Opinions of youngsters with congenital below-elbow deficiency, and those of their parents and professionals concerning prosthetic use and rehabilitation treatment

PLoS One. 2013 Jun 24;8(6):e67101. doi: 10.1371/journal.pone.0067101. Print 2013.

Abstract

Background: Youngsters with unilateral congenital below-elbow deficiency (UCBED) seem to function well with or without a prosthesis. Reasons for rejecting prostheses have been reported earlier, but unfortunately not those of the children themselves. Furthermore, reasons for acceptance are underexplored in the literature.

Objectives: To investigate opinions of children and early and late adolescents with UCBED, and those of their parents and healthcare professionals, concerning (1) reasons to wear or not to wear prostheses and (2) about rehabilitation care.

Methods: During one week of online focus group interviews, 42 children of 8-12 y/o, early and late adolescents of 13-16 and 17-20 y/o, 17 parents, and 19 healthcare professionals provided their opinions on various topics. This study addresses prosthetic use or non-use of prosthetics and rehabilitation care. Data were analyzed using the framework approach.

Results: Cosmesis was considered to be the prime factor for choosing and wearing a prosthesis, since this was deemed especially useful in avoiding stares from others. Although participants functioned well without prostheses, they agreed that it was an adjuvant in daily-life activities and sports. Weight and limited functionality constituted rejection reasons for a prosthesis. Children and adolescents who had accepted that they were different no longer needed the prosthesis to avoid being stared at. The majority of participants highly valued the peer-to-peer contact provided by the healthcare professionals.

Conclusions: For children and adolescents with UCBED, prostheses appeared particularly important for social integration, but much less so for functionality. Peer-to-peer contact seemed to provide support during the process of achieving social integration and should be embedded in the healthcare process.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Elbow Prosthesis*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Personnel* / psychology
  • Humans
  • Male
  • Parents* / psychology
  • Patient Compliance / psychology*
  • Patient Satisfaction
  • Treatment Refusal / psychology
  • Upper Extremity Deformities, Congenital / psychology
  • Upper Extremity Deformities, Congenital / rehabilitation*
  • Young Adult

Grants and funding

This study was financed by grants from national foundations: the OIM Foundation, Beatrixoord Foundation, Orthopedietechniek De Hoogstraat Foundation and the Gratama Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have no further financial relationships relevant to this article to disclose.