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Patient and caregiver knowledge of pediatric testicular torsion: A scoping review
Wyatt MacNevin1, Nicholas Dawe2, Abrahim Chidiac2
1Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada.
Insights
Low awareness of pediatric testicular torsion (PedTT) contributes to delayed treatment. Educational initiatives can improve knowledge and testicular salvage rates in children.
Area of Science:
- Pediatric Surgery
- Medical Education
- Public Health
Background:
- Pediatric testicular torsion (PedTT) is a surgical emergency where prompt presentation is crucial for testicular salvage.
- Delayed intervention due to lack of awareness, especially with milder symptoms, can lead to testicular loss.
- Understanding knowledge gaps in pediatric and caregiver populations is key to improving outcomes.
Purpose of the Study:
- To conduct a comprehensive scoping review of existing literature on pediatric and caregiver knowledge of PedTT.
- To evaluate the effectiveness of educational initiatives aimed at improving awareness and timely presentation for PedTT.
- To identify strategies for optimizing educational efforts to reduce pre-hospital delay and enhance testicular salvage.
Main Methods:
- A systematic scoping review of English-language literature was conducted.
- Included both qualitative and quantitative studies examining pediatric and caregiver knowledge of PedTT.
- Also reviewed studies on the outcomes of PedTT-focused educational initiatives.
Main Results:
- Analysis of 21 studies revealed significant knowledge gaps in the definition, symptoms, and critical timing for PedTT among children and caregivers.
- Caregivers expressed a strong desire for increased public awareness and education regarding PedTT.
- School-based and social media initiatives showed promise in improving knowledge and awareness.
Conclusions:
- Low awareness of PedTT among children and caregivers is a significant factor contributing to delayed emergency department presentation.
- Educational interventions are effective in enhancing knowledge and awareness of PedTT.
- Optimizing educational strategies is essential to improve public understanding and timely treatment of PedTT, thereby increasing testicular salvage rates.
Introduction:
Pediatric testicular torsion (PedTT) is a surgical emergency that requires prompt presentation. Delay in intervention can lead to testicular loss. In the PedTT care pathway, the pre-hospital phase prior to presenting to the emergency department, is the strongest determining factor for testicular salvage. Although the severe nature of testicular pain is likely to prompt many families to seek emergent care, patients with milder symptoms may delay presentation if they and their caregivers are unaware of PedTT as a disease entity. Understanding caregiver and pediatric knowledge of PedTT will aid in better designing and delivering educational initiatives to reduce pre-hospital delay and improve testicular salvage. This study is a comprehensive scoping review of the literature reporting on pediatric and caregiver knowledge of PedTT, and outcomes of educational initiatives.
Methods:
A scoping review was performed on all English-language literature reporting on pediatric and caregiver knowledge of PedTT, as well as PedTT-based educational initiatives. Both qualitative and quantitative studies were reviewed, analyzed, and compiled.
Results:
A total of 2773 articles were identified, with 21 studies included. After review, 11 studies focused on caregiver perspectives of PedTT, 5 studies examined patient perspectives, and 8 studies identified PedTT educational initiatives, with overlap between publications. Overall, knowledge gaps were identified in the definition of PedTT, presenting symptoms, and critical time frame for salvage by both pediatric and caregiver groups. Caregivers expressed a need and a desire for increased public awareness and teaching around PedTT. School-based educational initiatives were well-received among participants, with social media-based initiatives showing promise.
Conclusions:
Both pediatric and caregiver knowledge of PedTT is low, and lack of awareness may contribute to delayed presentation. Educational initiatives have been shown to improve PedTT knowledge and awareness. Results from this study can be used to optimize PedTT educational efforts to improve caregiver and public knowledge.
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