Clinician-led mental health conversations significantly associated with outcomes for scoliosis patients

Abstract

BACKGROUND The psychological impact of idiopathic scoliosis has been well established in the literature. While the diagnosis of scoliosis is concerning, bracing often compounds patients’ stress, and patients have expressed wanting to discuss their feelings with their healthcare providers. Counseling can be an effective coping strategy for adolescents facing chronic illness, but it has not been studied in individuals diagnosed with scoliosis. AIM To assess the frequency and effect of counseling and clinician-led mental health discussions on individuals diagnosed with scoliosis in childhood and adolescence. DESIGN Cross-sectional study. SETTING Community-based research, online. POPULATION Individuals diagnosed with scoliosis in childhood and adolescence. METHODS The online survey included the SRS-22r, the BSSQ-Brace, questions about demographics, mental health, the Scolios-us Mentor Program, and general scoliosis experience. The survey was distributed to Scolios-us Mentor Program participants and to scoliosis clinicians to provide to their patients. Responses about mental health, experiences with healthcare providers, and counseling were analyzed for group differences and associations. RESULTS Fifty-five subjects participated in the study, with a median age of 13 (IQR: 3). Our results indicate that mental health is not being discussed as much as it is desired. A desire to discuss mental health was associated with lower function (P=0.005), mental health (P<0.001), SRS-22r total scores (P=0.002), and BSSQ-Brace scores (P=0.015). Subjects who engaged in a mental health discussion with one or more scoliosis healthcare providers exhibited higher management scores (P=0.002). Only 18.2% of subjects sought counseling, and two-thirds of these subjects found counseling to be very or extremely helpful. CONCLUSIONS Mental health is not discussed by scoliosis providers as often as patients desire it, and a desire to have these conversations is negatively associated with several clinical outcomes. Although clinicians are not regularly talking about mental health, the positive associations of mental health discussions with clinical outcomes are encouraging. CLINICAL REHABILITATION IMPACT The ability to acknowledge the desire to discuss mental health, begin these discussions, and refer patients to a mental health professional may improve patient outcomes.

Comparison of the efficacy of thoracolumbosacral and lumbosacral orthosis for adolescent idiopathic scoliosis in patients with major thoracolumbar or lumbar curves: a prospective controlled study

“…Karol et al reported that patients who were counselled about compliance data wore their braces for an average of 13.8 h daily, compared to 10.8 h for those who were not counselled, which were both significantly less than the recommended minimum of 20 h daily ( 15 ). Therefore, improving bracing compliance remains a significant challenge in clinical practice ( 16 ).…”

Scoliosis and spinal deformities: twenty years of innovations

“…The paper by Castille et al focused on assessing the reported frequency and effect clinician-led mental health discussions on individuals diagnosed with scoliosis in childhood and adolescence. 11 This perspective is an original one on the problem and will open the field for a new care approach.…”