Psychosocial and Economic Burden on Families of Children With Cerebral Palsy: A Correlation With Locomotor Severity.

BACKGROUND

Cerebral palsy (CP) is a condition that often has significant psychosocial and economic impacts on the caregivers of affected children.

OBJECTIVE

This study aimed to assess the association between the Gross Motor Function Classification System (GMFCS) level and the psychosocial and economic impact on caregivers of children with CP.

METHODOLOGY

A hospital-based cross-sectional observational study was conducted on children with CP aged 2-14 years, admitted to the Inpatient Department (IPD) or attending the District Early Intervention Center (DEIC) for physiotherapy at a teaching hospital in Odisha, from December 2020 to November 2022. In DEIC, appropriate screening and therapy as per requirement is given to the high-risk infants. Early detection of CP is done. Children with CP come here with their parents for physiotherapy, occupational therapy, hearing, vision, and development assessment. Tools used included the GMFCS - Expanded and Revised (GMFCS-ER), a five-level classification system, the Modified Updated Kuppuswamy Socioeconomic Scale (2021) for socioeconomic status (SES), and the Pai and Kapur Family Burden Interview Scale.

RESULTS

A total of 160 children with CP were included in the study, with 98 males and 62 females, resulting in a male-to-female ratio of 1.58:1. Out of 160 children with CP, the socioeconomic distribution showed that 73 (45.6%) belonged to the upper-lower class, 68 (42.5%) to the lower-middle class, 9 (5.6%) to the lower class, and 10 (6.3%) to the upper-middle class. Regarding functional levels of 160 children with CP, 22 (13.8%) of children were in GMFCS class I, 30 (18.8%) in class II, 16 (10%) in class III, 17 (10.6%) in class IV, and 75 (46.7%) in class V. Financially, out of 160 families of children with CP, 75 (46.9%) families were moderately burdened, 84 (52.5%) were severely burdened, and only 1 (0.6%) reported no financial burden. Regarding psychosocial impact, 94 (58.8%) families experienced moderate disruption of family leisure, while 44 (27.5%) experienced severe disruption. Physical health was moderately affected in 73 (45.6%) families, and 14 (8.8%) reported a severe impact. Mental health was moderately affected in 88 (55%)of families, while 33 (20.6%) experienced severe mental health issues. There was a statistically significant association between the GMFCS level of the child and the psychosocial and economic burden on families.

CONCLUSIONS

The study concludes that higher GMFCS levels in children with CP are associated with a greater psychosocial and economic burden on their families.