BACKGROUND The Pavlik harness (PH) is the most common treatment for infants with developmental dysplasia of the hip. Although success rates are high when used appropriately, brace treatment may impact family function and parental bonding. The purpose of this study was to prospectively determine how PH treatment affected these psychosocial variables. METHODS This is a prospective, single-surgeon study at a tertiary-care, urban, academic children's hospital between November 2022 and March 2023. All patients newly treated with a Pavlik were eligible. Caregivers were administered the Postpartum Bonding Questionnaire and the Revised Impact on Family Scale (rIOFS) at the baseline visit and 2- and 6 weeks following treatment initiation. Demographic and treatment-specific information was collected through surveys and retrospective chart review. Descriptive statistics and bivariate analysis were used. RESULTS A total of 55 caregiver-child dyads were included in the final analysis. Most patients were female (89%) and/or first-born (73%). Forty (73%) hips were diagnosed as having stable dysplasia. rIOFS scores steadily improved from baseline, through 2- and 6 weeks posttreatment initiation. Six-week rIOFS scores were significantly lower than both baseline (P=0.002) and 2 weeks (P=0.018). Average parental bonding scores also improved steadily throughout treatment and did not surpass the threshold of clinical concern at any time. Neither full-time harness use (24 h/d vs. 23 h/d based upon clinical stability) nor age at treatment initiation had a statistically significant effect on parental bonding or family functioning (all P>0.05). Additional demographic variables such as birth order, parental history of anxiety/depression, and relative socioeconomic disadvantage also had no significant effect on psychosocial outcomes. CONCLUSION PH treatment did not significantly impact maternal-fetal bonding or family dynamics. Relative to other pediatric diseases, PH treatment has an impact on family life greater than that of single-leg spica, but less than that of school-age children with chronic medical illnesses. As PH treatment is a widely used treatment for infantile developmental dysplasia of the hip, this study provides information that clinicians may use to more accurately counsel families and assuage parental concerns. LEVELS OF EVIDENCE Level IV-prospective uncontrolled cohort study.

中文翻译：

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Pavlik 安全带治疗有哪些心理社会影响？关于对家庭和母婴关系的感知影响的前瞻性研究。

背景 Pavlik 背带 (PH) 是治疗患有发育性髋关节发育不良的婴儿最常见的治疗方法。尽管使用得当的话成功率很高，但支具治疗可能会影响家庭功能和父母关系。本研究的目的是前瞻性地确定 PH 治疗如何影响这些心理社会变量。方法 这是 2022 年 11 月至 2023 年 3 月期间在一家三级护理城市学术儿童医院进行的一项前瞻性单外科医生研究。所有新接受 Pavlik 治疗的患者均符合资格。在基线访视以及治疗开始后 2 周和 6 周时，护理人员接受了产后亲密调查问卷和修订后的家庭影响量表 (rIOFS)。通过调查和回顾性图表审查收集人口统计和特定治疗信息。使用描述性统计和双变量分析。结果 总共 55 名看护者-儿童二人组被纳入最终分析。大多数患者是女性（89%）和/或长子（73%）。四十个 (73%) 髋关节被诊断为稳定型发育不良。在治疗开始后 2 周和 6 周内，rIOFS 评分较基线稳步提高。六周 rIOFS 评分显着低于基线 (P=0.002) 和两周 (P=0.018)。在整个治疗过程中，平均亲子关系评分也稳步提高，并且在任何时候都没有超过临床关注的阈值。全职安全带使用（24 小时/天 vs. 23 小时/天，基于临床稳定性）和治疗开始时的年龄对父母亲情或家庭功能均没有统计学上的显着影响（所有 P>0.05）。其他人口统计学变量，如出生顺序、父母焦虑/抑郁史以及相对社会经济劣势也对心理社会结果没有显着影响。结论 PH 治疗并未显着影响母婴关系或家庭动态。相对于其他儿科疾病，PH治疗对家庭生活的影响大于单腿人字形，但小于患有慢性病的学龄儿童。由于 PH 治疗是婴儿期髋关节发育不良的一种广泛使用的治疗方法，因此本研究提供的信息可供临床医生用来更准确地为家庭提供咨询并减轻父母的担忧。证据级别 IV 级——前瞻性非对照队列研究。