Cognitive strategies and self-esteem as predictors of brace-wear noncompliance in patients with idiopathic scoliosis and kyphosis

Psychological determinants of brace-wear compliance were analyzed among 113 patients who used a brace because of an adolescent idiopathic scoliosis (9 2%), kyphosis (5%), or both (3%). The results showed that noncompliant girl s did not expect to succeed in dealing with scoliosis and that they were an xious about the possibility of failure. They also had low self-esteem and d id not seek social support from other people. Noncompliant boys, in contras t, had high self-esteem and high achievement success expectation. Among pat ients with a short time of brace use, low compliance was best predicted by low amount of reflective thinking and a good body-image. In turn, among pat ients who had used the brace for >6 months, low compliance was best predict ed by high amount of reflective thinking, poor body-image, low social succe ss expectation, and low master orientation in social behavior. Only sleepin g problems predicted compliance across gender and the time of brace use: th e more the patients experienced sleeping problems, the less they used the b race.