Overhead-Extension für die Therapie der isolierten Femurfraktur des Kleinkindes – Was lernt man von den Eltern

Zusammenfassung

Hintergrund Die konservative Therapie ist der Standard bei Unter-4-jährigen mit Femurfraktur. Um die Zufriedenheit der Eltern mit dieser aufwändigen Behandlung zu verbessern haben wir wichtige Einflussfaktoren auf diesen wichtigen Behandlungsaspekt untersucht. Patienten: 42 Fälle von Kindern unter 4 Jahren, mit Femurfraktur und Overheadextension-Therapie (OHE) wurden analysiert.

Methode Unser Standardverfahren beinhaltet die 10-tägige OHE mit anschließender Becken-Bein-Gips-Behandlung (BBG). Röntgenbilder wurden bezgl. des Heilverlaufs analysiert. Die Eltern wurden mittels eines pseudonymisierten Fragebogens über ihre Erfahrungen befragt.

Ergebnisse Die Art der Fraktur wurde 73.3% der Eltern „verständlich und detailliert“ erklärt. 23.3% gaben an, dass „viele Fragen unbeantwortet” blieben. 70% der Eltern bemerkten Verhaltensauffälligkeiten bei Ihrem Kind, 63.3% berichteten von therapie-spezifischen Problemen. 86.7% der Eltern waren mit dem Behandlungserfolg zufrieden, 80% mit der Art der Therapie und 73.3% würden die OHE erneut wählen. Spearman-Korrelations-Analysen fanden eine signifikante Korrelation zwischen der generellen Elternzufriedenheit und einem hohen Grad an Aufklärung bzgl. der Art der Fraktur. Eltern, welche Probleme während der Visite ansprechen konnten zeigten eine signifikant höhere Zufriedenheit.

Diskussion Die meisten Gründe für eine Unzufriedenheit der Eltern waren in Verbindung mit Kommunikationsproblemen zu sehen.

Schlussfolgerung Eine gute Evaluierung während der Visite, gute Kommunikation mit den Ärzten sowie gute pflegerische Hilfestellung beeinflussen die Zufriedenheit der Familien erheblich.

Abstract

Background Conservative options are the standard for treatment of femoral fractures for patients under the age of 4 years. We investigated possible factors influencing the satisfaction of the parents in order to improve their experience. Patients: We analyzed 42 cases of children under the age of 4 years treated with overhead extension therapy (OHE) for femoral fracture.

Methods Our protocol requires transition to spica cast treatment (SCT) and discharge from the hospital after the initial 10-day OHE. X-rays were analyzed for fracture healing. A pseudonymized questionnaire was sent to the parents in order to evaluate their experiences during the treatment.

Results The nature of the fracture was explained to 73.3% of the parents in a way that was “understandable and in detail”. However, 23.3% stated that “many questions were not answered”. Seventy percent of parents noticed behavioral abnormalities during treatment, and 63.3% reported treatment-specific problems. Additionally, 86.7% of parents were satisfied with the therapy outcome, 80% were content with the type of therapy, and 73.3% would choose OHE again. We found a high Spearman correlation between general satisfaction and parents who felt well informed. There was also a strong correlation between high general satisfaction and the opportunity for any problems to be discussed and addressed during the medical rounds.

Discussion The reasons for nonsatisfaction were primarily due to communication problems.

Conclusion Thorough evaluation during medical rounds, communication with healthcare professionals and care provided by the nurses affects the contentment of the families significantly.

Schlüsselwörter

Femurfraktur - Kleinkind - Overheadextension - Elternzufriedenheit - Kommunikation im Gesundheitswesen

Key words

femoral fractures - toddler - overhead extension therapy - parents’ satisfaction - communication in healthcare

Ferdinand Wagner and Viktoria Schütz contributed equally to this work.

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