Ammarah Jamal, Wajeeha Batool, Saad Shakil, Samar Sajid.
Consent Refusals for Lumbar Puncture in Children: Frequency and Factors Behind Them - An Experience in a Public Sector Hospital.
Pak Paed J Jan ;42(4):235-41.

Objectives: The objectives were to determine the frequency of refusals for lumber puncture (LP) in pediatric patients at Civil Hospital, Karachi and to identify the factors responsible for this denial of consent for lumbar puncture. Methodology: This study was done from April 2014 ? September 2015 on attendants of admitted pediatric patients required to undergo Lumbar Puncture for suspected meningoencephalitis. The available attendants fulfilling the inclusion criteria were interviewed on the first or second day after admission by the attending residents. Denying parents were re counseled by a senior doctor. Parents refusing persistently were then interviewed to find the reasons for refusal in accordance with a predesigned questionnaire. Data was analyzed using SPSS version 19. The results were described in frequencies/ percentages. Chi square test was applied to find the significance of factors affecting the consent. Results: Data of 155 patients requiring LP revealed 84 (54.00%) males with most patients being ? 12months [80/155 (51.6%)]. Consent refusal was persistent in 63.9% of study subjects with counseling showing a significantly positive influence on the consent (p-value of 0.000). Age or gender had no significant effect while parental educational status and consenting authorities had a significant impact on yielding for the procedure (p-value 0.010, 0.000 respectively). Fear of neurological sequelae and influence of the other relatives were the most common reasons behind refusal in 20 (20%) & 27 (27. 2%) subjects respectively. Conclusion: LP refusal is a common problem in our community influenced significantly by parental education, consenting authorities & counseling. Fear of neurological sequelae and influence of the relatives were the most common reasons behind refusal.

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