marginally correlated with impact on the family. Parent-child agreement about the severity of the illness was relatively high. Conclusion Caretakers of children with a BPI perceived impact on their families in the form of personal strain, family/social factors, financial stress, and mastery. A multidisciplinary clinical care team should address the various realms of impact on family throughout the course of treatment. Level of Evidence II Prognostic

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“…[25] Alyanak et al, found that children with neonatal BPI and their mothers are at increased risk for a variety of psychological stressors. [27]…”

Section: Discussionmentioning

confidence: 99%

The Impact of Pediatric Brachial Plexus Injury on Families

Louden¹,

Allgier²,

Overton³

et al. 2015

The Journal of Hand Surgery

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“…An assessment of psychological adjustment and coping strategies of parents/caregivers by the clinician is essential. 100–101 An older infant or toddler could be at-risk for self-mutilation due to altered sensation in the affected limb, pain or psychological stress. 102–103 Signs of injury or parental report of injury must be monitored on an ongoing basis.…”

Section: Assessment: Infantmentioning

confidence: 99%

Clinical assessment of the infant and child following perinatal brachial plexus injury

Duff

DeMatteo

2015

Journal of Hand Therapy

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STUDY DESIGN Literature review INTRODUCTION After perinatal brachial plexus injury (PBPI), clinicians play an important role in injury classification as well as the assessment of recovery and secondary conditions. Early assessment guides the initial plan of care and influences follow-up and long-term outcome. PURPOSE To review methods used to assess, classify and monitor the extent and influence of PBPI with an emphasis on guidelines for clinicians. METHODS We use The International Classification of Functioning, Disability, and Health (ICF) model to provide a guide to assessment after PBPI for rehabilitation clinicians. DISCUSSION With information gained from targeted assessments, clinicians can design interventions to increase the opportunities infants and children have for optimal recovery and to attain skills that allow participation in areas of interest.

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“…Age and sex were variables matched in 4 studies (23, 24, 33, 34). Although more statistically advanced, few studies (14%) used post hoc analysis to adjust for confounding (17, 19, 35, 36). In total, 30(81%) studies used at minimum one method to control for confounding.…”

Section: Resultsmentioning

confidence: 99%

“…They are most useful when participants do not have diseases related to the exposure being studied (2). Alyanak et al compared the emotional and behavioral characteristics of children with obstetrical brachial plexus palsy with healthy children presenting for a well-child visit from the same hospital (36). The validity of inferences from this study relied on the assumption that the well-child cohort was similar with respect to extraneous factors (e.g.…”

Section: Discussionmentioning

confidence: 99%

The Quality of Control Groups in Nonrandomized Studies Published in the Journal of Hand Surgery

Johnson¹,

Malay²,

Chung³

2015

The Journal of Hand Surgery

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Purpose To evaluate control group selection in non-randomized studies published in the Journal of Hand Surgery American (JHS). Methods We reviewed all papers published in JHS in 2013 to identify studies that used non-randomized control groups. Data collected included type of study design and control group characteristics. We then appraised studies to determine if authors discussed confounding and selection bias and how they controlled for confounding. Results Thirty-seven non-randomized studies were published in JHS in 2013. The source of control was either the same institution as the study group, a different institution, a database, or not provided in the manuscript. Twenty-nine (78%) studies statistically compared key characteristics between control and study group. Confounding was controlled with matching, exclusion criteria, or regression analysis. Twenty-two (59%) papers explicitly discussed the threat of confounding and 18(49%) identified sources of selection bias. Conclusions In our review of non-randomized studies published in JHS, papers had well-defined controls that were similar to the study group, allowing for reasonable comparisons. However, we identified substantial confounding and bias that were not addressed as explicit limitations, which might lead the reader to overestimate the scientific validity of the data. Clinical relevance Incorporating a brief discussion of control group selection in scientific manuscripts should help readers interpret the study more appropriately. Authors, reviewers, and editors should strive to address this component of clinical importance.

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Psychological Adjustment, Maternal Distress, and Family Functioning in Children With Obstetrical Brachial Plexus Palsy

Cited by 37 publications

References 17 publications

The Impact of Pediatric Brachial Plexus Injury on Families

The Impact of Pediatric Brachial Plexus Injury on Families

Clinical assessment of the infant and child following perinatal brachial plexus injury

The Quality of Control Groups in Nonrandomized Studies Published in the Journal of Hand Surgery

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