Parental needs and nursing response following SUFE Surgery: An interpretive descriptive study

<p><b>The parental experience of caring for a child following the unexpected admission and surgery for a significant hip injury has largely been unexplored in the New Zealand (NZ) context. Slipped Upper Femoral Epiphysis (SUFE) is one of the most common orthopaedic hip disorders prevalent amongst children between the ages of nine to fifteen years. In New Zealand, Māori and Pacific children are the most vulnerable population at risk of this hip condition. Existing literature focuses on the demographic and epidemiological studies, including surgical treatment and management of SUFE; however, there is a dearth of research concerning SUFE that focuses on parents’ experiences in the postoperative, discharge and rehabilitative phases of care and the nurses’ experience of caring for these children and their families.</b></p> <p>This qualitative study was undertaken at a large public hospital in New Zealand and interpretive descriptive methodology was utilised to examine the experiences of parents and nurses in caring for a child following invasive SUFE repair. As Māori and Pacific Island populations are highly represented in the SUFE statistics, most of the parents used in this study are from these socio-cultural backgrounds. Through transcribed semi-structured interviews with parents of five children who underwent SUFE repair, and five paediatric nurses caring for children and their families in the hospital ward, this study offers two perspectives of the journey for these parents following such an injury, from the child’s hospitalisation to caring for these children once they are home. Following thematic analysis, these perspectives are presented and contrasted revealing, insights of the parents’ ongoing need for support, information and planning for care and nurses’ efforts to meet these needs. Implications of nursing practice and parental education include the need for improved information sharing and delivery to aid parents understanding of the SUFE condition and effective management of care during hospitalisation and at home following discharge. Recommendations are made to improve the parental experience to support their child’s recovery following SUFE surgery.</p> <p>Key Words:SUFE, Parents and caregivers, Māori and Pacific populations, Nurses</p>

Parental needs and nursing response following SUFE Surgery: An interpretive descriptive study

<p><b>The parental experience of caring for a child following the unexpected admission and surgery for a significant hip injury has largely been unexplored in the New Zealand (NZ) context. Slipped Upper Femoral Epiphysis (SUFE) is one of the most common orthopaedic hip disorders prevalent amongst children between the ages of nine to fifteen years. In New Zealand, Māori and Pacific children are the most vulnerable population at risk of this hip condition. Existing literature focuses on the demographic and epidemiological studies, including surgical treatment and management of SUFE; however, there is a dearth of research concerning SUFE that focuses on parents’ experiences in the postoperative, discharge and rehabilitative phases of care and the nurses’ experience of caring for these children and their families.</b></p> <p>This qualitative study was undertaken at a large public hospital in New Zealand and interpretive descriptive methodology was utilised to examine the experiences of parents and nurses in caring for a child following invasive SUFE repair. As Māori and Pacific Island populations are highly represented in the SUFE statistics, most of the parents used in this study are from these socio-cultural backgrounds. Through transcribed semi-structured interviews with parents of five children who underwent SUFE repair, and five paediatric nurses caring for children and their families in the hospital ward, this study offers two perspectives of the journey for these parents following such an injury, from the child’s hospitalisation to caring for these children once they are home. Following thematic analysis, these perspectives are presented and contrasted revealing, insights of the parents’ ongoing need for support, information and planning for care and nurses’ efforts to meet these needs. Implications of nursing practice and parental education include the need for improved information sharing and delivery to aid parents understanding of the SUFE condition and effective management of care during hospitalisation and at home following discharge. Recommendations are made to improve the parental experience to support their child’s recovery following SUFE surgery.</p> <p>Key Words:SUFE, Parents and caregivers, Māori and Pacific populations, Nurses</p>

Paediatric orthopaedic surgery

This chapter outlines childhood growth and the physis and the management of paediatric fractures. The chapter also outlines the approach to the limping child or the child with a non-accidental injury. Conditions such as hip dysplasia, Legg–Calvé–Perthes disease, slipped upper femoral epiphysis, scoliosis and cerebral palsy are described in detail.

1071 SUFE and the Internet: Are Healthcare Information Websites Accessible to Parents?

Background Slipped upper femoral epiphysis(SUFE) is an adolescent hip disorder requiring rapid surgical intervention. Faced with the prospect of their child undergoing surgery, many fearful parents will turn to the internet to provide information and reassurance. Previous studies have shown the orthopaedic information can be difficult to comprehend. Objective Assess the readability of healthcare websites regarding SUFE. Method The term Slipped Upper Femoral Epiphysis was searched in Google, Bing and Yahoo and evaluated using readability software with seven specialised readability tests. A Flesich Read Ease Score (FRES) score above 65 and a Reading Grade Level (RGL) of sixth grade and under was considered acceptable. Results 21 unique websites were assessed. The average FRES was 52.5 +/- 15.4. Only 3 websites scored 65 or higher (14%). There was a statistically significant difference between website scores based on affiliation, with physician websites having the overall highest mean(P = 0.004). The average RGL was 8.67 +/- 1.8. Only two websites met the accepted RGL criteria (9.5%) while five websites were marked as extremely difficult to understand (23.8%). Only five websites offered translations (23.8%). There was no statistically significant difference in readability scores between websites which offered translation and those which did not. One-way t-tests showed that both the RGL (p &lt; 0.001; CI: 1.83-3.49) and the FRES (P &lt; 0.001, CI: -19.4 to -5.4) scores were significantly different from the accepted standard. Conclusions Most websites reviewed were deemed inaccessible. Improving readability would enhance the internet’s usability as a healthcare tool for parents.

SUFE and the internet: are healthcare information websites accessible to parents?

BackgroundSlipped upper femoral epiphysis is an adolescent hip disorder requiring rapid surgical intervention. Faced with the prospect of their child undergoing surgery, many fearful parents will turn to the internet to provide information and reassurance. Previous studies have shown the orthopaedic information can be difficult to comprehend.ObjectiveAssess the readability of healthcare websites regarding slipped upper femoral epiphysis.MethodsThe term Slipped Upper Femoral Epiphysis was searched in Google, Bing and Yahoo. The websites were evaluated using readability software with seven specialised readability tests including the Flesch-Kincaid Reading Grade Level, the Flesch Reading Ease Score, the Simple Measure of Gobbledygook, Coleman-Liau Index, Automated Readability Index and the Gunning Fog Index. The reading grade level (RGL) was also calculated.A Flesich Read Ease Score (FRES) score above 65 and an RGL of sixth grade and under was considered acceptable. Websites were also assessed for translation services.Results21 unique websites were assessed. The average FRES was 52.5±15.4. Only 3 websites scored 65 or higher (14%). There was a statistically significant difference between website scores based on affiliation, with physician websites having the overall highest mean(p=0.004).The average RGL was 8.67±1.8. Only two websites met the accepted RGL criteria (9.5%) while five websites were marked as extremely difficult to understand (23.8%). Only five websites offered translations (23.8%). There was no statistically significant difference in readability scores between websites which offered translation and those which did not.One-sample t-tests showed that both the RGL (p<0.001; CI 1.83 to 3.49) and the FRES (p<0.001, CI −19.4 to −5.4) scores were significantly different from the accepted standard.ConclusionMost websites reviewed were above the recommended RGL, making content inaccessible. Improving readability and translation services would enhance the internet’s usability as a healthcare tool for parents.

Temporal changes in slipped upper femoral epiphysis at a regional level: a declining incidence and literature review

Purpose Slipped upper femoral epiphysis (SUFE) is one of the most common adolescent hip pathologies in children with potential for life-long morbidity secondary to avascular necrosis (AVN). The primary aim is to determine an up-to-date demographic of SUFE, as well as current trends in presentation and radiological characteristics. Secondary aims are to quantify prophylactic fixation and subsequent contralateral SUFE. Methods Between 01 January 2013 and 31 December 2015, all cases of SUFE were identified in Northern Ireland. Patient demographics, slip characteristics and outcomes are presented and the incidence rates were calculated using census data. Temporal changes in incidence, compared with a previous cohort, are demonstrated. Results A total of 56 patients (80 hips) were identified. Based on census data, SUFE incidence has declined from 7.14 to 4.69/100,000 population aged < 16 years. Male cases predominated by > 2:1 ratio, and tended to be older than female cases. Approximately 75% of patients were above the 75th centile for age-sex adjusted body weight. Knee pain as a presenting symptom led to a delay in diagnosis. Prophylactic fixation was performed in 25.9%, with contralateral slips occurring in 27.5%. AVN occurred in 7.4% and remained static. Conclusion The incidence of SUFE has declined ~34% in our region. When SUFE occurs, knee pain often results in a delay in definitive diagnosis, and commands clinical vigilance to avoid delays in diagnosis. Patients in our region should be aware of a 1-in-4 contralateral slip rate. Overall, AVN rates remain static and are acceptable, despite the declining incidence of SUFE. Level of evidence Level III - Retrospective Cohort Study