Physical workload during caregiving activities and related factors among the caregivers of children with cerebral palsy

Cross-cultural adaptation, validation and psychometric properties of the Arabic version of the Nordic Musculoskeletal Questionnaire in office working population from Saudi Arabia

BACKGROUND

Office-workers who suffer from musculoskeletal pain/disability may experience reduced productivity and absenteeism from work. The Nordic Musculoskeletal Questionnaire (NMQ) is a valid, simple screening tool for the history and presence of self-perceived musculoskeletal symptoms in both general public and occupational settings.

OBJECTIVE

To translate and culturally adapt the NMQ into Arabic language and examine its psychometric properties.

METHODS

The published guidelines were followed to translate and adapt the NMQ into Arabic using a forward-backward process. Construct validity involved comparing NMQ responses with disability-related musculoskeletal questionnaires in different body regions, including the Neck Disability Index (NDI), Oswestry Disability Index (ODI), Quick-Disability of the Arm, Shoulder, and Hand (Quick-DASH), and Reduced Western Ontario and McMaster Universities Osteoarthritis Index (ArWOMAC). The reliability was evaluated using Cronbach's alpha for internal consistency and prevalence-adjusted bias-adjusted kappa (PABAK) for test-retest reliability.

RESULTS

The Arabic NMQ (Ar-NMQ) revealed excellent internal consistency (Cronbach's alpha = 0.85). For the test-retest reliability, the PABAK coefficient ranged between 0.50 and 1. The Ar-NMQ demonstrated strong construct validity. Participants reporting neck pain showed significantly elevated disability scores on the NDI (p < 0.05), while those with back pain exhibited higher ODI scores (p < 0.05). Moreover, individuals reporting shoulder, elbow, and wrist pain and disability displayed elevated Quick-DASH scores (p < 0.05). Similarly, participants reporting hip/thighs, knees, and ankle/feet pain/disability demonstrated significantly higher disability in ArWOMAC (p < 0.05).

CONCLUSION

The NMQ was successfully translated and adapted into Arabic language, providing a reliable and valid instrument for assessing pain in specific body regions in the Arabic-speaking population.

Family caregivers' experience of care with a child with cerebral palsy: the lived experiences and challenges of caregivers in a resource-limited setting in northern Ghana

INTRODUCTION

Caring for a child with cerebral palsy may be more emotionally and physically exhausting than caring for a typical growing child. The family caregivers' perspective of this phenomenon needs exploring to facilitate the development of services. Our study explored the challenges family caregivers face with children with cerebral palsy in a resource-limited context in northern Ghana.

METHODS

We conducted a qualitative study underpinned by phenomenological principles where it is believed that the reality of a phenomenon is tied to caregivers' perspectives of their own experiences. In this study, we unearthed caregivers' experiences/challenges from their own perspectives. The method of data analysis used was to allow the issues to emerge from the data (inductive process) using the content analysis approach. We recruited 13 caregivers of children with cerebral palsy from the physiotherapy unit at Tamale Teaching Hospital, and conducted individual in-depth interviews supported by an open-ended topic guide. Interviews were audio recorded, transcribed, and translated and coded inductively before conducting a content analysis of the data when grouped into themes.

RESULTS

We have identified barriers to managing a child with cerebral palsy, including sociocultural barriers (values, attitudes and belief systems within society), economic challenges and immediate physical care burdens. Specific barriers included discrimination and isolation, lack of family and societal support, with poor access to health information and formal education. Others were lack of information on the cause and course of cerebral palsy, caregivers' loss of jobs, increased healthcare expenditure and struggles in lifting and moving children, which resonate with evidence-based multidimensional model of caregiving process and caregiver burden.

CONCLUSION

Caregivers have the arduous task of caring for a child with cerebral palsy. Social support interventions and policy initiatives that seek to ameliorate caregivers' finances and make formal education accessible to this marginalised child population may be beneficial in this context.

Factors associated with caregiver burden among family caregivers of children with cerebral palsy: a systematic review

OBJECTIVES

To identify caregiver and children factors associated with caregiver burden on primary caregivers of children with cerebral palsy (CP).

DESIGN

Systematic review DATA SOURCES: Seven electronic databases, including PubMed, Cochrane Library, Scopus, PsycINFO, Web of Science, CINAHL and Embase, were systematically searched up to 1 February 2023.

ELIGIBILITY CRITERIA

Original observational studies reporting caregiver burden and related factors among caregivers of children with CP.

DATA ABSTRACTION AND SYNTHESIS

Two reviewers independently screened results and assessed the quality of studies. Title, abstract, full-text screening and data abstraction were done independently by two reviewers. Risk of bias was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. The quality of evidence for factors was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS

16 articles were included in the review. All studies were cross-sectional and examined caregiver-reported burden measures. The Zarit Burden Interview was the most commonly used questionnaire. Depression of caregiver and severity of illness in children with CP were moderate quality of evidence for factors contributing to caregiver burden.

CONCLUSIONS

Higher caregiver burden is associated with more depressive feelings and worse life quality of the caregiver, and with more severe physical disability of the children. Future studies should focus on high-quality longitudinal research and appropriate assistance to reduce caregiver burden and improve the quality of caregiving for children with CP.

PROSPERO REGISTRATION NUMBER

CRD42021268284.

Effects of a Family Caregiver Care Programme in Musculoskeletal Pain and Disability in the Shoulder-Neck Region-A Randomised Clinical Trial

Life expectancy in Spain has increased and older people need more health care to improve their quality of life. The high demands of the population sometimes collapse health services, making them insufficient to cover their needs, which leads to the development of “non-professional caregivers”. These caregivers have suffered musculoskeletal injuries of the cervical spine and shoulders and should be guided and assessed on ergonomics, biomechanics, or kinesiotherapy. However, there are no interventions to help them care for themselves. This study presents the application of a physical exercise programme to prevent these disorders in women caregivers of dependent patients. It consists of a randomised controlled clinical trial with two groups: both received a family caregiver care programme, and the intervention group also received a physical therapeutic exercise programme for 12 weeks. A total of 62 caregivers completed the study, who were mostly daughters or wives of dependents. Of these, 70.97% presented a “moderate” pain intensity and a cervical disability of 13.72 ± 7.64 points in the NDI questionnaire in the initial evaluation. In the intervention group of caregivers, there was a significant decrease in the pain intensity and a significant increase (p < 0.05) in all cervical joint amplitude movements. Caregivers present a high prevalence of musculoskeletal disorders. The physical exercise programme was effective in reducing the intensity of pain, lumbar disability, and cervical disability of the family caregivers.

Challenges Facing Family Caregivers of Children With Disabilities During COVID-19 Pandemic in Palestine

BACKGROUND

COVID-19 has caused great changes in all aspects of life which affected all people especially vulnerable groups such as children with disabilities (CWD) and their families.

OBJECTIVE

This study aimed to examine the challenges facing caregivers of CWD during the pandemic, and to explore these challenges from various physical, social, psychological, and financial aspects.

METHODS

A cross-sectional design was conducted in Palestine, a total of 130 caregivers of CWD completed a survey consisting of demographic and clinical characteristics questionnaire and the short version of the burden scale for family caregivers (BSFC-s) between March and May 2021.

RESULTS

Most of the caregivers were mothers (76.9%), the mean age of the children was (6.09 ± 3.43 years). The majority (88.5%) of the caregivers felt physically exhausted, about (75.4%) had decreased living standards, and (86.2%) indicated that caregiving is taking their strength. A high burden score was recorded, the mean BSFC-s score was 20.17 ± 5.57. Significant differences in BSFC-s scores were recorded based on the type of disability, and child's ability to take care of oneself, P < .05. The total scores of the BSFC-s were positively correlated with the physical, social, psychological, and financial challenges facing the caregivers (P < .001).

CONCLUSIONS

COVID-19 has caused increased burdens on the caregivers of CWD and a negative impact on the child's mobility accompanying a lack of access to health and rehabilitation services. Vital factors are to be considered in developing strategic health and rehabilitative plans for promoting better care for caregivers and their CWD during lockdown restrictions time.