Determinants of parent satisfaction and trust towards healthcare service environment in a dedicated club foot clinic.

Abstract

This study aimed to assess the determinants affecting parental satisfaction and trust in clinical care of children with clubfoot at a specialized clubfoot clinic in a tertiary care setting. In this cross-sectional study at Khyber Teaching Hospital, 306 attendants of children with clubfoot were recruited using consecutive sampling. Pirani score was used to evaluate the severity. Satisfaction levels were assessed using Short Assessment of Patient Satisfaction score. Data were analyzed using SPSS, with chi-square tests. The mean number of clinic visits was 8.52 ± 5.08; 55.6% of patients required more than eight clinical visits, and 82.7% underwent treatment for more than 8 weeks. Mean Short Assessment of Patient Satisfaction score was 23.37 ± 5.19; 82% of parents expressed satisfaction, whereas 18% showed variable levels of dissatisfaction. High dissatisfaction was correlated with greater than eight visits ( P  = 0.014), prolonged treatment duration ( P  = 0.008), Ponseti management with serial casting plus tenotomy versus serial casting only (very dissatisfied: 43.8% vs. 2.4%; P  < 0.001), and unsatisfactory clinical outcome ( P  < 0.001). Significant concerns included lack of shared decision-making (19.3% dissatisfied), unclear explanations (10.2% dissatisfied), and overall dissatisfaction towards the health services (23.6% dissatisfied; 16.0% neutral). Even with high satisfaction and satisfactory outcomes with the Ponseti method, high frequency of visits, long treatment durations, inadequate parental participation and lack of effective communication compromise caregivers' trust. Enhancing patient-centered approach, proper counseling, and effective care delivery may influence follow-up and satisfaction in sustained pediatric orthopedic care and optimize compliance.