Evaluating the quality of life in mothers caring for children with congenital clubfoot: prospective sequential evaluation along the course of Ponseti management.

Abstract

The post birth revelation of child with physical anomaly taxes maternal hopes of a healthy child. However, unlike many other congenital anomalies, the Ponseti method has enabled an early and effective treatment of the clubfoot deformity. Our study aimed to assess the quality of life (QoL) of mothers with child born with idiopathic clubfoot through various stages of its management compared to a healthy infant. The study was conducted on mothers of children born with untreated congenital idiopathic clubfoot presenting within first 3 months after birth and undergoing Ponseti treatment. The WHO Quality of Life Instrument (QoL), Short Form (WHOQOL-BREF) questionnaire was used to capture maternal responses at enrolment of the child at the clubfoot clinic, at percutaneous Achilles tenotomy, 3 weeks post tenotomy, and 1 month after prescription of foot abduction brace. Intertreatment comparison of QoL responses was performed. Baseline values for QoL domains were obtained for mothers born with healthy infants (controls). Responses from 29 affected mothers and 30 controls were available. The QoL responses from affected mothers were significantly lower than those born with healthy children. The domains most affected were psychological health and environment ( P  < 0.001). Subsequent responses through various stages of Ponseti management remained comparable. Although the affected mothers' QoL was lower than mothers of healthy child, they were pacified by the available treatment and the counseling for clubfoot. Physical health and social relationship domains were no longer areas of concern for them. Further, there was no change of QoL across sequential Ponseti management.