Backgrounds: Adolescent idiopathic scoliosis(AIS) is a common chronic disease in youths, presenting with spinal deformity. Previous studies reported that family functioning of family members will be affected after a child is diagnosed with a chronic health condition. Family functioning would be evaluated in AIS patients and their parents in this study.
Methods: 54 AIS patients (age=14.9±1.9 years old; F:M=51:3) who underwent conservative or surgical treatments in our hospital from April 2017 to March 2018, and their parents (age=43.0±4.1 years old; F:M=40:14) were enrolled in this study. Family functioning of both the patients and their parents was evaluated using McMaster family assessment device (FAD). The relationship of family functioning between the patients and their parents was first accessed using paired-samples t-test. Family functioning was defined to be “Unhealthy” if the family FAD scores (the mean scores of the patients and their parents) were above the cut-off. The potential risk factors of the unhealthiest subscales were analyzed using the chi-squared test or the independent t-test. Then, the effects of independent risk factors were analyzed using the logistic regression model if more than two risk factors were identified.
Results: There is no significant difference between the AIS patients (1.90±0.42~2.23±0.32) and their parents (1.92±0.35~2.21±0.29) in all seven subscales (p≥0.05). The scores of the parents were moderately/strongly correlated with those of the AIS patients in all seven subscales (𝛄=0.456~0.696, p<0.05). 20.4% to 87.0% of the families experienced unhealthy family functioning, and affective involvement (57.4%), and behavior control (87.0%) were the unhealthiest subscales with the mean scores above the cut-off. Coronal imbalance (p=0.041, Odds ratio [OR]=3.685) was the independent risk factor of unhealthy affective involvement.
Conclusions: 20.4%~ 87.0% families reported unhealthy family functioning, especially for affective involvement and behavior control. Coronal imbalance (body image) was an independent risk factor of unhealthy affective involvement. These facts suggest a potential need of the family for assistance with establishing and maintaining near-normal daily routines after a child is diagnosed with AIS. Medical workers should provide some practical suggestions for AIS families to improve their family functioning.