Caring for People With Untreated Pectus Excavatum: An International Online Survey

Chest. 2020 Mar;157(3):590-594. doi: 10.1016/j.chest.2019.10.034. Epub 2019 Nov 12.

Abstract

Background: Pectus excavatum is a chest wall deformity with no known cause and no standardized guidelines for evaluation or management. There is a pressing need to characterize the symptoms that these individuals experience and to evaluate a potential mismatch between their expected and observed experiences with health care. We hypothesized that these individuals would feel that their health-care needs are not adequately met.

Methods: A total of 331 participants with untreated pectus excavatum from 47 countries recruited from the Pectus Awareness and Support Group completed a questionnaire about living with pectus excavatum. We focused on characterizing physical and psychosocial symptom frequency and whether these problems were discussed with providers during encounters related to pectus excavatum.

Results: A total of 46% and 31% of participants experience daily physical and psychosocial symptoms, respectively, but providers disproportionally focus on physical symptoms. Seventy-seven percent and 61% of participants thought their providers could do more to address their physical and psychosocial symptoms, respectively. Only 8% of participants were very satisfied after their most recent health-care visit about pectus excavatum. The overwhelming majority of participants have encountered providers that lacked basic knowledge about pectus.

Conclusions: The results of this questionnaire expose a major discrepancy between expectations and delivery of care for people with pectus excavatum. These individuals should be routinely screened for both physical and psychosocial symptoms by general practitioners.

Keywords: pectus excavatum; physical symptoms; psychosocial symptoms.

MeSH terms

  • Adolescent
  • Adult
  • Australia
  • Body Dissatisfaction / psychology
  • Body Dysmorphic Disorders / psychology
  • Canada
  • Chest Pain / physiopathology
  • Child
  • Child, Preschool
  • Clinical Competence
  • Dyspnea / physiopathology
  • Female
  • Funnel Chest / physiopathology*
  • Funnel Chest / psychology*
  • General Practitioners
  • Health Personnel*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Needs Assessment*
  • Patient Satisfaction*
  • Self Concept
  • Surgeons
  • Surveys and Questionnaires
  • United Kingdom
  • United States
  • Young Adult