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Cheema K, Dunn T, Chapman C, Rockwood K, Howlett SE, Sevinc G. A systematic review of goal attainment scaling implementation practices by caregivers in randomized controlled trials. J Patient Rep Outcomes 2024; 8:37. [PMID: 38530578 DOI: 10.1186/s41687-024-00716-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Goal attainment scaling (GAS), an established individualized, patient-centred outcome measure, is used to capture the patient's voice. Although first introduced ~60 years ago, there are few published guidelines for implementing GAS, and almost none for its use when caregivers GAS is implemented with caregiver input. We conducted a systematic review of studies that implemented GAS with caregiver input; and examined variations in GAS implementation, analysis, and reporting. METHODS Literature was retrieved from Medline, Embase, Cochrane, PsycInfo and CINAHL databases. We included randomized controlled trials (published between 1968 and November 2022) that used GAS as an outcome measure and involved caregiver input during goal setting. RESULTS Of the 2610 studies imported for screening, 21 met the inclusion criteria. Most studies employed GAS as a primary outcome. The majority (76%) had children as study participants. The most common disorders represented were cerebral palsy, developmental disorders, and dementia/Alzheimer's disease. The traditional five-point GAS scale, with levels from -2 to +2, was most often implemented, with -1 level typically being the baseline. However, most studies omitted essential GAS details from their reports including the number of goals set, number of attainment levels and whether any training was given to GAS facilitators. CONCLUSIONS GAS with caregiver input has been used in a limited number of randomized controlled trials, primarily in pediatric patients and adults with dementia. There is a variability in GAS implementation and many crucial details related to the specifics of GAS implementation are omitted from reports, which may limit reproducibility. Here we propose catalog that may be utilized when reporting research results pertaining to GAS with caregivers to enhance the application of this patient-centered outcome measure.
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Affiliation(s)
- Kulpreet Cheema
- Ardea Outcomes, Halifax, NS, Canada
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | | | - Kenneth Rockwood
- Ardea Outcomes, Halifax, NS, Canada
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
- Geriatric Medicine Research Unit, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Susan E Howlett
- Ardea Outcomes, Halifax, NS, Canada
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
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Jeglinsky I, Kaakkuriniemi E, Veijola A, Kiviranta T. Profiles of functioning of children with cerebral palsy in Finland: analysis of multi-professional family meetings. Disabil Rehabil 2019; 43:2024-2030. [PMID: 31755320 DOI: 10.1080/09638288.2019.1692080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To explore what aspects of and how the child's functioning are discussed during a multi-professional team meeting when planning goals and interventions for rehabilitation. MATERIALS AND METHODS Multiprofessional rehabilitation meetings were videotaped, the discussions transcribed and all content related to the child's function was linked to the International Classification of Functioning, Disability and Health comprehensive Core Set for children with cerebral palsy. RESULTS Thirteen families gave their informed consent to participate. In nine meetings the child was present and one or two parents attended all meetings. The mean age of the children was 10 years (3-17 years). Functioning was described as wide-ranging and covered most components of the International Classification of Functioning, Disability and Health. Body structures were mentioned rarely, and of body functions, musculoskeletal functions were most commonly discussed. The focus was on activities and participation, the most discussed aspects being learning, applying knowledge and mobility. CONCLUSIONS The results showed that both children and their parents were involved when rehabilitation was planned. The comprehensive ICF Core Set for children and young people with CP was in this study used to analyze the areas of functioning discussed, but could also be useful in clinical practice to identify relevant areas of functioning.IMPLICATIONS FOR REHABILITATIONIdentifying areas of functioning facilitate communication among families and multi-disciplinary professionals during rehabilitation team meetings.Important areas of participation are overlooked during intervention planning meetings, which could be improved using ICF-based tools.The comprehensive ICF Core Set for cerebral palsy is a useful framework to identify areas of functioning in Finland.
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Affiliation(s)
- Ira Jeglinsky
- Institution of Health and Welfare, Arcada University of Applied Sciences, Helsinki, Finland
| | | | - Arja Veijola
- Oulu University of Applied Sciences, Oulu, Finland
| | - Tuula Kiviranta
- Centre for Learning and Consulting, Valteri, Ruskis, Helsinki, Finland
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Nguyen L, Cross A, Rosenbaum P, Gorter JW. Use of the International Classification of Functioning, Disability and Health to support goal-setting practices in pediatric rehabilitation: a rapid review of the literature. Disabil Rehabil 2019; 43:884-894. [PMID: 31345067 DOI: 10.1080/09638288.2019.1643419] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The International Classification of Functioning, Disability and Health (referred to as the ICF) is the World Health Organization's framework for health. It can be used to identify goals that capture all aspects of a person's life and to inform clinical goal-setting processes. This review aims to report how healthcare providers are using the ICF framework to support goal-setting practices in pediatric rehabilitation services. METHODS A rapid review was conducted using scoping review principles in the following databases: CINAHL, Medline and PsycINFO. Key terms included: "ICF", "goal-setting" and "pediatrics". RESULTS Sixteen studies met the inclusion criteria. Three main themes emerged about the use of the ICF in pediatric rehabilitation: 1) match the content of goals to the ICF domains; 2) implement with existing tools for goal-setting; and 3) inform the development of new tools for goal-setting. Healthcare providers often use a combination of goal-setting tools. The SMART approach is used to frame goals, while the Canadian Occupational Performance Measure and Goal Attainment Scale have been used to document and evaluate goals. CONCLUSION The ICF framework can be used with current goal-setting practices and offers a common lens and language with which to facilitate collaborative goal-setting with families and healthcare providers.Implications for RehabilitationThe International Classification of Functioning, Disability and Health (ICF) provides a common framework and language to support collaborative goal-setting between families and healthcare providersDespite the opportunity for the ICF to be used as a framework with goal-setting approaches, to date the ICF has mainly been used to match the content of goals to ICF domains for documentation purposesThe ICF should be incorporated into the established clinical routines in order to promote its use among healthcare providersThe ICF can be used with existing goal-setting tools in clinical practice and to inform the ongoing development of new tools to support the goal-setting process in family-centred services.
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Affiliation(s)
- Linda Nguyen
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Güeita-Rodríguez J, García-Muro F, Rodríguez-Fernández ÁL, Lambeck J, Fernández-de-Las-Peñas C, Palacios-Ceña D. What areas of functioning are influenced by aquatic physiotherapy? Experiences of parents of children with cerebral palsy. Dev Neurorehabil 2018; 21:506-514. [PMID: 28933572 DOI: 10.1080/17518423.2017.1368728] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To explore the experiences regarding aquatic physiotherapy among parents of children with cerebral palsy and to identify a list of relevant intervention categories for aquatic physiotherapy treatments. METHODS We conducted semi-structured interviews and focus groups using the components of the International Classification of Functioning, Disability and Health (ICF) as a frame of reference to explore and code experiences regarding aquatic physiotherapy. A non-probabilistic purposive sampling strategy was used. Content analysis methods and ICF linking processes were used to analyze data. RESULTS From the parents' perspective (n = 34), both the Body Functions and Activities and Participation components were mainly influenced by aquatic physiotherapy. Also, parents described Environmental Factors acting as barriers affecting progress during therapy. CONCLUSIONS Parents identified a wide range of categories influenced by aquatic physiotherapy. Social and contextual aspects were highlighted, as well as a series of changes related to the illness as a result of treatment.
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Affiliation(s)
- Javier Güeita-Rodríguez
- a Department of Physiotherapy , Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University , Alcorcón , Madrid , Spain
| | - Francisco García-Muro
- b Department of Nursing and Physiotherapy , School of Medicine, CEU-San Pablo University , Madrid , Spain
| | | | - Johan Lambeck
- c International Aquatic Therapy Faculty , Valens , Switzerland
| | - Cesar Fernández-de-Las-Peñas
- a Department of Physiotherapy , Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University , Alcorcón , Madrid , Spain
| | - Domingo Palacios-Ceña
- a Department of Physiotherapy , Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University , Alcorcón , Madrid , Spain
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Goal setting in paediatric rehabilitation for children with motor disabilities: a scoping review. Clin Rehabil 2018; 32:954-966. [DOI: 10.1177/0269215518758484] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: The three objectives of this scoping review were to (1) identify key conceptual/theoretical frameworks and the extent to which they are used to inform goal setting related to rehabilitation goal setting with children with motor disabilities, (2) describe research that has evaluated goal setting processes and outcomes, and (3) summarize the purposes of goal setting described in paediatric rehabilitation literature. Methods: The scoping review process described by Arksey and O’Malley was used to guide article selection and data extraction. Results: A total of 62 articles were included in the final review. While the concept of family-centered care was well represented, theoretical frameworks specific to goal setting (i.e. goal setting theory described by Locke and Latham, mastery motivation, social cognitive, personal construct, and self-determination theories) were rarely addressed. No articles reviewed addressed prominent behavior change theory. With the exception of the description of tools specifically designed for use with children, the role of the child in the goal setting process was generally absent or not well described. Few studies ( n = 6) discussed the linkage between goals and intervention strategies explicitly. Only two studies in the review evaluated outcomes associated with goal setting. The primary purpose for goal setting identified in the literature was to develop goals that are meaningful to families ( n = 49). Conclusion: The results highlight significant gaps in the literature explicating a sound theoretical basis for goal setting in paediatric rehabilitation and research evaluating the effects of goal qualities and goal setting processes on the achievement of meaningful outcomes.
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Nguyen L, Mesterman R, Gorter JW. Development of an inventory of goals using the International Classification of Functioning, Disability and Health in a population of non-ambulatory children and adolescents with cerebral palsy treated with botulinum toxin A. BMC Pediatr 2018; 18:1. [PMID: 29301539 PMCID: PMC5755464 DOI: 10.1186/s12887-017-0974-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the management of hypertonicity in children with cerebral palsy (CP), goals should be clearly identified in order to evaluate the effectiveness of botulinum toxin A (BoNT-A) treatment, specifically in non-ambulatory children and adolescents, Gross Motor Function Classification System (GMFCS), level IV or V. A retrospective chart review (Mesterman et al., 2013) identified the need for the development of a set of specific and meaningful goals linked to the International Classification of Functioning, Disability and Health (ICF) for future goal setting and evaluation in this population. Our objective is to create an inventory of goals based on the ICF framework that captures the needs and values of families with children with CP. METHODS This cross-sectional observational study recruited parents of twenty children and youths with CP in GMFCS levels IV or V (mean age 11.2 years, SD 4.3, 13 males) who were assessed for BoNT-A treatment at the Spasticity Management Clinic at McMaster Children's Hospital (Hamilton, ON). A previous inventory of goals was developed by a group of experts at a national botulinum toxin conference held in January 2014 (Montreal, Canada). The inventory of goals was further refined by asking the parents to select goals from the inventory list that they would like their child to accomplish after receiving BoNT-A treatment, and asking healthcare professionals for clarity and phrasing of goals in the inventory list. RESULTS All parents identified body structure and function goals, with more than 75% of parents selecting reduction in muscle tone and increased range of movements in the upper and lower extremities. More than 50% of parents identified activity goals related to ease of caregiving. Two activity goals and three participation goals were missing from the inventory. Participation goals were identified by less than 5% of parents. CONCLUSION The inventory may be a helpful tool to facilitate a discussion about goal setting between healthcare professionals and families in the context of BoNT-A treatment. A future study is needed to conduct qualitative interviews to better understand the information that families may require about setting goals during BoNT-A treatment and to evaluate the usefulness of the inventory.
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Affiliation(s)
- Linda Nguyen
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON, L8S 1C7, Canada
| | - Ronit Mesterman
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON, L8S 1C7, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON, L8S 1C7, Canada.
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Mendonça AP, Castro SS, Stone JH, Andrade PMO. Work process related to cerebral palsy of neurological rehabilitation centers. Dev Neurorehabil 2016; 18:252-9. [PMID: 23869698 DOI: 10.3109/17518423.2013.796418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the work process for CP cases in different rehabilitation centers according to Brazilian health policies and recommendations from the "World Report on Disability". METHODS A questionnaire - Evaluation Process of Rehabilitation of Children with CP was applied to the Coordinators of 13 services. This instrument has a maximum score of 108 points. RESULTS The results of the questionnaire varied from 28 to 64 points. The mean and SD were 43.5 and 10.9, respectively. The main administrative difficulties were: (a) presence of unmet demand, (b) patient absenteeism, (c) referral to primary care services, (d) inadequate physical facilities, (e) the scarce provision of prosthetics and orthotics, (f) insufficient financial resources, (g) human resources training, (h) difficulties with the use of the information system and (i) transportation difficulties for patients. CONCLUSION Administrative and clinical guidelines are needed for uniformity of the work process of the rehabilitation centers.
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Affiliation(s)
- Ana Paula Mendonça
- Department of Physical Therapy, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM) , Diamantina, MG , Brazil
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McAnuff J, Boyes C, Kolehmainen N. Family-clinician interactions in children's health services: a secondary analysis of occupational therapists' practice descriptions. Health Expect 2015; 18:2236-51. [PMID: 24766653 PMCID: PMC5810711 DOI: 10.1111/hex.12194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Effective family-clinician interactions are important for good health outcomes. Two types of interactions are consistently recommended: relational (e.g. listening, empathy, and respect) and participatory (e.g. shared decision-making, planning and problem-solving), but there is little specific guidance on how to implement these interactions in practice. OBJECTIVE To identify specific, practice-based examples of relational and participatory family-clinician interactions in children's occupational therapy. DESIGN A qualitative secondary analysis was used. The data consisted of a list of occupational therapists' self-reported practice actions (n = 217) and direct quotes describing their content and context. The practice actions were categorized into a range of relational and participatory family-centred interactions using a modified framework analysis. RESULTS Of the 217 practice actions, the majority [121 (55.76%)] did not describe examples of therapists implementing family-clinician interactions. Of the remaining practice actions, 19 (8.76%) described 'relational' interactions (e.g. 'Listen to carer', 'Gather perspectives from others'); 47 (21.66%) described 'participatory' interactions (e.g. 'Identify the family's goals and priorities', 'Allow the family to choose'); 2 (0.92%) described both ('Take guidance from carers'); and 28 (12.9%) were excluded from the analysis. DISCUSSION AND CONCLUSIONS A range of relational and participatory interactions were identified. Descriptions of participatory interactions were more frequent than descriptions of relational interactions, and overall the therapists described their family-clinician interactions less frequently than their other practice actions. The specific, real-life examples of different types of interactions identified in the study can be used as a basis for reflection on practice and developing more specific guidance.
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Affiliation(s)
- Jennifer McAnuff
- Children's Occupational Therapy ServiceLeeds Community Healthcare NHS TrustLeedsUK
| | - Chris Boyes
- Faculty of Health and Life SciencesYork St. John UniversityYorkUK
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Forsingdal S, St John W, Miller V, Harvey A, Wearne P. Goal setting with mothers in child development services. Child Care Health Dev 2014; 40:587-96. [PMID: 23662628 DOI: 10.1111/cch.12075] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/08/2013] [Indexed: 12/01/2022]
Abstract
AIM The aim of this grounded theory study was to explore mothers' perspectives of the processes of collaborative goal setting in multidisciplinary child development services involving follow-up home therapy. METHODS Semi-structured interviews were conducted in South East Queensland, Australia with 14 mothers of children aged 3-6 years who were accessing multidisciplinary child development services. Interviews were focussed around the process of goal setting. RESULTS A grounded theory of Maternal Roles in Goal Setting (The M-RIGS Model) was developed from analysis of data. Mothers assumed Dependent, Active Participator and Collaborator roles when engaging with the therapist in goal-setting processes. These roles were characterized by the mother's level of dependence on the therapist and insight into their child's needs and therapy processes. Goal Factors, Parent Factors and Therapist Factors influenced and added complexity to the goal-setting process. CONCLUSION The M-RIGS Model highlights that mothers take on a range of roles in the goal-setting process. Although family-centred practice encourages negotiation and collaborative goal setting, parents may not always be ready to take on highly collaborative roles. Better understanding of parent roles, goal-setting processes and influencing factors will inform better engagement with families accessing multidisciplinary child development services.
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Affiliation(s)
- S Forsingdal
- Child Development Service (Bayside) Child & Youth Community Health Service, Children's Health Queensland, Queensland Health, Brisbane, Queensland, Australia
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Abstract
Client-centred occupational therapy approaches aim to increase client motivation and confidence in working towards self-identified occupational performance goals. In this opinion piece we explore whether measurement of confidence in goal pursuit could complement existing tools, such as the Canadian Occupational Performance Measure (Law et al 1998), in documenting clinical outcomes. Cognitive theories of motivation and behaviour change support links between confidence in problem solving around self-identified goals, effort, and motivation to persist and engage in therapy. We propose that evaluating goal-related confidence is an important but neglected area of practice. Providing feedback about confidence in relation to goal pursuit may increase the likelihood of occupational performance goals being attained.
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Affiliation(s)
- Anne A Poulsen
- Senior Research Fellow, University of Queensland — Division of Occupational Therapy, School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, St Lucia, Queensland, Australia
| | - Jenny Ziviani
- Professor, Children's Allied Health Research, Queensland Health; University of Queensland — School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, St Lucia, Queensland, Australia
| | - Katja Kotaniemi
- Occupational Therapy Graduate, University of Queensland — Division of Occupational Therapy, School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, St Lucia, Queensland, Australia
| | - Mary Law
- Professor, McMaster University — School of Rehabilitation Science, IAHS Bldg, 1400 Main St W, Hamilton, Ontario, Canada and Adjunct Professor, LaTrobe University, Melbourne, Australia
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Escorpizo R, Bemis-Dougherty A. Introduction to Special Issue: A Review of the International Classification of Functioning, Disability and Health and Physical Therapy over the Years. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2013; 20:200-9. [PMID: 24339331 DOI: 10.1002/pri.1578] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 08/28/2013] [Accepted: 11/10/2013] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND PURPOSE The International Classification of Functioning, Disability and Health (ICF) of the World Health Organization was developed as a common framework to understand health and to describe the impact of health condition on functioning. The purpose of this paper is to summarize the literature on the use of the ICF in physical therapy practice and research. METHODS We performed a scoping-narrative review and searched for relevant English language articles from 2001 to 2012 in multiple databases that included MEDLINE, PsycINFO, PubMed and Physiotherapy Evidence Database. Our keywords for the search consisted of ['physical therapy' OR 'physiotherapy'] AND ['ICF']. All types of articles were considered. RESULTS We found 268 articles; out of which, 79 were reviewed. The years with most publications were 2011 (n = 16), 2008 (n = 15) and 2010 and 2012 (both with n = 13). Publications mostly came from the United States with 27% of the articles. The journal Physical Therapy leads with almost a third of ICF-related physical therapy publications. The ICF has been mostly used in studies of musculoskeletal and neuromuscular conditions. We found a wide array of application of the ICF in research, clinical practice and teaching (classroom and clinical education). Emerging topics included using the ICF in resource allocation and prevention and wellness. CONCLUSION The use of the ICF in physical therapy practice and research is promising and continues to evolve. With recent developments in ICF-based measurement and integration in assessment tools for use in the clinics, research and teaching, the need to show the added value of using the ICF in practice and research remains.
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Affiliation(s)
- Reuben Escorpizo
- Department of Physical Therapy, Louisiana State University Health Sciences Center, New Orleans, LA, USA.,ICF Research Branch in Cooperation with the WHO FIC CC in Germany (DIMDI), Nottwil, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland
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Jeglinsky I, Brogren Carlberg E, Autti-Rämö I. How are actual needs recognized in the content and goals of written rehabilitation plans? Disabil Rehabil 2013; 36:441-51. [PMID: 23721521 DOI: 10.3109/09638288.2013.797511] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE The primary aim of the study was to investigate the interrelation between needs and functional difficulties and the therapeutic goals in children with cerebral palsy (CP) as documented in individual written rehabilitation plans. METHOD The study was a retrospective cross-sectional register study. The data consisted of randomly chosen register documents for 77 children and adolescents with CP in different predetermined age ranges. The International Classification of Functioning, Disability and Health-Child and Youth version (ICF-CY) was used as a reference for analyzing the content of the written statements. RESULTS The rehabilitation plans for 70 children, 1-16 years of age, representing all GMFCS levels were analyzed. Goals were not well reflected in the children's needs and functional difficulties. The needs, functional difficulties and goals mainly encompassed the components of body functions and activity/participation. In half of the plans the presence of the parents was mentioned, and the plans were made in multidisciplinary collaboration. CONCLUSIONS The results of this study indicate deficiencies in the content and goals of the written rehabilitation plans. The ICF-CY could serve as a framework to help professionals and parents identify the child's needs and those areas where the goals should be targeted. Implications for Rehabilitation Documenting the child's and family's needs in relation to activity and participation preferences is critical to rehabilitation and intervention planning. Goals, based on the child's needs, should be identified in collaboration with all parties involved, and focus on the child's functioning in meaningful everyday activities. The ICF-CY could serve as a framework for the family and professionals to identify needs and to communicate rehabilitation goals.
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Affiliation(s)
- Ira Jeglinsky
- Arcada, University of Applied Sciences , Helsinki , Finland
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Andrade PMO, Haase VG, Oliveira-Ferreira F. An ICF-based approach for cerebral palsy from a biopsychosocial perspective. Dev Neurorehabil 2013; 15:391-400. [PMID: 23030598 DOI: 10.3109/17518423.2012.700650] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To integrate instruments to operationalize an ICF-based approach for cerebral palsy (CP); to assess differences in activity and participation among children with hemiplegia, diplegia and quadriplegia CP; to verify the facilitators or barriers to functioning; and to investigate the explanatory factors (cognitive and motor) for the type of school attended by children with CP (regular or special). METHODS Sixty children with CP were assessed using the Mini-Mental State Examination and an ICF-based instrument and their parents were interviewed. Data were analysed by Chi-Squared, Anova's and Kruskal-Wallis tests and multivariate logistic regression. RESULTS Significant differences between CP sub-groups were found for chewing, urinary function, cognitive function and activities and participation. Twelve environmental factors were identified as barriers. Multivariate regression identified cognitive function as a significant explanatory variable for the type of school attended, whereas motor function was not significant. CONCLUSIONS The ICF-based approach allows a comprehensive assessment, relevant for planning interventions.
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Affiliation(s)
- Peterson Marco O Andrade
- Department of Physical Therapy, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Brazil.
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Andrade PMO, Oliveira Ferreira F, Mendonça AP, Haase VG. Content identification of the interdisciplinary assessment of cerebral palsy using the International Classification of Functioning, Disability and Health as reference. Disabil Rehabil 2012; 34:1790-801. [DOI: 10.3109/09638288.2012.662572] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rodger S, O’Keefe A, Cook M, Jones J. Parents’ and Service Providers’ Perceptions of the Family Goal Setting Tool: A Pilot Study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2012; 25:360-71. [DOI: 10.1111/j.1468-3148.2011.00674.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lopaschuk F, Brown CA. The Effectiveness of Skill-Based Intervention for Female Victims of Intimate Partner Violence: A Critical Review. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/aasoci.2012.21004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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de Oliveira Andrade PM, de Oliveira Ferreira F, Haase VG. Multidisciplinary perspective for cerebral palsy assessment after an international, classification of functioning, disability and health training. Dev Neurorehabil 2011; 14:199-207. [PMID: 21732804 DOI: 10.3109/17518423.2011.584781] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess knowledge related to the ICF before and after an ICF training and to identify items to compose a monocentric rehabilitation ICF code set for cerebral palsy (CP). METHODS (a) DESIGN A cross-sectional study with a descriptive-explorative design. (b) PARTICIPANTS Professionals from the fields of physiotherapy, nutrition, dentistry, occupational therapy, psychology, social work, speech therapy and medicine. (c) INSTRUMENT A questionnaire to assess ICF's knowledge (total score = 17). RESULTS A high effect size of the ICF training was found (Cohen's d = 4.10). Ninety-one and 43 ICF categories were selected for a comprehensive evaluation and triage, respectively, for CP. CONCLUSION ICF categories were identified to compose a comprehensive evaluation and for triage through an ICF code sets for CP. Studies are needed to validate the instrument on the knowledge of the ICF and to test the impact of ICF's training for clinical rehabilitation of CP.
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Andrade PMO, Oliveira Ferreira FD, Vasconcelos AG, Paula Lima ED, Haase VG. Perfil cognitivo, déficits motores e influência dos facilitadores para reabilitação de crianças com disfunções neurológicas. REVISTA PAULISTA DE PEDIATRIA 2011. [DOI: 10.1590/s0103-05822011000300003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Investigar se crianças e adolescentes saudáveis e com doenças neurológicas podem ser reunidas em grupos distintos e homogêneos, usando como critérios o desempenho cognitivo, o funcionamento motor e as percepções dos pais quanto aos facilitadores para a reabilitação. MÉTODOS: Participaram deste estudo 15 crianças saudáveis (C) e 43 pacientes (28 com paralisia cerebral e 15 com acidente vascular cerebral), entre cinco e 18 anos. Foi aplicado aos pais o instrumento denominado Avaliação dos Fatores Ambientais relacionados à Reabilitação Neurológica Infantil (AFARNI). O comprometimento cognitivo foi avaliado por meio do Mini-Exame do Estado Mental, adaptado para essa faixa etária, e o comprometimento motor foi investigado por avaliação clínica. Para comparar os resultados, foi realizada uma análise de conglomerados e ANOVA. RESULTADOS: A análise de conglomerados identificou quatro grupos de pacientes com características clínicas e sociodemográficas distintas, confirmados pela ANOVA (p<0,001). Houve dissociação entre os grupos com relação ao comprometimento cognitivo e motor. Os pais de crianças com maior comprometimento avaliaram de forma mais positiva os facilitadores para a reabilitação. CONCLUSÕES: A qualificação dos facilitadores para a reabilitação por meio da AFARNI e a avaliação cognitiva com auxílio do Mini-Exame do Estado Mental podem contribuir para identificar as necessidades de suporte para crianças com deficiências neurológicas que apresentam comprometimento cognitivo e motor.
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Øien I, Fallang B, Østensjø S. Goal-setting in paediatric rehabilitation: perceptions of parents and professional. Child Care Health Dev 2010; 36:558-65. [PMID: 20030659 DOI: 10.1111/j.1365-2214.2009.01038.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND In paediatric rehabilitation, there is a belief in goal-setting as a fundamental component of decision-making that encourages collaboration and motivation, and improves outcomes. This study aimed to explore parents' and professionals' perceptions of setting and implementing goals within a family centred rehabilitation programme for preschoolers with cerebral palsy (CP). METHODS Parents and service providers of 13 preschoolers with CP, classified in Gross Motor Function Classification System level I-III, participated in two-step focus group interviews. RESULTS Three major themes emerged, each with two subthemes: (1) 'Goals enhance competence' with the subthemes 'parents as drivers', and 'awareness through observation'; (2) 'Goals direct attention' with the subthemes 'goals as valuable means' and 'collaboration through participation', and (3) 'Goals enter everyday life' with the subthemes 'goals as activities' and 'training vs. everyday practise'. A fourth theme 'child perspective' with the subthemes 'follow-up initiative', 'capture mastery', and 'create learning opportunities' was both an exclusive theme and integrated in the other three main themes. CONCLUSIONS Active involvement of parents throughout the process of setting and implementing goals seemed to increase their feeling of competency and partnership with professionals. Concrete goals based on families' preferences and concerns, participatory observation, and discussions with professionals, came out as valuable means for practice of functional tasks within home environments.
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Affiliation(s)
- I Øien
- Faculty of Health Sciences, Physiotherapy Programme, Oslo University College, Norway.
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Wiart L, Ray L, Darrah J, Magill-Evans J. Parents' perspectives on occupational therapy and physical therapy goals for children with cerebral palsy. Disabil Rehabil 2009; 32:248-58. [DOI: 10.3109/09638280903095890] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Nieuwenhuijsen C, Donkervoort M, Nieuwstraten W, Stam HJ, Roebroeck ME. Experienced Problems of Young Adults With Cerebral Palsy: Targets for Rehabilitation Care. Arch Phys Med Rehabil 2009; 90:1891-7. [DOI: 10.1016/j.apmr.2009.06.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 06/03/2009] [Accepted: 06/26/2009] [Indexed: 10/20/2022]
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Allet L, Bürge E, Monnin D. ICF: Clinical relevance for physiotherapy? A critical review. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/14038190802315941] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ostensjø S, Oien I, Fallang B. Goal-oriented rehabilitation of preschoolers with cerebral palsy--a multi-case study of combined use of the Canadian Occupational Performance Measure (COPM) and the Goal Attainment Scaling (GAS). Dev Neurorehabil 2008; 11:252-9. [PMID: 19031197 DOI: 10.1080/17518420802525500] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To explore setting and implementing goals as an ongoing process, using the COPM and the GAS in combination. METHODS Multi-case study of a goal-setting approach, involving parents and service providers of 13 children (aged 23-50 months) with mild-to-moderate CP enrolled in a 9-month rehabilitation programme consisting of two blocks of setting and implementing goals. The children's COPM reports and GAS goals and information from a questionnaire about implementation were analysed. RESULTS In the initial assessment, most problems prioritized by the parents in the COPM were phrased in terms of activities. The priorities for intervention changed during the process of setting and implementing goals. GAS goals were frequently integrated in everyday activities both at home and in kindergarten based on decisions on how to implement the goals. Changes in the children's performance were recognized by a high proportion of goal attainment and a small, but clear change in the parents' perception of performance. Parents and service providers reported many gains working towards concrete and measurable goals, but also some challenges. CONCLUSION By using the COPM and GAS in combination, a dynamic and interactive process of setting and implementing goals in the context of everyday activities emerged.
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Affiliation(s)
- Sigrid Ostensjø
- Faculty of Health Sciences, Oslo University College, Oslo, Norway.
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Steenbeek D, Ketelaar M, Galama K, Gorter JW. Goal Attainment Scaling in paediatric rehabilitation: a report on the clinical training of an interdisciplinary team. Child Care Health Dev 2008; 34:521-9. [PMID: 19154553 DOI: 10.1111/j.1365-2214.2008.00841.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Goal Attainment Scaling (GAS) is a responsive method for individual goal setting and treatment evaluation. However, current knowledge about its reliability when used in paediatric rehabilitation treatment is insufficient and depends highly on standardization of the GAS method. A training programme was developed to introduce GAS to a team of 27 professionals from five disciplines. The purpose of the paper is to share the experiences of professionals and parents during this training. METHODS The training consisted of three 2-h general discussion sessions and intensive individual feedback from the study leader (i.e. the first author). Feedback was given until the GAS scales met predetermined criteria of ordinality, described specific, measurable, acceptable, realistic abilities and activities in a single dimension, used the 'can-do' principle and could be scored within 10 min. Therapists and parents were asked to give their opinion by completing a questionnaire. RESULTS One hundred and fifteen GAS scales were developed and scored by professionals. The development of a GAS scale remained a time-consuming procedure, despite the training: 45 (SD = 27) minutes per scale. The content criteria of GAS were found to be useful by all participants. Common issues requiring revision of the initial scales were equal scale intervals, specificity, measurability and selection of a single variable. After the training, 70% of the therapists and 60% of the parents regarded GAS as a suitable tool to improve the quality of rehabilitation treatment. Examples of GAS scales developed by the various disciplines are presented and discussed. CONCLUSIONS The experiences reported in this paper support the further development of training procedures for GAS before it can be used as an outcome measure in effect studies. The findings may be helpful in introducing GAS in the field of childhood disability.
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Affiliation(s)
- D Steenbeek
- Rehabilitation Centre Breda, Breda, the Netherlands.
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