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. 2014 Fall;22(3):183-7.

'Wondering and waiting' after obstetrical brachial plexus injury: Are we underestimating the effects of the traumatic experience on the families?

Carol DeMatteo  1 , James R Bain  2 , Deborah Gjertsen  3 , Jessica A Harper  4
Affiliations

'Wondering and waiting' after obstetrical brachial plexus injury: Are we underestimating the effects of the traumatic experience on the families?

Carol DeMatteo et al. Plast Surg (Oakv). 2014 Fall.

Abstract
in English, French

Background: Obstetrical brachial plexus injury (OBPI) in children can cause great distress to a family due to uncertain recovery, variability in spontaneous recovery and unclear indicators for surgery.

Objective: To investigate the impact of having a child with OBPI on the family and whether the Impact on Family Scale (IoFS) can assist in addressing family concerns.

Methods: A mixed-method (cross-sectional survey and semistructured interviews) study design was used.

Results: Thirty-eight families of children with OBPI completed the IoFS. Surgery significantly predicted a higher IoFS total impact score (P=0.02). No statistically significant association between the total impact score and severity or age was found, suggesting that impact on family was not dependent on these factors. Themes that emerged from the interviews included traumatic birthing experience, wondering and waiting, and experiencing surgery.

Conclusion: All families should receive support and acknowledgement of the widespread impact of OBPI.

Historique: La lésion obstétricale du plexus brachial (LOPB) chez les enfants peut susciter une grande détresse dans une famille en raison de l’incertitude quant au rétablissement, de la variabilité du rétablissement spontané et du caractère flou des indicateurs de chirurgie.

Objectif: Examiner les répercussions d’un enfant ayant une LOPB sur la famille et si l’échelle IoFS des répercussions sur les membres de la famille peut contribuer à répondre à leurs inquiétudes.

Méthodologie: Une méthodologie mixte (étude transversale et entrevues semi-structurées) a été privilégiée.

Résultats: Trente-huit familles d’enfants ayant une LOPB ont rempli l’échelle IoFS. La chirurgie prédisait de manière significative un indice d’IoFS total plus élevé (P=0,02). L’association entre l’indice total et la gravité ou l’âge n’était pas significative. Les répercussions sur la famille ne dépendraient donc pas de ces facteurs. Les thèmes qui ont émergé des entrevues incluaient une expérience d’accouchement traumatisante, de l’inquiétude et de l’attente et l’expérience de la chirurgie.

Conclusion: Toutes les familles devraient recevoir du soutien, et les effets généralisés de la LOPB sur leur état devraient être pris en compte.

Keywords: Child; Evaluation; Family impact; Interview; Obstetrical brachial plexus injury; Questionnaire.

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Figures

Figure 1)
Figure 1)
Comparison of scores across Narakas levels on the five Impact on the Family Scale (IoFS) subscales. An ANOVA revealed no significant difference between groups on any of the subscales, including the total impact (F=1.650; P=0.196), financial impact (F=0.461; P=0.711), general negative impact (F=2.155; P=0.111), disruption of social relations (F=1.556; P=0.218) and coping (F=0.072; P=0.975). Note: Outlier more than 1.5 box lengths from the box edge. *Extreme outlier more than three box lengths from the box edge
Figure 2)
Figure 2)
Comparison of scores between surgery and no surgery families on the five Impact on Family Scale (IOFS) subscales. The surgery families had significantly higher total impact (t=2.436; P=0.020 [+]) and disruption of social relations (t=2.475; P=0.018 [++]) scores. There were no significant differences in financial impact (t=1.440; P=0.159), general negative impact (t=1.903; P=0.065) or coping (t=−0.090; P=0.929). Note: Outlier >1.5 box lengths from the box edge. *Extreme outlier >3 box lengths from the box edge
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