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Muehlan H, Alvarelhao J, Arnaud C, Cytera C, Fauconnier J, Himmelmann K, Marcelli M, Markwart H, Rapp M, Schmidt S, Thyen U. Satisfaction with health care services in young people with cerebral palsy in the transition period: results from a European multicenter study. Front Med (Lausanne) 2024; 11:1306504. [PMID: 38352143 PMCID: PMC10862483 DOI: 10.3389/fmed.2024.1306504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024] Open
Abstract
Background Young people with chronic health conditions and disabilities rely on the healthcare system to maintain their best possible health. The appropriate delivery and utilization of healthcare services are key to improve their autonomy, self-efficacy and employment outcomes. The research question of our study is directed toward investigating if poor availability and accessibility of healthcare services in general, as identified by unmet needs in healthcare, are associated with dissatisfaction with healthcare. Methods Within a European multicenter observational study, 357 young adults with cerebral palsy aged 19-28 were included. We assessed special healthcare needs, utilization of healthcare services, and satisfaction with healthcare applying the short-form of the YHC-SUN-SF, environmental and social variables (EAEQ) as well as indicators for severity of condition and functionality (e.g., GMFCS) of these participants based on a self-, assisted self- or proxy-reports. We used correlation analyses to explore associations between satisfaction with healthcare and respective indicators related to availability and accessibility of healthcare services as well as severity of the condition. In addition, we included reference values for satisfaction with heath care from young adults with various chronic conditions assessed within population-based surveys from some of the European countries included in the study. Results We identified several unmet healthcare needs, especially for widely used and established services (e.g., physical therapy). Satisfaction with healthcare (YHC-SUN-SF general and subscale scores) was moderate to high and almost consistently better for the sample of young adults with cerebral palsy as compared to reference values for young adults with various chronic conditions assessed within general population surveys). Correlation coefficients between satisfaction with healthcare and utilization of services and (unmet) healthcare needs were low, also with different indicators for severity of the condition or functionality. Conclusion Young adults with cerebral palsy reports of unmet healthcare needs varied largely but showed substantial deficits in some aspects. This seems to have no impact on the satisfaction with healthcare those patients currently receive. We conclude that these are two different constructs and somewhat independent indicators to evaluate the quality of healthcare. Clinicians and other practitioners should consider this distinction when monitoring patient needs in their daily practice.
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Affiliation(s)
- Holger Muehlan
- Department Health and Prevention, University of Greifswald, Greifswald, Germany
| | | | - Catherine Arnaud
- UMR 1295 CERPOP Centre for Epidemiology and Research in POPulation Health, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France
- Clinical Epidemiology Unit, University Hospital, Toulouse, France
| | - Chirine Cytera
- Hospital for Child and Adolescent Medicine, University of Luebeck, Luebeck, Germany
| | - Jerome Fauconnier
- Laboratoire TIMC-IMAG Equipe ThEMAS, Pavillon Taillefer, Université Joseph Fournier, Grenoble, France
| | - Kate Himmelmann
- Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marco Marcelli
- Azienda Sanitaria Locale Viterbo, Child and Adolescent Neuropsychiatric Unit—Adult Disability Unit, Viterbo, Italy
| | - Henriette Markwart
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marion Rapp
- Hospital for Child and Adolescent Medicine, University of Luebeck, Luebeck, Germany
| | - Silke Schmidt
- Department Health and Prevention, University of Greifswald, Greifswald, Germany
| | - Ute Thyen
- Hospital for Child and Adolescent Medicine, University of Luebeck, Luebeck, Germany
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Abid M, Cherni Y, Batcho CS, Traverse E, Lavoie MD, Mercier C. Facilitators and barriers to participation in physical activities in children and adolescents living with cerebral palsy: a scoping review. Disabil Rehabil 2023; 45:4322-4337. [PMID: 36447398 DOI: 10.1080/09638288.2022.2150327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/05/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE This scoping review aimed to synthetize personal and environmental facilitators and barriers to participation in physical activities among youths living with cerebral palsy. METHODS A systematic literature search was performed in five databases: CINAHL, EMBASE, MEDLINE, PsycINFO, Cochrane, WEB OF SCIENCE. The studies were selected by two independent researchers based on inclusion and exclusion criteria. A semi-quantitative evaluation assessed the consistency of results for a given variable. Variables displaying consistent associations were classified based on the Physical Activity for people with Disability Model. RESULTS The electronic search yielded 10 795 articles, of which 57 were included. The main barriers to physical activity identified were motor impairments (30 studies), older age (15 studies), pain (6 studies), attendance in regular school (6 studies), and communication problems (4 studies). Barriers such as upper limb impairment and visual deficit were less frequently studied, while cognitive attributes, adapted physical environments and positive attitude, and family support were identified as facilitators. CONCLUSION Personal and environmental factors influencing physical activities behaviors among youths living with cerebral palsy are multiple and complex since they interact with each other. Rehabilitation interventions need to adopt a person-based approach to address barriers and reinforce facilitators.IMPLICATIONS FOR REHABILITATION:Physical activity participation among youths with cerebral palsy is a multidimensional phenomenon, dependent on different personal and environmental factors.Gross motor impairments, communication problems, and pain were the most common personal factors limiting physical activity participation.Environmental factors consistently associated with physical activity participation were school settings, physical environment such as transportation, and social and family support and attitude.Rehabilitation interventions to promote an active lifestyle should consider not only personal factors but their interaction with the child's environment.
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Affiliation(s)
- Manel Abid
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, Quebec City, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Yosra Cherni
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, Quebec City, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Charles Sèbiyo Batcho
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, Quebec City, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Elodie Traverse
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, Quebec City, Canada
| | | | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, Quebec City, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Canada
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van Alphen GJ, Ketelaar M, Voorman JM, Scholten EW, Post MW. Assessing Participation in Adolescents With Cerebral Palsy: Comparison of Life-Habits and USER-Participation. Arch Rehabil Res Clin Transl 2022; 4:100240. [PMID: 36545524 PMCID: PMC9761302 DOI: 10.1016/j.arrct.2022.100240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective To explore and compare the contents and scores of the Assessment of Life Habits (Life-H) with the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) in adolescents with cerebral palsy. Design Youth versions of both instruments were used for (1) content comparison and (2) analyses of relations between both instruments, based on cross-sectional data. Setting Clinic. Participants Participants were adolescents with cerebral palsy, aged 12-18 years; Gross Motor Function Classification System I-V; N=45. Interventions Not applicable. Main outcome measures Assessment of Life Habits (Life-H) with USER-Participation. Results Both instruments measure independence in participation, called accomplishment (Life-H) and restrictions (USER-Participation), and satisfaction with participation. Life-H provides a profile of 6 domain scores and the USER-Participation a total score per dimension. Compared with the USER-Participation, the Life-H contains more specific items, more items not-applicable to many participants and more ceiling effects. Total scores on the accomplishment/restrictions and satisfaction scales between both instruments showed strong correlation coefficients (0.87 and 0.67, respectively). Correlations between domain scores were stronger within the accomplishment/restrictions scales (range 0.37-0.88) compared with the satisfaction scales (range 0.22-0.68). Conclusions Compared with the USER-Participation, the Life-H takes more effort to complete but provides a more comprehensive assessment of participation. Participation accomplishment/restrictions scores were more similar between the instruments compared with satisfaction scores. Researchers and clinicians should carefully compare participation instruments in selecting one that matches their purpose.
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Affiliation(s)
| | - Marjolijn Ketelaar
- UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands,De Hoogstraat Rehabilitation, Utrecht, The Netherlands,Corresponding author M. Ketelaar, PhD, University Medical Center Utrecht, Brain Center, Department of Rehabilitation Medicine, Physical Therapy Science and Sports, Huispostnummer W01.121, PO Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Jeanine M. Voorman
- Wilhelmina Children's Hospital Utrecht, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Eline W.M. Scholten
- UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marcel W.M. Post
- UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands,De Hoogstraat Rehabilitation, Utrecht, The Netherlands,University of Groningen, University Medical Centre Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
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Eide AH, Ofstad D, Støylen M, Hansen E, Høiseth M. Participation and Inclusion of Children and Youth with Disabilities in Local Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11893. [PMID: 36231197 PMCID: PMC9565650 DOI: 10.3390/ijerph191911893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
This research aimed at strengthening the evidence base for interventions to promote the participation and inclusion of children and youth with disabilities in their communities. Four selected municipalities in four different regions of Norway participated. Focus group discussions (FGDs) were carried out in all four municipalities with service providers, children and youth with disabilities, and parents of children and youth with disabilities. The FGDs were used to develop a questionnaire to measure participation indicators. A survey was carried out among 186 children and youth, combining (a) random sampling of children and youth without disabilities and (b) invitations to all children and youth with disabilities, as registered by the municipalities. High-level analyses of the FGDs are presented, indicating the barriers and facilitators for participation for children and youth with disabilities, as well as requests for improvement of services to stimulate participation. The categories of family, technology, and volunteering were identified primarily as facilitators of participation, while school environment was primarily identified as a barrier. The survey measured four different aspects of perception of one's own participation. Data analyses revealed higher level of environmental barriers among children and youth with disabilities, and lower level of actual participation, satisfaction with one's own participation and one's own participation compared with that of peers.
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Affiliation(s)
- Arne H. Eide
- SINTEF Digital, Health Research, Forskningsveien 1, N-0314 Oslo, Norway
- Department of Social Work, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, N-7491 Trondheim, Norway
| | - Dag Ofstad
- Norwegian National Advisory Unit on Disability in Children and Youth (NKBFU), Valnesfjord Health Sports Center (VHSS), N-8215 Valnesfjord, Norway
| | - Marit Støylen
- SINTEF Digital, Health Research, Forskningsveien 1, N-0314 Oslo, Norway
| | - Emil Hansen
- Norwegian National Advisory Unit on Disability in Children and Youth (NKBFU), Valnesfjord Health Sports Center (VHSS), N-8215 Valnesfjord, Norway
| | - Marikken Høiseth
- SINTEF Digital, Health Research, Forskningsveien 1, N-0314 Oslo, Norway
- Department of Design, Faculty of Architecture and Design, Norwegian University of Science and Technology, N-7491 Trondheim, Norway
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Odintsova M, Lubovsky D, Gusarova E, Ivanova P. Adolescent Resilience Profiles (on the Example of Adolescents with Congenital, Acquired Disabilities and Healthy Peers). КЛИНИЧЕСКАЯ И СПЕЦИАЛЬНАЯ ПСИХОЛОГИЯ 2022. [DOI: 10.17759/cpse.2022110308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The problem of the research is important in the context of psychological assistance and interaction with adolescents with disabilities. The study aimed to carry out a comparative analysis of the resilience profiles of adolescents with congenital (cerebral palsy), acquired disabilities (oncology, rheumatic diseases) and healthy peers. The study involved 51 adolescents with cerebral palsy, 61 with oncological diseases, 51 with rheumatic diseases and 86 conditionally healthy adolescents aged 13 to 18 years old. In total it embraced 249 teenagers (mean age 14.94+1.48), of which 128 were male and 121 were female. There were used the following methods: the “Victimity” questionnaire (M.A. Odintsova, N.P. Radchikova), “Resilience Test” (E.N. Osin, E.I. Rasskazova) and “COPE” questionnaire (E.I. Rasskazova, T.O. Gordeeva, E.N. Osin). The study revealed significant differences in the resilience profiles of adolescents from different groups: healthy teenagers are mainly characterized by unstable and resilient profiles; adolescents with oncology and rheumatic diseases — by all three profiles; adolescents with cerebral palsy — by victim and unstable ones. The female part of the sample, unlike the male part, are characterized by unstable and victim profiles. The most significant differences in groups with different resilience profiles were found in coping strategies related to the dysfunctional coping style. The use of coping strategies: behavioral disengagement, mental disengagement, concentration on emotions and humor leads to a decrease in resilience in the boys of the entire sample. Concentration on emotions, behavioral disengagement, mental disengagement, and infrequent use of active coping are predictors of reduced resilience
in girls.
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Affiliation(s)
| | | | | | - P.A. Ivanova
- Moscow State University of Psychology & Education graduate
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