Health beliefs regarding pediatric cerebral palsy among caregivers in Botswana: A qualitative study.

BACKGROUND: Cerebral palsy (CP) is the most common motor disability worldwide with an incidence of 2.5 per 1,000 births globally. Health beliefs among caregivers may be major drivers of health-related behaviours and service utilization, but little is known regarding health beliefs around CP in Africa. METHODS: Between July 2013 and September 2015, children with CP were identified in Gaborone, Botswana, and their caregivers were invited to participate in a qualitative study utilizing semistructured in-person one-on-one interviews. Interview questions addressed their understanding of CP, challenges of caring for a handicapped child, and community response to children with CP. RESULTS: Sixty-two caregivers participated in the study. Common themes elicited were variable knowledge about CP, financial and physical burden, lack of therapies and educational resources, and the impact of stigma. Caregivers in Botswana generally subscribed to a biomedical explanation of CP but expressed concerns regarding more stigmatizing folks beliefs expressed in the community. CONCLUSION: Health beliefs regarding CP in Botswana likely have a significant impact on utilization of healthcare resources. Information from this study should inform future educational interventions for caregivers of children with CP.

[Assessment of quality of life in patients with recurrent varicosity].

The present study was aimed at assessing the patients' perception of the remote outcomes obtained after treatment for relapsing varicose disease. The patients treated for recurrent varicosity in 2007-2009 at the Minsk Municipal Centre for Vascular Surgery were encouraged to fill in the Chronic Venous Insufficiency Questionnaire (CIVIQ-2). The Questionnaire had been sent by post to a total of 67 operated patients, with the answers received from 40 (60%) subjects. The mean duration of the postoperative period amounted to 29.78 months. An excellent surgical outcome (i. е., no varicose veins present) was observed in seven responders, a satisfactory one was noted in sixteen patients (a minor, symptom-free relapse), an unsatisfactory outcome was noted in eleven subjects (a symptomatic relapse), and a poor one--in six. 57.9% of the patients considered their result as excellent to satisfactory and 42.1% turned out to be dissatisfied with the outcomes of the surgical intervention performed. The median of the CIVIQ-2 score in the group of the patients with satisfactory postoperative results amounted to 55.50 points [interquartile range (IQR) 27-87] as compared with 66.60 points (IQR 28-90) in the cohort of the patients dissatisfied with the therapeutic outcomes (P=0.009, Wilcoxon test). Hence, on average 29.78 months after surgery for a relapse of varicose disease, two thirds of the patients turned out to be satisfied with the outcomes of the treatment performed, with the remaining one third of the patients having remained dissatisfied therewith. Based on these findings, a conclusion was drawn that in all cases it is necessary to advise the patients presenting with varicose disease of possible long-term sequelae of the operation and possible development of recurrent varicosity.