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Developing a Parental-Friendly Scoring System for Children with Congenital Hand Differences
Wee Leon Lam1, Christopher Arthur James Trew2, Lauren Wong2
1Department of Plastic Surgery, Royal Hospital for Sick Children, Edinburgh, UK.
The Journal of Hand Surgery Asian-Pacific Volume
|February 9, 2021
Summary
A new scoring system improved understanding of congenital hand differences (CHD) severity between surgeons and parents. This classification aids in managing expectations and reducing anxiety for families facing CHD.
Area of Science:
- Pediatric Surgery
- Orthopedics
- Medical Communication
Background:
- Congenital hand differences (CHD) present significant diversity, leading to discrepancies in perceived severity between surgeons and parents.
- This disparity complicates effective parental consultation and expectation management.
Purpose of the Study:
- To develop and validate a novel severity classification system for congenital hand differences (CHD).
- To align surgeon and parental perceptions of CHD severity and prognosis.
- To assess the impact of the classification system on parental understanding and anxiety.
Main Methods:
- Parents rated CHD severity and concerns (function, appearance) on a 1-4 scale before and after consultation.
- A 4-point scale defining treatment outcomes was explained to parents.
- Surgeons independently scored CHD severity using the same scale.
- Inter-rater reliability (kappa) was calculated pre- and post-explanation and post-operatively.
Main Results:
- Initial scoring showed no agreement between surgeons and parents.
- Agreement significantly improved after explanation (kappa = 0.437) and post-operatively (kappa = 0.706).
- No correlation was found between perceived severity and hand function or appearance.
Conclusions:
- A simple, explained scoring system effectively bridges the understanding gap regarding CHD severity between surgeons and parents.
- The classification system demonstrates good inter-rater reliability and can be implemented in outpatient settings.
- Utilizing this tool can significantly improve parental understanding, manage expectations, and reduce anxiety associated with congenital hand differences.
