The impact of brace treatment for developmental dysplasia of the hip on caregivers and families : a thematic analysis of literature review and stakeholder survey.

Abstract

Aims: To identify the effect on the family and/or caregivers when infants undergo brace treatment for developmental dysplasia of the hip (DDH) by integrating findings from a literature review and stakeholder survey.

Methods: Thematic analysis combining a comprehensive literature review and data from a UK-based online survey with international involvement. Identification of key themes related to the effect of brace treatment for DDH on the family/ caregivers.

Results: The literature review identified eight relevant articles for inclusion. The online survey had 131 participants. During the thematic analysis, ten key themes emerged, highlighting substantial emotional distress among parents, issues with information provision and consistency, and practical challenges related to clothing, feeding, and sleep. Additional concerns included cleanliness, equipment, child development concerns, infant discomfort, bonding, financial impact, and disruption to daily life.

Conclusion: Brace treatment for DDH has a significant impact on various aspects of family life. Identifying the specific areas of family life affected by brace treatment enables recognition of key challenges, informing the development of robust support systems, clear communication strategies, and customized informational resources. While bracing remains the cornerstone of DDH management in infants, with proven effectiveness in achieving positive clinical outcomes, substantial uncertainties persist regarding critical aspects of treatment, including determining the severity of dysplasia that warrants brace treatment, the optimal duration of treatment, and the most effective approach to brace removal. Resolving these uncertainties requires well-designed randomized controlled trials to establish clear, evidence-based guidelines. Furthermore, evaluations of brace treatments should explicitly incorporate family-centred outcomes. Developing a core outcome set focused on family-relevant measures would significantly enhance the design, comparability, and quality of future DDH research.