Questionnaire by Nogueira and Morcuende.

Name of patient:

Age:

Date:

Relationship with patient:

1. Did you have a prenatal diagnosis of clubfoot with ultrasound?

2. Had you heard of the Ponseti method when you learned your child had congenital clubfoot?

3. How did you learn about the Ponseti method?

a. Referral from pediatrician; b. Orthopedic; c. Internet; d. Other

4. Did you have a pre-natal appointment to learn about treatment with the Ponseti method?

5. How much did you know about the technique at the beginning of treatment?

a. A lot; b. A little; c. Next to nothing; d. Nothing

6. When the first cast was applied, did your child have any problems adapting to the cast when he/she was at home?

7. Did your child sleep well the first night he/she slept in the cast?

8. Did your child breastfeed normally with the cast?

9. Were you prepared for your child to have difficulties adapting to the cast at the initiation of treatment?

10. Did you have the support of your family and friends during the cast phase of treatment?

11. During the casting phase, was maintaining the hygiene and bathing habits of your child

a. Very difficult; b. Difficult; c. Relatively easy; d. Without difficulty

12. Was your child colicky during the casting phase?

13. Would you have preferred to have the cast removed in a different manner? For example, would you prefer to submerge the cast in lukewarm water for approximately 20 minutes before cutting it off with a serrated knife?

14. Did your child have any difficulty with his/her skin during the casting phase?

Tenotomy

15. Were you prepared for the Achilles tenotomy?

16. Was the tenotomy a simpler procedure than what you had anticipated?

17. Would you have preferred to perform the tenotomy in a surgical center at hospital?

Bracing

18. Did you have difficulties with the first week of brace use?

19. Were you well-oriented regarding the correct use of the brace?

20. Was it easy to transport your child with the brace?

21. Was it difficult for your child to find a comfortable position to sleep in while wearing the brace?

22. Did you use the brace adequately during the phase of continuous use (23 h a day)?

23. Did you understand the importance of using the brace for this time?

24. If you had difficulties using the brace, when did these difficulties occur?

a. At the beginning of treatment (first six months); b. From six months to one year; c. From one year to two years; d. From two years to three years; e. After three years

25. Did you have any problem in leaving the house with your child while he/she was using the brace?

26. In general, did you have difficulties using the brace?

a. No; b. A little; c. Some; d. Yes, very much

27. Did you explain to your child why using the brace was necessary?

28. Did your child sleep outside of the house (for example, at his grandmother’s or aunts’ or uncles’ homes) while using the brace?

29. Did your child have any problems in school during the bracing phase?

30. Did your child have any skin problems due to the brace?

31. Did your child kick while wearing the brace?

32. Did your child stand while wearing the brace?

33. Do you have anything you would like to say about using the brace or any ‘trick’ you used to help your child adjust to using the brace? (Open-ended)

Results

34. For unilateral clubfoot patients: Can you notice any visual difference between the two feet of your child?

35. Does your child practice sports? If yes, which ones? (Open-ended)

36. Does your child participate in physical therapy?

37. Does your child have any physical limitations compared with other children because of his/her feet?

Impressions about treatment

38. Which was more difficult: the casting phase or the bracing phase?

a. Casting; b. Bracing

39. Are you satisfied with the results of treatment?

40. Would you recommend this treatment for another child? Would you treat a second child with clubfoot the same way?

41. What advice would you give to a family who has just received a diagnosis of clubfoot by ultrasound? (Open-ended)