Family Perceptions Regarding Conversion Surgery Experiences for Children with Congenital Lower Limb Deficiencies: Stresses, Decision Making, and Outcomes
ANN SWAGMAN, M.P.H., C.P.N.P., R.N.,LINDA BOND, Ph.D., BETTY KLOOSTERMAN, B.S.N., R.N.,AND KIRSTEN LUNDEEN, M.S., R.N.
Purpose: 27 families of children who have had conversion surgery (either ankle or knee disarticulation) for fibular hemimelia, tibial hemimelia, or PFFD were studied to determine the factors involved in the decision making regarding the surgery, subsequent satisfaction with the results, and the long-term effects on the child and family.
Methods: Structured interviews and questionnaires were used to collect data from parents in conjunction with routine clinic visits. The Impact-on-Family Scale (Stein and Riessman, 1980) was used to assess family adjustment. The 24-item scale contains the 4 sub-scales which measure the impact (of the child's condition) on various components of family life: financial, social/familial, personal strain, and mastery/coping. Children above pre-school age were asked to draw a self-portrait, complete an activities questionnaire and the Coopersmith Self-Esteem inventory (school form).
Results: Interview results suggest that the majority of families feel satisfied with their decisions surrounding the conversion surgery. The most frequent reason given for the surgery decision involved normalization for the child. Scores on the Impact-on-Family scale support these selfassessments. Family adjustment was not significantly correlated with either the age of the child at surgery or the time having elapsed since surgery.
Area Child Amputee Center, 235 Wealthy S.E., Grand Rapids, MI 49503