What was the article looking for?
This article aimed to provide an overview of practical experience and the scientific evidence in relation to the psychological aspects of scoliosis in adolescents (1). In this article, Dagmar and Shanz (2003) provide a valuable insight into the psychological aspects of scoliosis treatment for adolescent patients. The authors provided a detailed overview of the knowledge that was available at the time.
Adolescence and scoliosis
The authors noted that adolescence is a sensitive phase of a young person’s life. Coupling this with a chronic condition therefore brings other considerations, such as:
- facing up to cosmetic impairments
- coming to terms with a commitment of treatments, which often involves time-consuming appointments
- dealing with the fact that the interruption to life is for a condition that does not always cause physical symptoms and success is not always related to an improvement in state of health.
Does scoliosis impair quality of life?
The authors acknowledged that scoliosis is a risk factor for impairment of quality of life in children and adolescents. They also acknowledged that supporting patients wearing a brace was particularly important. Some of the factors they noted that need to be considered when working with a patient included:
- Scoliosis can cause changed expectations in relation to work and leisure for the patient (2).
- Chronic illnesses during this critical time of growth require a high degree of structure, organisation and control in dealing with the condition (3).
- Coupled with scoliosis, the changes of puberty can result in adolescents finding themselves in a particularly sensitive stage of development that is highly susceptible to disruptive factors, but also dealing with a condition.
- The diagnosis of a chronic illness during this sensitive phase can potentially impede the achievement of adolescent specific development goals (4).
Overall, a compromise between adjusting to the condition and obtaining adequate development opportunities is potentially a suitable approach (4).
Bracing and adolescents with scoliosis
Prescription of a brace takes place at a time where these adolescents are often more aware of physical appearance (4). There has been question as to whether the orthosis creates a lasting change in the patient’s self image and body image, however it appears that this is not correct (5, 6, 7).
Take home message
Once an adolescent is diagnosed with scoliosis, there needs to be consideration and time allowed for adjustment to the situation. Consideration of the time consuming appointments and commitments to scoliosis specific exercises and wearing of a brace are important. There can be emotional uncertainty for an adolescent who is diagnosed with scoliosis, and this is coupled with what is already a particularly vulnerable stage of life.
Note: The appearance and bulkiness of a brace appears to affect some patients. This has been carefully considered in the design of the ScoliBrace. The patient can choose their own design and the profile of the brace allows the patient to wear their clothes quite comfortably.
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