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Published on: December 7, 2018
Discrepancies in Parent Perceptions and Patient-Reported Psychosocial Function in Children with Craniofacial
Elizabeth J Volpicelli1, Miles J Pfaff1, Hi'ilani M K Potemra1
1From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles David Geffen School of Medicine; the Institute for Digital Research and Education, Department of Statistics, University of California, Los Angeles; the Cleft Palate Program, Orthopaedic Institute for Children; and the Division of Plastic and Reconstructive Surgery, Northwell Health Hofstra School of Medicine.
Background:
Understanding and optimizing psychosocial functioning in children with craniofacial anomalies are essential components of their reconstructive care. This work compared parental perceptions to pediatric self-reported psychosocial functioning in children with craniofacial anomalies.
Methods:
Two hundred twenty-one children with craniofacial anomalies (aged 8 to 17 years) and their parents were prospectively evaluated at two institutions using the parent-proxy and pediatric Patient-Reported Outcomes Measurement Information System to assess anger, anxiety, depression, and peer relationships. Children were stratified into three age groups: group A, 8 to 10 years; group B, 11 to 13 years; and group C, 14 to 17 years. Pearson correlations, analyses of variance with post hoc comparisons under the Tukey criterion, and paired samples t tests were performed.
Results:
When stratified by age, no correlations between parent and child reports were found in anxiety for group A and anger, anxiety, and peer relationships for group C. Whereas group A reported the worst psychosocial functioning, group C parents perceived their children to have the worst psychosocial functioning. Group A parents perceived lower depression and better peer relationships, whereas group C parents perceived higher anxiety and depression compared to self-reports.
Conclusions:
Parents perceived an inverse relationship between age and psychosocial functioning compared to self-reports by children with craniofacial anomalies. These discrepancies in the current work highlight the importance of child self-report and suggest incorporating longitudinal patient-reported and parent-proxy-reported outcomes measures for psychosocial functioning as part of standard clinical care for patients with craniofacial anomalies.
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