Factors influencing participation in home, school, and community settings by children and adolescents with neuromuscular disorders: A qualitative descriptive study

What are the barriers and facilitators to participation of people with Down syndrome? A scoping review

AIM

To determine the barriers and facilitators of active community participation of children, adolescents, and adults with Down syndrome.

METHOD

Searches were completed in five electronic databases to identify original studies about participation of children, adolescents (ages < 18 years), and adults (ages 18-59 years) with Down syndrome. Barriers and facilitators to participation were categorized into four factors: personal, social, environmental, and policy and programme. Findings were analysed and validated by a young adult with Down syndrome and a family member, using the public and patient involvement strategy.

RESULTS

Fourteen studies were included: eight with children and adolescents and six with adults. Of the 14 studies, 10 were qualitative and four quantitative. Most studies (n = 9) investigated participation in physical activities, while only a few examined participation in community/social activities (n = 3), daily activities (n = 2), and leisure activities (n = 1). The most commonly cited barriers and facilitators were the availability of programmes and specialized professionals, transportation, as well as attitudes and behaviours. Physical and psychological characteristics of people with Down syndrome and facilities were also frequently mentioned as barriers. On the other hand, the desire to stay active and personal interest in the activity were among the most frequently reported facilitators.

INTERPRETATION

The participation of people with Down syndrome is mainly influenced by physical or psychological factors, the support and attitudes of parents/caregivers, and the availability of specialized programmes. Given the scarcity of research investigating the participation of people with Down syndrome in community activities, daily activities, and leisure, especially in adults, more studies are still needed.

Quais são as barreiras e facilitadores para a participação de pessoas com Síndrome de Down? Uma Revisão de Escopo

Objetivo

Determinar as barreiras e facilitadores da participação ativa na comunidade de crianças, adolescentes e adultos com Síndrome de Down (SD). Métodos: Foram realizadas buscas em cinco bases de dados eletrônicas para identificar estudos originais sobre a participação de crianças, adolescentes (idades <18 anos) e adultos (idades de 18 a 59 anos) com SD. Barreiras e facilitadores para a participação foram categorizados em fatores: pessoais, sociais, ambientais e de políticas e programas. Os achados foram analisados e validados por um jovem adulto com SD e um membro da família, utilizando a estratégia de Envolvimento do Público e Paciente. Resultados: Quatorze estudos foram incluídos, oito com crianças e adolescentes e seis com adultos. Dos 14 estudos, dez eram qualitativos e quatro quantitativos. A maioria dos estudos (n = 9) investigou a participação em atividades físicas, enquanto apenas alguns estudos examinaram a participação em atividades comunitárias/sociais (n = 3), atividades diárias (n = 2) e atividades de lazer (n = 1). As barreiras e facilitadores mais frequentemente citados foram a disponibilidade de programas e profissionais especializados, transporte, bem como atitudes e comportamentos. As características físicas e psicológicas das pessoas com SD e as instalações também foram frequentemente mencionadas como barreiras. Por outro lado, o desejo de se manter ativo e o interesse pessoal na atividade estavam entre os facilitadores mais frequentemente relatados.

Interpretação

A participação de pessoas com SD é principalmente influenciada por fatores físicos ou psicológicos, o apoio e as atitudes dos pais/cuidadores e a disponibilidade de programas especializados. Dada a escassez de pesquisas investigando a participação de pessoas com SD em atividades comunitárias, atividades diárias e lazer, especialmente em adultos, mais estudos ainda são necessários.

Predictors of overload in parents of children with neuromuscular diseases

Introduction

Parents of children with neuromuscular diseases experience multiple difficulties in their daily lives that affect their physical and psychological health. The risk factors for these health issues have not been sufficiently investigated. Therefore, the aim of this study was to analyze the potential predictors of overload in these parents, including QoL, somatic symptomatology, life satisfaction, psychological adjustment and certain sociodemographic variables.

Methods

A cross-sectional research study was conducted among parents who are caregivers for children with NMD in Spain. A convenience sample of 110 parents who were contacted by associations and hospitals was used. Variables were evaluated using the sociodemographic questionnaire, CarerQol-7D, PHQ-15, Barthel Index, Psychological Adaptation Scale, Zarit Overload Scale and Satisfaction with Life Scale.

Results

One of the most relevant findings of the present study is the identification of 3 overload groups (mild to moderate, moderate to severe, and severe overload) based on life satisfaction and somatic symptom scores within the predictive model of the discriminate analysis. Wilk's lambda of the discriminant function was 0.568, χ2 (2, n = 55) = 8.815, p < 0.001.

Discussion

This study presents a model that reveals the influence of unemployment, having a child with a severe level of dependency, the presence of somatic symptomatology and life satisfaction on caregiver overload. Likewise, the caregiver's self-esteem could be a protective factor against overload.