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Kaelin VC, Bosak DL, Saluja S, Newman-Griffis D, Boyd AD, Khetani MA. Representation of child and youth participation within the Unified Medical Language System (UMLS). Disabil Rehabil 2024:1-6. [PMID: 38596871 DOI: 10.1080/09638288.2024.2338191] [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: 04/04/2023] [Accepted: 03/28/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE To examine (1) how much participation is represented in the benchmark Unified Medical Language System (UMLS) resource, and (2) to what extent that representation reflects the definition of child and youth participation and/or its related constructs per the family of Participation-Related Constructs framework. MATERIALS AND METHODS We searched and analysed UMLS concepts related to the term "participation." Identified UMLS concepts were rated according to their representation of participation (i.e., attendance, involvement, both) as well as participation-related constructs using deductive content analysis. RESULTS 363 UMLS concepts were identified. Of those, 68 had at least one English definition, resulting in 81 definitions that were further analysed. Results revealed 2 definitions (2/81; 3%; 2/68 UMLS concepts) representing participation "attendance" and 18 definitions (18/81; 22%; 14/68 UMLS concepts) representing participation "involvement." No UMLS concept definition represented both attendance and involvement (i.e., participation). Most of the definitions (11/20; 55%; 9/16 UMLS concepts) representing attendance or involvement also represent a participation-related construct. CONCLUSION(S) The representation of participation within the UMLS is limited and poorly aligned with the contemporary definition of child and youth participation. Expanding ontological resources to represent child and youth participation is needed to enable better data analytics that reflect contemporary paediatric rehabilitation practice.
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Affiliation(s)
- Vera C Kaelin
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, USA
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA
- Department of Computer Science, University of Illinois Chicago, Chicago, IL, USA
- Department of Computing Science, Umeå University, Umeå, Sweden
| | - Dianna L Bosak
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA
| | - Shivani Saluja
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA
| | | | - Andrew D Boyd
- Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Mary A Khetani
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, USA
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, CA, USA
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Knight S, Rodda J, Tavender E, Anderson V, Lannin NA, Scheinberg A. Understanding factors that influence goal setting in rehabilitation for paediatric acquired brain injury: a qualitative study using the Theoretical Domains Framework. BRAIN IMPAIR 2024; 25:IB23103. [PMID: 38593747 DOI: 10.1071/ib23103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 03/14/2024] [Indexed: 04/11/2024]
Abstract
Background While goal setting with children and their families is considered best practice during rehabilitation following acquired brain injury, its successful implementation in an interdisciplinary team is not straightforward. This paper describes the application of a theoretical framework to understand factors influencing goal setting with children and their families in a large interdisciplinary rehabilitation team. Methods A semi-structured focus group was conducted with rehabilitation clinicians and those with lived experience of paediatric acquired brain injury (ABI). The 90-min focus group was audio-recorded and transcribed verbatim. Data were thematically coded and mapped against the Theoretical Domains Framework (TDF) to understand influencing factors, which were then linked to the Capability, Opportunity, Motivation - Behaviour (COM-B) model. Results A total of 11 participants (nine paediatric rehabilitation clinicians, one parent and one young person with lived experience of paediatric ABI) participated in the focus group. Factors influencing collaborative goal setting mapped to the COM-B and six domains of the TDF: Capabilities (Skills, Knowledge, Beliefs about capabilities, and Behavioural regulation), Opportunities (Environmental context and resources), and Motivation (Social/professional role and identity). Results suggest that a multifaceted intervention is needed to enhance rehabilitation clinicians' and families' skills and knowledge of goal setting, restructure the goal communication processes, and clarify the roles clinicians play in goal setting within the interdisciplinary team. Conclusion The use of the TDF and COM-B enabled a systematic approach to understanding the factors influencing goal setting for children with acquired brain injury in a large interdisciplinary rehabilitation team, and develop a targeted, multifaceted intervention for clinical use. These represent important considerations for the improvement of collaborative goal setting in paediatric rehabilitation services to ensure that best practice approaches to goal setting are implemented effectively in clinical practice.
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Affiliation(s)
- Sarah Knight
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia; and Melbourne School of Psychological Sciences, The University of Melbourne, Vic., Australia; and Department of Paediatrics, The University of Melbourne, Vic., Australia; and Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital Melbourne, Vic., Australia
| | - Jill Rodda
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Emma Tavender
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia; and Melbourne School of Psychological Sciences, The University of Melbourne, Vic., Australia; and Department of Paediatrics, The University of Melbourne, Vic., Australia
| | - Natasha A Lannin
- Department of Neuroscience, Monash University, Melbourne, Vic., Australia; and Alfred Health, Melbourne, Vic., Australia
| | - Adam Scheinberg
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Vic., Australia; and Department of Paediatrics, The University of Melbourne, Vic., Australia; and Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital Melbourne, Vic., Australia; and Department of Neuroscience, Monash University, Melbourne, Vic., Australia
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Castilho JDS, Barbosa RMF, Ayupe KMA, Defilipo ÉC, Chagas PSDC. Reliability and Acceptability to Caregivers of Telehealth Administration of the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT) for Brazilian Youth with Down Syndrome. Physiother Can 2024; 76:104-108. [PMID: 38465305 PMCID: PMC10919367 DOI: 10.3138/ptc-2021-0110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 03/12/2024]
Abstract
Purpose To estimate test-retest reliability of the two versions of the PEDI-CAT administered via telehealth to caregivers of Brazilian young people with DS, to compare scores on the two versions, and to determine caregiver acceptance of telehealth administration of the assessment. Method A methodological study approved by the research ethics committee. Data collection was performed online, with a mean duration of 45.0 minutes for the content-balanced version of the PEDI-CAT and 17.5 minutes for the speedy version. Results In total, 28 caregivers of individuals with DS up to age 21 years participated (mean = 5.9 years; SD = 4.9 years). Intra-class correlation coefficients for the four domains of the PEDI-CAT content-balanced version and four domains of the PEDI-CAT speedy version ranged from 0.77 to 0.97. There was a statistical difference between the versions in the scores of the social-cognitive domain (p < 0.05). A mean of 105 items (SD = 21) was administered in the content-balanced version and a mean of 51 items (SD = 8) in the speedy version. All the caregivers found the method of administration of the PEDI-CAT acceptable. Conclusions This study demonstrated that either version of the Brazilian version of the PEDI-CAT can be used by telehealth in clinical practice to assess children, adolescents, and young adults with DS.
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Affiliation(s)
- Julia de Souza Castilho
- From the:Faculty of Physical Therapy, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | | | | | - Érica Cesário Defilipo
- Department of Physical Therapy, Universidade Federal de Juiz de Fora - campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Paula Silva de Carvalho Chagas
- Department of Physical Therapy of the Old, the Adult and Maternal-Infant, Faculty of Physical Therapy, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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Ayupe KMA, Dias IMBC, Cazeiro APM, de Campos AC, Longo E. Rehabilitation Practices Delivered by Physical and Occupational Therapists to Brazilian Children With Congenital Zika Syndrome: A Cross-Sectional Study. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e2300219. [PMID: 38123996 PMCID: PMC10749651 DOI: 10.9745/ghsp-d-23-00219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Congenital Zika syndrome (CZS) is a health condition that has affected the development of thousands of children in Brazil. Because it is a new condition, its understanding is an ongoing process. Therefore, it is important to know the rehabilitation interventions being delivered to improve the functioning of these children. We aimed to describe the practices of physical therapists (PTs) and occupational therapists (OTs) who provide follow-up care for children with CZS in Brazil. METHODS This cross-sectional study included PTs and OTs who assist children with CZS in Brazil. An online questionnaire was used to verify the participants' personal characteristics and professional work environment, as well as the rehabilitation programs they implemented in Brazil for children with CZS. Data were analyzed using descriptive statistics. RESULTS A total of 116 professionals (79 PT and 37 OT) who work mainly in public health services (81.9%) participated in the study. Of these, 24.1% plan interventions based on reading scientific articles, 66.4% did not report using the biopsychosocial model, 52.6% do not perform any assessments before starting an intervention, 31.9% use neurodevelopmental treatment, and 22.4% use sensorimotor stimulation interventions. The majority of the interventions are delivered 1 to 2 times a week, lasting up to 1 hour. CONCLUSIONS Professional training and knowledge translation strategies are needed to implement evidence-based practices and improve the quality of rehabilitation programs for Brazilian children with CZS.
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Affiliation(s)
- Kennea Martins Almeida Ayupe
- Department of Integrated Health Education, Center for Health Sciences, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil.
| | - Ianka Maria Bezerra Cunha Dias
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Faculty of Health Sciences of Trairi, Santa Cruz, Rio Grande do Norte, Brazil
| | | | - Ana Carolina de Campos
- Postgraduate Program in Physical Therapy, Universidade Federal do São Carlos, São Carlos, São Paulo, Brazil
| | - Egmar Longo
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Faculty of Health Sciences of Trairi, Santa Cruz, Rio Grande do Norte, Brazil
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Botchway-Commey E, Muscara F, Greenham M, D'Cruz K, Bonyhady B, Anderson V, Scheinberg A, Knight S. Rehabilitation models of care for children and youth with traumatic brain and/or spinal cord injuries: A focus on service structure, service organization, and the barriers and facilitators of rehabilitation service provision. Neuropsychol Rehabil 2023; 33:1697-1727. [PMID: 36423210 DOI: 10.1080/09602011.2022.2147196] [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: 06/14/2021] [Accepted: 11/08/2022] [Indexed: 11/25/2022]
Abstract
To understand the systems underlying current rehabilitation models of care used with children and youth (0-21years) who sustain traumatic brain and/or spinal cord injuries. This study gathered qualitative data on service structures, service organization, and the barriers and facilitators of service provision in selected medical rehabilitation service(s) (MRS) and community-based rehabilitation service(s) (CBRS). Informants from 11 rehabilitation services were interviewed using a semi-structured interview guide. Interviews were analysed in NVivo using content analysis method. Experiences shared by the service representatives indicated that most services supported children and youth with brain injury, with a limited number also specializing in spinal cord injuries. MRS often delivered care in inpatient or outpatient settings, while CBRS offered home/community-based services. Care planning often started either prior to or shortly after admission from acute care settings, using either multidisciplinary or interdisciplinary teamwork models. Strengths of the services included innovation and provision of family-centred care; while challenges experienced included difficulty translating evidence into practice and poor team communication. Models of care were similar across services, with a focus on providing family-centred care. Several shared challenges were described, and service representatives expressed interest in forming partnerships and collaborations to address these challenges through innovative initiatives.
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Affiliation(s)
- Edith Botchway-Commey
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
| | - Frank Muscara
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Mardee Greenham
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
| | - Kate D'Cruz
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Bruce Bonyhady
- Melbourne Disability Institute, University of Melbourne, Melbourne, Australia
| | - Vicki Anderson
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Adam Scheinberg
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
- Victorian Paediatric Rehabilitation Service, Parkville, Australia
| | - Sarah Knight
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
- Victorian Paediatric Rehabilitation Service, Parkville, Australia
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Roldán-Pérez P, San Miguel-Pagola M, Doménech-García V, Bellosta-López P, Buesa-Estéllez A. Identification of the needs of children with neurodisability and their families at different stages of development: A qualitative study protocol. PLoS One 2023; 18:e0291148. [PMID: 37682853 PMCID: PMC10490905 DOI: 10.1371/journal.pone.0291148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Within the field of childhood neurodisability, the tendency in the study of needs has been to categorize them based on ability (motor, verbal, cognitive). However, current perspectives such as F-words, family-centered practices, or the principles of family empowerment, lead the researcher to ask: What are these needs according to the stage of development? METHODS AND ANALYSIS A descriptive qualitative study will be carried out. Several methods will be followed to ensure the reliability and validity of the results, and the Standards for Reporting Qualitative Research and the Consolidated criteria for reporting qualitative research checklists will also be used to guide the project. Data collection is sought from three main sources: Focus groups (detection of needs), a survey to collect sociodemographic and clinical data necessary to obtain an overview of the context of the participants, and a survey to find out the level of satisfaction with this initiative. DISCUSSION The results expected to be obtained after this study will respond to the main needs of families with childhood neurodisability, based on age groups and covering the whole territory of the Spanish population. Thanks to these detected needs, it will be possible to design future lines of work to improve the design of family-centered practices and increase the empowerment of families. The intention is to detect needs by stage of development, which can be categorized within the F-words framework, showing families and professionals a clear picture of the needs of this population.
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Affiliation(s)
| | | | | | - Pablo Bellosta-López
- Universidad San Jorge, Campus Universitario, Villanueva de Gállego, Zaragoza, Spain
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7
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Houwen-van Opstal SLS, Tak RO, Pelsma M, van den Heuvel FMA, van Duyvenvoorde HA, Cup EHC, Sie LTL, Vles JSH, de Groot IJM, Voermans NC, Willemsen MAAP. Long-term outcomes for females with early-onset dystrophinopathy. Dev Med Child Neurol 2023; 65:1093-1104. [PMID: 36562406 DOI: 10.1111/dmcn.15496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022]
Abstract
AIM To study long-term disease course for females with early-onset dystrophinopathy, including common (female) symptoms, challenges in social participation, the need for care, and current healthcare management to support guideline development. METHOD Twelve females with early-onset dystrophinopathy were followed for a median period of more than 17 years (range 1-36). RESULTS One patient died owing to end-stage cardiac failure. Cardiac abnormalities were observed in three of the remaining 11 participants. Respiratory function was reduced in seven of 10 participants. Fatigue, myalgia, lower back pain, and arthralgia were reported in more than six of the participants. Functional status varied from exercise intolerance to wheelchair dependency. Most or all of the 10 participants reported restrictions in participation in work (n = 10), household duties (n = 10), sports (n = 9), and education (n = 8). Only a few participants received followed-up pulmonary (n = 2) or rehabilitation (n = 3) care. INTERPRETATION Females with early-onset dystrophinopathy experience a wide range of impairments, comorbidities, limitations in activities, and restrictions in social participation. The whole spectrum should be acknowledged in the healthcare setting. Neuromuscular and cardiac follow-up are indispensable. Additional respiratory assessment and rehabilitation care are expected to improve health status and support daily activities and participation. WHAT THIS PAPER ADDS No standard diagnostic procedures seem to exist for female patients suspected for dystrophinopathy. Female participants with early-onset dystrophinopathy experienced a broad scope of burdening symptoms, such as fatigue, myalgia, lower back pain, and arthralgia. None of participants worked full time, all felt restricted in paid work, and most felt restricted in education. Most participants showed decreased lung function, while only one was symptomatic. Availability of rehabilitation care may improve support for daily activities and participation for females with early-onset dystrophinopathy.
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Affiliation(s)
- Saskia L S Houwen-van Opstal
- Department of Rehabilitation, Amalia Children's Hospital, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ramon O Tak
- Department of Paediatrics, Sint Antonius Hospital, Nieuwegein, the Netherlands
| | - Maaike Pelsma
- Department of Rehabilitation, Amalia Children's Hospital, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | - Edith H C Cup
- Department of Rehabilitation, Amalia Children's Hospital, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lilian T L Sie
- Department of Pediatric Neurology, Juliana Children's Hospital/Haga Teaching Hospital, The Hague, the Netherlands
| | - Johan S H Vles
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Imelda J M de Groot
- Department of Rehabilitation, Amalia Children's Hospital, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nicol C Voermans
- Department of Neurology, Donders Centre for Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Michel A A P Willemsen
- Department of Pediatric Neurology, Donders Centre for Neuroscience, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands
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Pizzighello S, Raggi A, Vavla M, Uliana M, Pellegri A, Martinuzzi M, Martinuzzi A. The perception of disability in cerebral palsy: a cross-sectional study using the WHODAS 2.0. Dev Neurorehabil 2023; 26:302-308. [PMID: 37403444 DOI: 10.1080/17518423.2023.2232002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/05/2023] [Accepted: 06/28/2023] [Indexed: 07/06/2023]
Abstract
This observational study aims to describe the level of perceived disability in Cerebral Palsy (CP). We described the perception of adults by using the interviewer-administered version of the WHO disability assessment schedule (WHODAS 2.0). In case of intellectual disability (ID), the proxy-administered version was used, and a caregiver was asked to report the difficulties experienced by the patient; 199 patients were enrolled. The level of perceived disability was higher when referred to patients with ID (proxy report) than when referred to patients without ID (p < .001). For all patients, the level of perceived disability varied depending on the severity and the localization of motor impairment (both p < .001). No differences were observed based on the type of motor impairment. The perceived disability was correlated with age only for patients with no ID (p < .05). The WHODAS 2.0 may be a useful tool to explore the perception of disability in CP.
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Affiliation(s)
| | - Alberto Raggi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, UOC Neurologia Salute Pubblica E Disabilità, Lombardia, Italy
| | - Marinela Vavla
- Department of Women's and Children's Health, Padoua University Hospital, Child and Adolescent Neuropsychiatry, Padoua, Italy
| | - Marianna Uliana
- Scientific Institute, IRCCS E.Medea, Conegliano, Treviso, Italy
| | - Alda Pellegri
- Scientific Institute, IRCCS E.Medea, Scientific Institute, IRCCS, Bosisio Parini, Lecco, Italy
| | - Michela Martinuzzi
- Department of medecine, King's College London GKT School of Medical Education, London, UK
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Ferro MA, Toulany A. Longitudinal Association Between Youth Multimorbidity and Psychological Distress: Impact of the COVID-19 Pandemic. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01564-3. [PMID: 37358802 DOI: 10.1007/s10578-023-01564-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 06/27/2023]
Abstract
This research examined longitudinal associations between youth physical-mental multimorbidity and psychological distress before and during the COVID-19 pandemic; assessed the contextual impact of the pandemic on these associations; and, investigated potential moderating factors. The Multimorbidity in Youth across the Life-course, an ongoing study of youth aged 2-16 years (mean 9.4; 46.9% female) with physical illness, was used as the sampling frame for this COVID-19 sub-study, in which 147 parent-youth dyads participated. Psychological distress was measured using the Kessler-6 (K6). Multimorbidity was associated with higher pre-pandemic, but not with intra-pandemic distress. Disability moderated pre-pandemic distress-multimorbidity was associated with higher K6 among youth with high disability, but not among youth with low disability. Age moderated intra-pandemic distress-multimorbidity was associated with higher K6 in older youth, but not among younger youth.
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Affiliation(s)
- Mark A Ferro
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Alene Toulany
- Division of Adolescent Medicine, Hospital for Sick Children, Toronto, ON, Canada
- School of Public Health, University of Toronto, Toronto, ON, Canada
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Siira H, Kääriäinen M, Jämsä U. Experiences of implementation of the group-based adaptation training intervention for patients with chronic somatic illnesses or disabilities among multi-professional teams in specialized healthcare. Ann Med 2023; 55:2253725. [PMID: 37695695 PMCID: PMC10496520 DOI: 10.1080/07853890.2023.2253725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/12/2023] [Accepted: 08/26/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE To describe the experiences of multi-professional teams of implementation of group-based adaptation training intervention for patients with chronic somatic illnesses or disabilities in specialized healthcare. MATERIALS AND METHODS Multi-professional teams (n = 7) implementing adaptation training courses for chronically ill patients in specialised healthcare were interviewed between 09/2020 and 12/2021. The themes for thematic group interviews were based on the standard protocol implementation of adaptation training in specialised healthcare, including planning, implementation and evaluation of the adaptation training courses. The interviews were audio-recorded and transcribed. The data were analysed using inductive content analysis. RESULTS The experiences of multi-professional teams involved using pedagogical methods, providing guidance and counselling to support the rehabilitation process, ensuring opportunities for peer support, and supporting the course participants' involvement and activities in everyday life. CONCLUSIONS Healthcare professionals should use pedagogical methods in reflective guidance and counselling to promote client-oriented approach in supporting adaptation. Their competence in pedagogy needs to be build and maintained by continuous education. Multi-professional teams need to ensure sufficient and versatile conditions for peer support and involvement of family members by creating open and trusting atmosphere, unhurried encounters, discussions, different and varying ways of working. Adaptation training can strengthen the self-efficacy of participants and help them shift their attention from illness and disability to thoughts of the future. Adaptation training can support active and meaningful daily life in a changed life situation.
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Affiliation(s)
- Heidi Siira
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Medical Rehabilitation, Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Oulu, Finland
| | - Ulla Jämsä
- Department of Medical Rehabilitation, Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Oulu, Finland
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11
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Stefanac S, Oppenauer C, Zauner M, Durechova M, Dioso D, Aletaha D, Hobusch G, Windhager R, Stamm T. From individualised treatment goals to personalised rehabilitation in osteoarthritis: a longitudinal prospective mapping study using the WHO international classification for functioning, disability and health. Ann Med 2022; 54:2816-2827. [PMID: 36259346 PMCID: PMC9586611 DOI: 10.1080/07853890.2022.2131326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND/OBJECTIVE(S)/INTRODUCTION In clinical practice, treatment goals are often set up without exploring what patients really want. We, therefore, collected individualised treatment goals of patients with osteoarthritis (OA), categorised and mapped them to the World Health Organisation International Classification for Functioning, Disability and Health (ICF). PATIENTS/MATERIALS AND METHODS A longitudinal prospective cohort study was conducted (2019-2021). We used descriptive statistics and Chi2/Fisher's Exact Tests, where appropriate, as well as Kruskal-Wallis-Tests for the mean score ranks of the patients' goals. RESULTS In total, 305 goals reported by 132 participants were analysed (267 women vs. 38 men). The top 3 ICF categories were sensation of pain (ICF:b280), mobility of joint (ICF:b710) and muscle power functions (ICF:b730). Overall, 51% of all individually reported functional goals were achieved after 3 months. Men were more likely to achieve their goals than women (p = 0.009). The majority of the "very important" goals (51%) and "very difficult" goals (57%) was not improved. Goals' mean score ranks significantly differed between baseline and follow-up. CONCLUSION(S) As the human lifespan as well as the number of people affected by OA worldwide increase, there is a growing need to identify and evaluate rehabilitation outcomes that are relevant to people with OA.Key MessagesTreat-to-target agreements between patients and health care providers present a step towards more personalised precision medicine, which will eventually lead to better reported functional and health outcomes.In patients with osteoarthritis, the Goal Attainment Scale instrument can be used to measure health outcomes at different time points and its content may be linked to ICF providing a unified language and conceptual scientific basis.
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Affiliation(s)
- Sinisa Stefanac
- Institute for Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Claudia Oppenauer
- Karl Landsteiner Private University for Health Sciences, Krems, Lower Austria
| | - Michael Zauner
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Martina Durechova
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daffodil Dioso
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daniel Aletaha
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Gerhard Hobusch
- Department of Orthopaedics, Medical University of Vienna, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopaedics, Medical University of Vienna, Vienna, Austria
| | - Tanja Stamm
- Institute for Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
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Pádua RF, Sá CDSCD. Avaliação do desenvolvimento neuropsicomotor de lactentes expostos ao HIV a partir do modelo da CIF. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/22008129042022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
RESUMO Este estudo objetivou sistematizar e construir um checklist com instrumentos de avaliação do desenvolvimento infantil de acordo com o modelo biopsicossocial da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) de lactentes nas idades entre 4 e 12 meses expostos ao HIV. Trata-se de um estudo observacional, analítico e longitudinal. Foram utilizados na avaliação e descritos de acordo com as categorias dos domínios da CIF a escala Bayley de desenvolvimento infantil III; o questionário Affordances no Ambiente Domiciliar para o Desenvolvimento Motor - Escala Bebê; o critério de classificação econômica Brasil; e a ficha de avaliação com histórico do lactente. Os instrumentos trabalhados neste estudo contemplam os componentes de estrutura e funções corporais; atividades e participação; e fatores ambientais e pessoais. A descrição dos instrumentos de avaliação do desenvolvimento infantil de lactentes expostos ao HIV, por meio dos constructos e domínios da CIF, permitiu construir um raciocínio clínico durante a avaliação, enfatizando a vigilância do desenvolvimento infantil e a funcionalidade no primeiro ano de vida.
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Pádua RF, Sá CDSCD. Assessment of the neuropsychomotor development of HIV-exposed infants using the ICF model. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/22008129042022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
ABSTRACT This study aimed to systematize and build a checklist with tools to assess child development according to the biopsychosocial model of the International Classification of Functioning, Disability, and Health (ICF) of infants exposed to HIV, aged from 4 to 12 months. This is an observational, analytical, and longitudinal study. Bayley-III Scale of Infant and Toddler Development; Affordances in the Home Environment for Motor Development-Infant Scale; Brazilian Criteria of Economic Classification; and infant’s history used in the assessment were described according to the ICF domain categories. The tools used in this study include the components of body structure and functions; activities and participation; environmental and personal factors. The description of the assessment tools in the child development of infants exposed to HIV-by the constructs and domains of the ICF-allowed for the construction of clinical reasoning during the assessment, emphasizing the surveillance of child development and functioning in their first year of life.
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Crawford L, Maxwell J, Colquhoun H, Kingsnorth S, Fehlings D, Zarshenas S, McFarland S, Fayed N. Facilitators and barriers to patient-centred goal-setting in rehabilitation: A scoping review. Clin Rehabil 2022; 36:1694-1704. [PMID: 36017567 PMCID: PMC9574028 DOI: 10.1177/02692155221121006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective Identify, map, and synthesize existing reviews, to extract and analyse the most prominent barriers and facilitators to applying patient-centred goal-setting practice in rehabilitation using the Capability, Opportunity Motivation Behaviour (COM-B) model. Design Scoping review. Data source A primary search was conducted in MEDLINE, CINAHL, EMBASE, PsychInfo, and Cochrane. Citation chaining was employed. Review methods All types of review (systematic, scoping, and narrative) studies published up to June 14, 2022 that included physical and neurological rehabilitation, patient-centeredness, and goal-setting were reviewed. Studies were scrutinized for relevance, quality was not assessed. The most prominent barriers and facilitators were synthesized using thematic content analysis and mapped onto the COM-B model. Results Twenty-six review studies covering a range of conditions and settings, acute to community were included. Barrier and facilitators were identified at patient, provider, and organizational level. Barrier themes include provider's existing beliefs about goal-setting, lack of skills, and integration into clinical routines. Patient barriers related to capacity and opportunity to participate. Organizational barriers include lack of clinical guidelines, patient preparation, insufficient provider time, and high productivity expectations. Facilitators included goal-setting guidelines, training and education of providers and patients, revised clinical routines, performance monitoring, adequate time, and resources. Conclusion Healthcare providers should be the primary target of intervention. A provider's motivation to change current practice is the most prominent barrier, followed closely by capacity and opportunity. Patients require information, training, and structured engagement opportunities. Organizations play a key role in creating the optimal environmental conditions to enable patient-centred goal-setting.
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Affiliation(s)
- L. Crawford
- School of Rehabilitation Therapy, Queen's University, Toronto, Canada
- Nora Fayed, Queens University, Louise D Acton Building, 31 George St, Kingston, ON K7L 3N6, Canada.
| | - J. Maxwell
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Bloorview Research Institute, Toronto, Canada
- Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - H. Colquhoun
- Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - S. Kingsnorth
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Bloorview Research Institute, Toronto, Canada
- Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - D. Fehlings
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Bloorview Research Institute, Toronto, Canada
| | - S. Zarshenas
- Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - S. McFarland
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Nora Fayed
- School of Rehabilitation Therapy, Queen's University, Toronto, Canada
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Developing an International Classification of Functioning, Disability and Health Core Set for Pediatric Brain Tumor Survivors in Chinese Clinical Settings. Cancer Nurs 2022:00002820-990000000-00013. [DOI: 10.1097/ncc.0000000000001117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wright M, Twose D, Gorter JW. Scootering for Children and Youth Is More Than Fun: Exploration of a Feasible Approach to Improve Function and Fitness. Pediatr Phys Ther 2021; 33:218-225. [PMID: 34432761 DOI: 10.1097/pep.0000000000000829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Describe scootering as a physical therapy intervention for children/adolescents with mobility limitations within the "F-Words for Child Development" (fitness, function, family, friends, fun, and future) and through motion analysis. METHODS Perspectives of scootering were explored using the holistic "F-words for Child Development" recommendations for pediatric rehabilitation and through 3-dimensional instrumented motion analysis of children/adolescents with cerebral palsy and children/adolescents with typical development. RESULTS Scootering was consistent with the F-words tenets for rehabilitative best practice. Many of the motion characteristics of scootering reflected desirable exercise and gait attributes relevant to children/adolescents with cerebral palsy. CONCLUSIONS Scootering is a feasible, functional, and fun activity that has the potential to address many aspects of fitness, function, and gait; meet the needs of families; and provide opportunities for interaction with friends. It is a physical therapy intervention that has the potential to contribute to future health and well-being of children with disabilities. VIDEO ABSTRACT For more insights from the authors, see Supplemental Digital Content 1, available at: http://links.lww.com/PPT/A331.
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Affiliation(s)
- Marilyn Wright
- Developmental Pediatrics & Rehabilitation (Mss Wright and Twose and Dr Gorter), McMaster Children's Hospital, Hamilton, Ontario, Canada; CanChild Centre for Childhood Disability Research (Ms Wright and Dr Gorter), McMaster University, School of Rehabilitation Sciences, Hamilton, Ontario, Canada
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Matérne M, Frank A, Arvidsson P. The utility of goal attainment scaling in evaluating a structured water dance intervention for adults with profound intellectual and multiple disabilities. Heliyon 2021; 7:e07902. [PMID: 34504979 PMCID: PMC8417330 DOI: 10.1016/j.heliyon.2021.e07902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/24/2021] [Accepted: 08/27/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Adults with profound intellectual and multiple disabilities (PIMD) have problems to be actively involved in essential life activities that affect their health. The aim of this study was to explore the utility of goal attainment scaling (GAS) in evaluating an intervention for adults with PIMD, and to describe how the GAS goals were set according to the International Classification of Functioning, Disability and Health (ICF) domains of body function as well as activity and participation. METHOD As part of an aquatic intervention (Structured water dance), 28 adults with PIMD received GAS goals which were adapted to their individual needs and which the intervention could affect. RESULT Twenty of the goals were formulated within the ICF Activity/Participation domain and eight within the Body Functions domains. On average, participants improved by 1.25 levels on the five-level GAS scales. CONCLUSION GAS can be a useful tool for setting and evaluating individualized and meaningful goals, in body functions as well as in activity and participation, related to a healthpromoting activity for adults with PIMD.
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Affiliation(s)
- Marie Matérne
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE 70185 Örebro, Sweden
- School of Law, Psychology and Social Work, Örebro University, Sweden
| | - André Frank
- Center for Adult Habilitation, Region Örebro County, Örebro, Sweden
| | - Patrik Arvidsson
- Region Gävleborg, Centre for Research & Development, Region Gävleborg, Sweden
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
- CHILD, Swedish Institute for Disability Research, Jönköping University, Sweden
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Preede L, Soberg HL, Dalen H, Nyquist A, Jahnsen R, Saebu M, Bautz-Holter E, Røe C. Rehabilitation Goals and Effects of Goal Achievement on Outcome Following an Adapted Physical Activity-Based Rehabilitation Intervention. Patient Prefer Adherence 2021; 15:1545-1555. [PMID: 34276210 PMCID: PMC8277449 DOI: 10.2147/ppa.s311966] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To explore the goal-setting process carried out at a rehabilitation facility providing adapted physical activity, by 1) identifying goals set by individuals with chronic disabilities, 2) comparing these goals to the negotiated goals set in collaboration with the rehabilitation team and 3) assessing goal achievement and its association with self-reported functioning after 12 months. METHODS A prospective observational study where adults (18-67 years) admitted to Beitostølen Healthsports Centre (n=151) reported mental and physical functioning measured by the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) administered at baseline (eight weeks before rehabilitation), admission, discharge and follow-up 12 months after rehabilitation. The participants provided their individual goals for rehabilitation in the admission questionnaire. Individual goals were compared to negotiated goals set by the participants and the rehabilitation team together as part of the goal-setting process at the facility. The goals were linked to The International Classification of Functioning, Disability and Health (ICF) for comparison. Goal achievement was assessed on a 10-point numeric rating scale (NRS) in the discharge questionnaire. The association between SF-12 physical and mental functioning at long-term follow-up and goal achievement was explored. RESULTS The 293 individual goals and the 407 negotiated goals were most frequently linked to the ICF-component Body Functions. When comparing negotiated to individual goals, negotiated goals were more frequently linked to activities and participation. Goals to wide to be linked to the ICF were less frequent. For 76% of the participants, content of individual goals was captured in negotiated goals. Goal achievement with NRS scores ≥9 points was reported by 66% of the included participants. Goal achievement was a significant predictor for long-term mental functioning (p=0.04). CONCLUSION Collaboration between participants and health professionals resulted in more specific goals directed towards the activities and participation component. Goal achievement predicted long-term mental functioning following rehabilitation.
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Affiliation(s)
- Line Preede
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Beitostølen Healthsports Centre, Beitostølen, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Helene L Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Håkon Dalen
- Beitostølen Healthsports Centre, Beitostølen, Norway
| | | | - Reidun Jahnsen
- Beitostølen Healthsports Centre, Beitostølen, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Martin Saebu
- Beitostølen Healthsports Centre, Beitostølen, Norway
| | - Erik Bautz-Holter
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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