Abstract
Background
Adolescent idiopathic Scoliosis (AIS) patients undergoing rigid brace treatment are experiencing both physical and psychological complaints, which reported resulting low compliance. According to the Comfort Theory, patients will engage with more attention to seek healthy behaviors if they are more comfortable, and treatment tends to have more productive outcomes.
Objective
In our study, we follow the rationale behind Comfort Theory in measuring the comfort levels for scoliotic adolescents under brace treatment to pursue a better understanding of patients’ wearing habits and preferences, as well as potential solutions to improve adherence.
Methods
Seventeen AIS patients (mean age,13.2 ±2.4 years [range, 10–17]) treated with Cheneau brace or Boston brace were recruited. The study consisted of a questionnaire survey, measuring brace/body interface corrective force and discomfort level, and an interview. All participants were administrated with Scoliosis Research Society-22 questionnaire (SRS-22), General Comfort questionnaire (GCQ), and Oswestry Disability Index (ODI) to assess their brace wearing experience. A TekScan FlexiForce Electronic (OEM Development Kit) was used to measure the body/brace interface corrective force acting upon the body in eight different positions, while participants used a feeling-of discomfort slider to indicate their level of discomfort on a scale from “comfortable” to ”extremely uncomfortable”.
Results
Regarding to the outcomes of GCQ, participants scored lowest on environmental and psycho-spiritual factors, with the psycho-spiritual domain showing smaller variation. Through the SRS-22 questionnaire, participants reported lower median scores for satisfaction and self-image, with satisfaction having a relatively large variance. No correlations between discomfort level and interface corrective force were found in supine position and weak correlations were found for the positions: standing, sitting, prone, standing with single leg, and these relations were not significant based on p-value. Significant moderate positive correlations were found for the lying positions. A moderate negative correlation between age and discomfort level was found in the prone position, and weak correlations were found in the other 7 positions, none of these were significant. A negligible correlation was found between treatment duration and discomfort level in the lying on right side position, and a weak correlation was found in the other 7 positions, none of these relations were significant. Based on the interview survey, appearance, uncomfortable issues, inconvenience were the three most frequently mentioned problems of the daily feelings on brace treatment.
Conclusion
Participants have serious concerns on self-image and psycho-spiritual difficulties caused by negative peer attitudes and critical comments about their physical shape based on the outcomes of questionnaire and interview survey. We were unable to find any evidence on a relationship between interface corrective force and perceived comfort of bracing. We might be able to draw a conclusion that the interface corrective force is not the major contributory factor to an uncomfortable bracing experience based on the outcomes of the study.
Adolescent idiopathic Scoliosis (AIS) patients undergoing rigid brace treatment are experiencing both physical and psychological complaints, which reported resulting low compliance. According to the Comfort Theory, patients will engage with more attention to seek healthy behaviors if they are more comfortable, and treatment tends to have more productive outcomes.
Objective
In our study, we follow the rationale behind Comfort Theory in measuring the comfort levels for scoliotic adolescents under brace treatment to pursue a better understanding of patients’ wearing habits and preferences, as well as potential solutions to improve adherence.
Methods
Seventeen AIS patients (mean age,13.2 ±2.4 years [range, 10–17]) treated with Cheneau brace or Boston brace were recruited. The study consisted of a questionnaire survey, measuring brace/body interface corrective force and discomfort level, and an interview. All participants were administrated with Scoliosis Research Society-22 questionnaire (SRS-22), General Comfort questionnaire (GCQ), and Oswestry Disability Index (ODI) to assess their brace wearing experience. A TekScan FlexiForce Electronic (OEM Development Kit) was used to measure the body/brace interface corrective force acting upon the body in eight different positions, while participants used a feeling-of discomfort slider to indicate their level of discomfort on a scale from “comfortable” to ”extremely uncomfortable”.
Results
Regarding to the outcomes of GCQ, participants scored lowest on environmental and psycho-spiritual factors, with the psycho-spiritual domain showing smaller variation. Through the SRS-22 questionnaire, participants reported lower median scores for satisfaction and self-image, with satisfaction having a relatively large variance. No correlations between discomfort level and interface corrective force were found in supine position and weak correlations were found for the positions: standing, sitting, prone, standing with single leg, and these relations were not significant based on p-value. Significant moderate positive correlations were found for the lying positions. A moderate negative correlation between age and discomfort level was found in the prone position, and weak correlations were found in the other 7 positions, none of these were significant. A negligible correlation was found between treatment duration and discomfort level in the lying on right side position, and a weak correlation was found in the other 7 positions, none of these relations were significant. Based on the interview survey, appearance, uncomfortable issues, inconvenience were the three most frequently mentioned problems of the daily feelings on brace treatment.
Conclusion
Participants have serious concerns on self-image and psycho-spiritual difficulties caused by negative peer attitudes and critical comments about their physical shape based on the outcomes of questionnaire and interview survey. We were unable to find any evidence on a relationship between interface corrective force and perceived comfort of bracing. We might be able to draw a conclusion that the interface corrective force is not the major contributory factor to an uncomfortable bracing experience based on the outcomes of the study.
| Original language | English |
|---|---|
| Title of host publication | The International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) |
| Subtitle of host publication | eSOSORT2021 |
| Publication status | Published - 1 May 2021 |
Keywords
- Adolescent idiopathic scoliosis
- Brace treatment
- discomfort level
- interface corrective force