Impact of Clubfoot Diagnosis and Treatment on Parental Mental Health in Children

Background: Clubfoot affects mental soundness of the care givers and dealing with its treatment can be psychosocially challenging for parents. The reliable tool for evaluating anxiety, depression, and stress is the DASS-21 (Depression, Anxiety, and Stress Scale-21). Objectives: The goal of this study is to compare the levels of parental anxiety, stress, and depression before and after clubfoot treatment using the DASS-21 scale. The study will also assess the differences in DASS-21 scores between parents with higher and lower education levels. Study Design: Cross-sectional study Place and Duration of Study: Department of Orthopaedics, Liaquat National Hospital Karachi, from January 21, 2022, to December 31, 2022. Methodology: Forty parents of clubfoot patients were enrolled in the study. The questionnaire was provided to the parents before the start of the Ponseti casting. The standard six-week Ponseti regimen was followed by TA tenotomy and full casting. The second questionnaire was given to the parents two weeks after the removal of the final cast. Results: Sixty-five percent of the attendants were fathers. The majority of parents had an undergraduate level of education. Ten percent of parents reported experiencing stress before treatment. The mean DASS-21 scores before treatment were 6.35±1.29 for depression, 5.17±1.17 for anxiety, and 6.37±0.92 for stress. After treatment, the scores decreased to 0.92±0.61, 0.37±0.52, and 0.37±0.58, respectively. The overall mean DASS-21 score before treatment was 17.90±1.945, which significantly reduced to 1.68±0.693 (p<0.001) after treatment. Furthermore, the DASS-21 scores showed significant differences across age groups, parental background, and educational levels. Conclusion: The overall DASS-21 score showed a significant reduction after treatment. Additionally, educational level demonstrated variation across the groups.