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Metzner G, von der Warth R, Glattacker M. The concept of treatment beliefs in children and adolescents with chronic health conditions: a scoping review. Health Psychol Rev 2024; 18:421-455. [PMID: 37675876 DOI: 10.1080/17437199.2023.2253300] [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: 07/14/2022] [Accepted: 08/24/2023] [Indexed: 09/08/2023]
Abstract
Children and adolescents with chronic health conditions are faced with ongoing challenges, making self-regulation crucial. As children grow up, they gradually develop differentiated beliefs about illness and treatment. While research indicates treatment beliefs as relevant factor on outcomes like adherence, the specific contents and dimensions of children's and adolescents' treatment beliefs remained unclear. This scoping review therefore aimed at the identification of treatment beliefs dimensions in children and adolescents with chronic health conditions, the underlying theoretical frameworks, and methodological operationalisation. Published literature was examined by applying systematic searches in electronic databases (Medline, PsycINFO, CINAHL) and comprehensive selection criteria, resulting in 49 included studies. The predominant treatment beliefs dimensions were necessity, concerns, perceived benefits and costs/barriers, and expectations. The latter can be differentiated into outcome, social, process, and structural expectations, and expectations of one's own role in the treatment process. In addition, dimensions that cover emotions and reasons for treatment were identified. The results are related to the methods and theoretical models applied, which were often adapted from adult research. However, additional and possibly more child-specific dimensions such as social expectations and emotions were found. This scoping review indicates several research gaps and discusses practical implications.
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Affiliation(s)
- Gloria Metzner
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Rieka von der Warth
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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Gmelig Meyling C, Verschuren O, Rentinck ICM, van Driel D, Te Slaa E, Engelbert RH, Gorter JW. "Your brain can't wait": perspectives of children and adolescents with acquired brain injury and their parents on physical rehabilitation during the subacute phase. Disabil Rehabil 2024; 46:4420-4427. [PMID: 37909065 DOI: 10.1080/09638288.2023.2275742] [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: 03/26/2023] [Revised: 09/13/2023] [Accepted: 10/23/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE Physical interventions during subacute rehabilitation have potential to improve functional recovery. This study explored the perspectives of children and adolescents with acquired brain injury (ABI) and their parents with respect to physical rehabilitation during the subacute phase. METHODS Thirteen children and adolescents with ABI and their parents were included and interviewed using semi-structured interviews. Interview transcripts were analysed using inductive thematic analysis approach. RESULTS Six themes were identified: 1) beliefs of physical rehabilitation, 2) content of physical rehabilitation, 3) tailored care, 4) impact of context, 5) communication and 6) transition. The importance of intensive physical practice was widely supported. The positive can-do mentality was emphasised to create an atmosphere of hope, meaning that every effort would be made to achieve maximum recovery. Intensive involvement of parents is considered essential during subacute rehabilitation including an open and mutual dialogue about the focus of rehabilitation, therapy goals and future participation in their own environment. CONCLUSIONS Our findings highlight the need for an intensive rehabilitation approach, tailored to the individual's needs. The perspectives of children and adolescents and their parents in our study contribute to a better understanding of factors that are important for optimal recovery through physical rehabilitation during the subacute phase.
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Affiliation(s)
- Christiaan Gmelig Meyling
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine, Utrecht University, Utrecht, The Netherlands
- Department of Paediatric Rehabilitation, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Institute of Human Movement Studies, Master Program Physiotherapy Specialization Paediatric Physiotherapy, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Olaf Verschuren
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine, Utrecht University, Utrecht, The Netherlands
| | - Ingrid C M Rentinck
- Department of Paediatric Rehabilitation, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Dimara van Driel
- Institute of Human Movement Studies, Master Program Physiotherapy Specialization Paediatric Physiotherapy, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Esmée Te Slaa
- Institute of Human Movement Studies, Master Program Physiotherapy Specialization Paediatric Physiotherapy, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Raoul H Engelbert
- Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Paediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Willem Gorter
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine, Utrecht University, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- CanChild Centre for Childhood Disability Research, Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada
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Metzner G, Glattacker M. The rehabilitation treatment beliefs questionnaire-revised: assessing adolescents' treatment beliefs. J Pediatr Psychol 2024; 49:501-511. [PMID: 38787965 DOI: 10.1093/jpepsy/jsae037] [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: 01/26/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVE While there are several studies on children's and adolescents' beliefs about illness and medication treatment, there is limited research on their treatment beliefs in the context of rehabilitation. The Rehabilitation Treatment Beliefs Questionnaire (RTBQ) was the first instrument available to assess pediatric patients' rehabilitation-related treatment beliefs. However, the RTBQ had some limitations that we aimed to address in this study: We revised the content of the RTBQ to include previously unaddressed dimensions of rehabilitation-related treatment beliefs, and we thoroughly tested its psychometric properties based on a sizeable, multicenter sample of adolescents with different chronic diseases. METHODS Across 11 pediatric rehabilitation clinics throughout Germany, eligible patients aged 12-18 years with any chronic physical or mental health condition were invited to participate in an online survey. Psychometric evaluation included item analysis, exploratory factor analysis, internal consistency and construct validity. RESULTS The sample comprised N = 294 adolescents (M = 14.2 years) with various chronic conditions. Psychometric testing demonstrated a coherent factor structure with 6 interpretable scales covering process and outcome expectations, expectations of one's own role in the treatment process, structural expectations, concerns, and emotions, the latter three representing previously unaddressed dimensions of rehabilitation-related treatment beliefs. Internal consistency was acceptable to good. Construct validity analyses showed mostly hypotheses-consistent correlations with related constructs. CONCLUSIONS The revised RTBQ provides a psychometrically well-tested, adolescent-specific, and disease-generic instrument that captures multiple dimensions of rehabilitation-related treatment beliefs. Practical implications include identifying adolescents' beliefs about rehabilitation treatment in order to actively involve them in their illness management.
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Affiliation(s)
- Gloria Metzner
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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Roubea I, Korakakis V. Rehabilitation following ulnar collateral ligament injury of the elbow in a female acrobatic athlete: A case report. J Bodyw Mov Ther 2024; 38:329-338. [PMID: 38763577 DOI: 10.1016/j.jbmt.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND The mechanism of injury and the conservative rehabilitation of the ulnar collateral ligament of the elbow (UCL) are well studied and reported in overhead athletes, while research on gymnastic athletes is sparse. Evidence suggests exercise as the mainstay in UCL injury rehabilitation. With this report, we aimed to provide a complete rehabilitation protocol following a partial UCL tear of an acrobatic athlete, where exercise and adjunct treatments, such as manual therapy, were used in a progressive staged rehabilitation. CASE DESCRIPTION A 16-year-old female acrobatic athlete was diagnosed with partial tear of the anterior band of UCL. The rehabilitation included progressive exercise loading in conjunction with manual therapy for 10 sessions in 8 weeks. Pain, UCL special tests, the Disabilities of Arm, Shoulder and Hand Score Questionnaire (DASH), and the Upper Limb Functional Index (ULFI) were assessed and administered at baseline and at 3, 6, 10 weeks, and 3 months. RESULTS Improvement in all outcome measures was noted at the 3-month follow-up indicating a substantial reduction in pain and disability, and an increase in stability of the elbow joint. Return to training was achieved at 8 weeks from the initial visit, while return to sport at the pre-injury level was achieved at 3 months. CONCLUSION Progressive exercise loading along with the addition of manual therapy is an effective intervention for the rehabilitation and return to sport following a partial UCL tear. A progressive staged rehabilitation guideline for acrobatic athletes with UCL injuries has been provided to be used and guide clinical practice. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Iliana Roubea
- Physiotherapy Department, University of West Attica, Egaleo, Athens, Greece; Hellenic Orthopaedic Manipulative Therapy Education (HOMT Edu), Athens, Greece.
| | - Vasileios Korakakis
- Hellenic Orthopaedic Manipulative Therapy Education (HOMT Edu), Athens, Greece; Department of Health Sciences, School of Life Sciences and Health Sciences, PhD in Physiotherapy Program, University of Nicosia, Cyprus
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Stotsky MV, Henning E. Commentary: Developing a Measure of Inpatient Rehabilitation Treatment Beliefs and Expectations for Youth With Chronic Illness. J Pediatr Psychol 2023; 48:14-16. [PMID: 35997553 DOI: 10.1093/jpepsy/jsac065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/17/2023] Open
Affiliation(s)
- Mimi V Stotsky
- Department of Behavioral Psychology, Kennedy Krieger Institute, USA.,Johns Hopkins University School of Medicine, USA
| | - Ellen Henning
- Department of Behavioral Psychology, Kennedy Krieger Institute, USA
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Metzner G, Höhn C, Nau A, Sehlbrede M, Waldeck E, Glattacker M. Treatment Beliefs of Children and Adolescents With Chronic Diseases: Development of the Rehabilitation Treatment Beliefs Questionnaire for Children and Adolescents. J Pediatr Psychol 2023; 48:5-13. [PMID: 35426935 DOI: 10.1093/jpepsy/jsac033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Rehabilitation is an important component in the health care of children and adolescents with chronic diseases and aims at supporting patients' self-regulation for dealing with the disease. Patients' beliefs about illness and treatment are core elements in the self-regulation process. While questionnaires measuring illness beliefs for children and adolescents exist, questionnaires about their rehabilitation-related treatment beliefs are lacking. We therefore developed a questionnaire to assess the rehabilitation-related treatment beliefs of children and adolescents with chronic diseases (Rehabilitation Treatment Beliefs Questionnaire, RTBQ) and tested its psychometric properties. METHODS Ahead of their rehabilitation, children and adolescents, aged 12-17 years, answered 129 items, which were developed based on previous qualitative findings exploring children and adolescents' rehabilitation-related treatment beliefs. Psychometric testing included item analyses, exploratory factor analysis, internal consistency and bivariate correlations of the extracted scales, and the discriminatory power and difficulty of the final items. RESULTS The sample consisted of 170 participants with a mean age of 14.3 years (SD = 1.6); 53.5% were female. After item analyses, 47 items remained for the exploratory factor analysis which revealed 22 items allocated to 4 scales: "expectations of communication and interaction," "expectations of the treatment process," "expectations of treatment success and sustainability," and "expectations of one's own role in the rehabilitation process." The psychometric properties were acceptable to good. CONCLUSIONS The RTBQ assesses various dimensions of rehabilitation-related treatment beliefs of children and adolescents with chronic diseases. While first psychometric results are promising, further psychometric testing is needed.
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Affiliation(s)
- Gloria Metzner
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Cindy Höhn
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Anne Nau
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Matthias Sehlbrede
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Edith Waldeck
- Deutsche Rentenversicherung Rheinland-Pfalz, Edelsteinklinik (Specialized Clinic for Child- and Adolescent Rehabilitation), Bruchweiler, Germany
| | - Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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