Causes of Parental Refusal for Lumber Puncture in Children and Adolescents

Abstract

Background: Lumbar puncture (LP) is an important procedure utilized in diagnosing and treating central nervous system (CNS) infections in individuals of all ages. This study was done to determine the causes of parental refusal for LP in children and adolescents. Methods: This cross-sectional study was conducted at the Department of Pediatrics, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawalakot, Azad Kashmir, Pakistan, from July 2022 to December 2022. A total of 289 children, aged between 1 month to 12 years, and planned to undergo diagnostic LP were analyzed. Data about the parents included gender, residence, education level, and socio-economic status. Chi-square and logistic regression analyzed the impact on LP refusal taking p<0.05 as significant. Results: Of a total of 289 study participants, 206 (71.3%) were mothers. There were 63 (21.8%) study participants (parents) who refused their children to undergo LP. The most dominant causes behind refusal for LP were fear of complications of LP, invasiveness nature of the LP procedure, LP procedure is unnecessary, wanted consultation with a family physician, close family relative influenced refusal, and history of LP related complications in a family member, reported by 27 (42.9%), 12 (19.0%), 9 (14.3%), 6 (9.5%), 5 (7.9%), and 4 (6.3%), respectively. Parents from low socio-economic status households demonstrated a statistically significant association with LP refusal (p=0.008). Conclusion: A significant proportion of parents (21.8%) refused diagnostic lumbar puncture for their children. The most dominant causes behind refusal for LP were fear of complications, invasiveness nature, and perceived unnecessary need.