Investigation of Obstacles for Early Detection of Developmental Dysplasia of the Hip in Children: A Qualitative Research Study

Abstract

Abstract: Developmental dysplasia of the hip (DDH) is a disorder that requires early detection and especially early treatment. It is responsibility not only orthopedists, but also health practitioners and parents to help to prevent a delay in diagnosis of DDH. The aim of this study is to explore the knowledge and attitudes of neonatologists, pediatricians/FDs, as well as mothers of children with DDH regarding DDH, in order to reveal possible obstacles for early detection of this disorder. This study will help to investigate the problem regarding DDH detection in Armenia more profoundly and from different sides: from neonatologists’, pediatricians’/FDs’, and mothers’ points of view. The qualitative research method has been chosen as more feasible and appropriate for this study. Twenty-two face-to-face in-depth interviews were conducted from June to August 2007 in Yerevan. Six of them were with neonatologists, 6 with pediatricians/FDs, and 10 with mothers of children with DDH. This study was the first qualitative study that explored the situation of DDH in Armenia. The results of the study showed insufficient level of mothers’ knowledge regarding DDH and lack of awareness. Mothers considered doctors responsible for late detection/treatment of this disorder and suggested starting improvements from maternity hospitals. Doctors’ level of knowledge was not high, although they could describe diagnosing procedures and referral mechanisms. Doctors did not consider DDH their responsibility and preferred to rely on orthopedists for its detection. Doctors supposed DDH was diagnosed timely but thought that it could be missed in villages. The suggested ways for improvement of DDH management in Armenia, by doctors’ opinion, should increase parents’ knowledge and awareness. Based on the results of the study it is proposed to conduct further research in this field. A quantitative study might help to figure out the true prevalence of DDH in Armenia as well as prevalence of late detected cases. The study shows necessity of training for doctors regarding DDH risk factors, early diagnosis, and examination skills. It is suggested improving doctors’ and parents’ awareness on DDH problem in Armenia.