FACTORS AFFECTING PARENTAL ADHERENCE TO AN INTERVENTION PROGRAM FOR CONGENITAL TORTICOLLIS

 

Sheri Rabino M.A. Maccabi Health Services, Haifa

Shirley Rokach B.A. Child Development Center, Maccabi Health Services, Haifa

Tsophie Kastel-Deutch MD Child Development Center, Maccabi Health Services, Haifa

Emanuel Tirosh MD. Hannah Khoushy Child Development Center, Bnai Zion Medical Center, Haifa,The faculty of Medicine, Technion, Israel Institute of Technology.

Parents are responsible for implementing intervention programs.

Importance identifying factors influencing parental adherence.

Congenital torticollis having a measurable end point makes impairment ideal for this investigation

Hypothesis: Parental perceptions of the severity of the impairment the degree of negative impact on infant’s daily routine and belief that without treatment it will worsen.

This motivation will be more than that resulting from the relationship with the therapist. expectations and belief in the treatment and preferred type of involvement in health

care .

Sixty five mothers of full term infants referred to physical therapy were sequentially included. Valid and reliable questionnaires assessed the following independent variables: 1. Preference for active vs. passive involvement in treatment2. Satisfaction and trust in the therapist3. Expectations and belief in treatment credibility4. Disease Threat: Maternal perceptions of the severity of the torticollis and the effect of treatment on her infant's function.

The dependent variable, i.e. adherence, was measured by: 1 .Attendance

2 .Exercise compliance, monitored by parent's daily logs 3 .Premature termination of treatment .

Results

•Thirty one percent of the prescribed exercises were performed and seventy eight percent of the scheduled visits were attended. Treatment was terminated with resolution of the torticollis in 69.2%.

•Spearman correlation found statistically significant relationships between the proportion of clinic attendance and the proportion of exercises performed (r =0.69 p < .0001) and fewer premature terminations (r = -0.43 p =.0003).

•The only variable found to be statistically significant in predicting adherence as measured by attendance and the proportion of exercises performed was "Disease Threat" (p= 0.005 for both outcomes).

• Premature termination was not predicted by the independent variables but was related to attendance and exercises performed.

Conclusion

Maternal perceptions of the severity of the torticollis and the importance of the treatment on future function predicted adherence.