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Parents' Lived Experiences during their Child's Ilizarov Treatment: A Qualitative Study from a Tertiary Paediatric
Sitanshu Barik1, Denish Chandrakar1, Piyush Chauhan1
1Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India.
Insights
Caring for a child with an Ilizarov frame for limb reconstruction is demanding. Parents face significant psychosocial, financial, and logistical challenges, but trust and family support aid coping during this pediatric orthopedic treatment.
Area of Science:
- Paediatric Orthopaedics
- Psychosocial Health
- Caregiver Studies
Background:
- Circular external fixation (Ilizarov method) is common in pediatric orthopedics for limb reconstruction.
- Clinical outcomes are known, but family psychosocial experiences during Ilizarov treatment are understudied, especially in low- and middle-income countries.
- This study explores parents' lived experiences during their child's Ilizarov treatment.
Purpose of the Study:
- To explore the psychosocial and caregiving experiences of parents whose children underwent Ilizarov treatment.
- To identify challenges and coping mechanisms during prolonged external fixation.
- To inform improvements in family-centered care for pediatric limb reconstruction.
Main Methods:
- Qualitative exploratory study in a tertiary care hospital in India.
- Semi-structured, in-depth interviews with 12 parents/caregivers.
- Reflexive thematic analysis used for data interpretation, with rigor enhanced by triangulation and journaling.
Main Results:
- Six themes emerged: diagnosis confrontation, trust in healthcare, caregiving burden, financial/travel hardship, coping strategies, and recovery.
- Parents experienced initial fear but adapted to frame care demands.
- Trust in clinicians and family support were crucial for coping.
Conclusions:
- Ilizarov treatment imposes significant psychosocial and caregiving burdens on families.
- Enhanced family-centered care, including counseling and education, can improve treatment experiences.
- Addressing caregiver needs is vital for pediatric limb reconstruction outcomes.
Background:
Circular external fixation using the Ilizarov method is widely used in paediatric orthopaedics for deformity correction and limb reconstruction. Although clinical outcomes are well documented, the psychosocial and caregiving experiences of families during prolonged frame treatment remain underexplored, particularly in low- and middle-income settings. This study aimed to explore parents' lived experiences during their child's treatment with a circular external fixator.
Methods:
A qualitative exploratory study was conducted in the paediatric orthopaedic unit of a tertiary care teaching hospital in central India. Parents or primary caregivers of children undergoing or recently completing Ilizarov treatment were recruited using purposive maximum-variation sampling. Data were collected through semi-structured, in-depth interviews and analysed using reflexive thematic analysis following Braun and Clarke's approach. Rigour was enhanced through investigator triangulation, reflexive journaling, and the maintenance of an audit trail.
Results:
Twelve parents participated in the study. Six major themes emerged: Confronting the diagnosis, trust in the healthcare team, caregiving burden during the frame period, financial and travel hardship, emotional coping strategies, and recovery with reflection. Parents initially experienced fear and uncertainty but gradually adapted to the demands of frame care. Trust in clinicians and family support were key factors facilitating coping.
Conclusion:
Ilizarov treatment places considerable psychosocial and caregiving demands on families. Strengthening family-centred care, including structured counselling and caregiver education, may improve treatment experiences for children undergoing limb reconstruction.
Clinical Significance:
Understanding caregiver experiences during Ilizarov treatment highlights the substantial psychosocial, logistical, and financial burden on families. Incorporating structured pre-treatment counselling, caregiver training, and family-centred support strategies may improve treatment adherence, reduce complications, and enhance overall patient and caregiver outcomes in paediatric limb reconstruction.
