Patient and caregiver knowledge of pediatric testicular torsion: A scoping review.

Abstract

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.