Prevalence and Factors Associated with Anxiety among Parents of Children with Idiopathic Congenital Clubfoot: A Single-center, Cross-sectional Study

Abstract Background: Idiopathic congenital clubfoot (congenital talipes equinovarus) is a common congenital musculoskeletal deformity with an incidence of approximately 1–2 per 1000 live births. The Ponseti method is the current standard of treatment and requires prolonged parental involvement, repeated hospital visits, and strict adherence to bracing protocols. These demands may impose psychological stress on caregivers. This study aimed to determine the prevalence of anxiety among parents of children with idiopathic congenital clubfoot and identify factors associated with increased anxiety levels. Materials and Methods: A cross-sectional study was conducted at the clubfoot clinic of the Department of Pediatric Orthopedics, King George’s Medical University, Lucknow. Parents of children undergoing treatment for idiopathic clubfoot using the Ponseti method were enrolled after obtaining informed consent. Sociodemographic characteristics and clinical variables were recorded. Anxiety was assessed using the anxiety subscale of the Depression Anxiety Stress Scale-21 (DASS-21). Perceived social support and stressful life events were evaluated using validated questionnaires. Bivariate analysis was performed to identify factors associated with increased anxiety scores. Results: A total of 190 parents were included in the analysis. The mean age of participants was 28.51 ± 4.72 years, with mothers constituting 76.3% of respondents. Thirty-eight (20%) parents had anxiety scores above the normal range on the DASS-21 anxiety subscale. More than half of the participants (52.1%) belonged to rural areas. On bivariate analysis, female gender, education up to grade 12, possession of a Below Poverty Line card, lower perceived social support scores, and higher stressful life event scores were significantly associated with elevated anxiety levels. Conclusion: A considerable proportion of parents of children undergoing clubfoot treatment experience anxiety. Identifying vulnerable caregivers and incorporating psychological support and counseling into clubfoot care programs may improve caregiver well-being and support treatment adherence.