ISSN: 2640-2653
Authors: Omaima Mujazah, Zainab Al-Ajmi and Nawal Al-Maskari*
Objectives: While lumbar puncture (LP) is often performed and plays a major role in the diagnosis and management of suspected central nervous system (CNS) infections, many parents withhold consent for LP. Refusal to LP results in an unfavourable result. This study aimed to assess the parenteral LP refusal rate and the related factors behind it. Method: A cross-sectional study was performed to include all paediatric patients suspected of having a CNS infection in the paediatric department of a tertiary hospital between January 2015 and December 2017. Using a questionnaire, their parents were interviewed via phone calls. The data were registered and analysed in Epidata form using SPSS version 16 and Chisquared testing. Results: A total of 314 parents, of which 33.1 % declined LP, were included. The most common cause of refusal was fear of complications, primarily paralysis (66.3 %). The study showed that 49 % of parents thought it was unnecessary, 32 % did not know the indications, 14 % did not want to take responsibility for the decision, and 14 % had a lack of faith in obtaining consent. It also revealed, when LP benefits were clarified, 78.1 % of parents approved, compared to 21 % when not explained. Also, when LP disadvantages were clarified, 33.3 % of parents refused, compared with 66.7 % when not explained. Conclusions: This study revealed that the LP refusal rate is high. A lack of awareness and fear of complications were the key variables of LP parenteral rejection. As a result, the study authors designed LP parents’ awareness leaflet to provide consistent guidance and enhanced understanding to physicians and parents.
Keywords: Meningitis; Lumbar Puncture (LP); Cerebrospinal Fluid; Central Nervous System Infections (CNS)
