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Effectiveness of psychosocial interventions for pediatric patients with scoliosis: a systematic review
Maike van Niekerk1, Ann Richey1, John Vorhies1
1Pediatric Orthopaedic Surgery, Stanford University, Stanford, California, USA.
Insights
Psychosocial interventions for pediatric scoliosis patients show promise, particularly those with frequent provider interaction. Further research is needed to develop and test these interventions for improved patient care.
Area of Science:
- Pediatric Orthopedics
- Psychology
- Evidence-Based Practice
Background:
- Pediatric scoliosis presents significant psychological and social challenges.
- Psychosocial interventions may improve patient outcomes.
- This study systematically reviews the efficacy of these interventions.
Approach:
- Searched multiple databases (Medline, PsycINFO, CINAHL, CENTRAL) up to March 2022.
- Included studies evaluating psychosocial interventions for pediatric scoliosis with quantitative outcomes.
- Assessed study quality using Cochrane Risk of Bias and MINORS tools.
Key Points:
- Ten studies on adolescent idiopathic scoliosis (1007 participants) were analyzed.
- Brace compliance improved with monitoring and counseling.
- Post-spinal surgery mental healthcare delivery by nurses showed positive outcomes.
- Efficacy of brief educational interventions was largely unclear.
- Methodological quality was often limited by reporting.
Conclusions:
- Evidence for psychosocial interventions in pediatric scoliosis is limited.
- Interventions with frequent patient-provider interaction show the most promise.
- Future research should focus on multidisciplinary, holistic care models.
Background:
Pediatric patients affected by scoliosis have complex psychological and social care needs, and may benefit from psychosocial interventions. We therefore aimed to summarize evidence of the efficacy of psychosocial interventions for this patient population.
Methods:
Literature was identified by searching Medline, PsycINFO, Embase, EBSCO Cumulated Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Central Register of Controlled Trials (CENTRAL) from database inception to 20 March 2022. Articles that evaluated the effectiveness of psychosocial interventions for pediatric patients diagnosed with scoliosis and reported at least one quantitative outcome were included. Article eligibility, data extraction, and quality assessment (using the Cochrane Collaboration's Risk of Bias Tool and Methodological Index for Non-Randomized Studies) were performed by two independent researchers. Findings are presented using narrative synthesis.
Results:
We identified ten studies, all of which focused on adolescent idiopathic scoliosis. Studies included a total of 1007 participants, most of whom were female. Three studies focused on patients undergoing bracing, six on patients undergoing spinal surgery, and one on patients broadly. Brace compliance monitoring and counseling were found to significantly improve brace compliance quality and quantity. Proactive mental healthcare delivery by nurses after spinal surgery was similarly found to improve outcomes. Several studies examined the efficacy of brief educational interventions; most did not report clear evidence of their efficacy. The methodological quality of studies was often unclear due to limitations in articles' reporting quality.
Conclusions:
Research on the efficacy of psychosocial interventions for pediatric patients with scoliosis is limited, with interventions involving frequent patient-provider interactions showing the most promise. Future clinical and research efforts should focus on developing and testing psychosocial interventions for this patient population, with emphasis on multidisciplinary teams delivering holistic care.
Trial Registration Number:
PROSPERO number CRD42022326957.
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