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Rousseau MC, Winance M, Baumstarck K. Polyhandicap, profound intellectual multiple disabilities : Concept and definition of a highly specific public health issue. Rev Epidemiol Sante Publique 2023; 71:102184. [PMID: 37918043 DOI: 10.1016/j.respe.2023.102184] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVES The concept of polyhandicap first emerged in the late '60s in France, with actually a consensus on its definition. This consensus has yet to be reached internationally. The absence of an international consensus on a definition and name for persons with polyhandicap limits progress in research and health planning for these people. METHODS This article describes the history of the emergence of the concept of polyhandicap in France and internationally. RESULTS The emergence of the concept and definition of polyhandicap is part of the history of the development of special education and care for children with disabilities started at the end of the 19th century and during the first half of the 20th century. In France, between 1970 and 2002, working groups composed of professionals and family associations gradually developed and refined the definition of polyhandicap, differentiating it from other clinical entities such as cerebral palsy. Internationally, the term polyhandicap is used in 4 European countries: in France where it first appeared, in Italy, in French-speaking Belgium, and in French-speaking Switzerland but also outside the EU. Various terms may be used around the world to describe clinical entities similar to polyhandicap; the most frequently used in the literature is the term Profound Intellectual and Multiple Disabilities (PIMD) or PIMD Spectrum which does not systematically refer to an early brain injury. DISCUSSION We are currently in the process of internationalizing the concept and definition of polyhandicap, and hopefully, as was the case for cerebral palsy in the 2000s, the various research teams working on this subject around the world will create collaborations and research networks targeting this specific population. CONCLUSION A consensus around a precise definition of polyhandicap is important to ensure that these people are recognized for their uniqueness and specific qualities and to provide them adapted care.
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Affiliation(s)
- Marie-Christine Rousseau
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27 boulevard Jean-Moulin, 13385 Marseille, France; Hôpital San Salvadour, Hospital Fédération des Hôpitaux de Polyhandicap et Multihandicap, University Hospital of Paris, 4312 Rte de l'Almanarre, 83400 Hyères, France.
| | - Myriam Winance
- CERMES3, INSERM, Université Paris Cité, CNRS, EHESS, France
| | - Karine Baumstarck
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27 boulevard Jean-Moulin, 13385 Marseille, France; Epidemiology and Health Economy Department, Aix Marseille University, 27, boulevard Jean-Moulin, 13385 Marseille, France
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Oti-Boadi M, Osei-Tutu A, Mate-Kole CC. Challenges and support needs of parents of children with developmental disabilities (DD) in Accra, Ghana. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 128:104274. [PMID: 35753167 DOI: 10.1016/j.ridd.2022.104274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 05/05/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Parents of children with developmental disabilities (DD) have diverse challenges and needs. If met, these parents are able to provide adequate care for their children. Unfulfilled needs like information about their child's diagnosis, counselling, and poor access to informal and formal supports increase parental stress and hinder their potential to provide optimal care for their children and themselves. AIMS This study explores the unique challenges and needs of parents caring for children with DD in the Accra metropolis. This is the first study exploring the needs of parents in a Lower-middle income (LMIC) country like Ghana. METHODS AND PROCEDURES A qualitative research design was adopted for this study. Data was collected using semi-structured interviews from 9 parents of children with DD. RESULTS Findings from thematic analysis revealed five themes including; Emotional needs; Informational needs; Financial needs; Informal Support, and Formalized Support. Parents indicated their great need for information on their children's condition, support from family, religious groups, and other formalized institutions and how to provide better care. CONCLUSIONS AND IMPLICATIONS Parents have several expectations and needs which must be addressed. Findings have the potential of influencing the design and development of appropriate interventions to meet the needs and improve the quality of life of parents of children with DD in the Ghanaian context.
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Affiliation(s)
- M Oti-Boadi
- Department of Psychology/Center for Ageing Studies, University of Ghana, Accra, Ghana.
| | - A Osei-Tutu
- Department of Psychology, University of Ghana, Accra, Ghana.
| | - C C Mate-Kole
- Department of Psychology/Center for Ageing Studies, University of Ghana, Accra, Ghana.
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Milićević M. Exploring participation in family activities among Serbian children with cerebral palsy and children with typical development: diversity, frequency, children's presence, and engagement. Disabil Rehabil 2021; 44:1583-1594. [PMID: 34342549 DOI: 10.1080/09638288.2021.1958931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This study aimed to characterize the participation in family activities in two groups of children: children with cerebral palsy (CP group) and children with typical development (TD group), with regard to diversity, frequency, children's presence, and engagement. METHOD The convenience sample of this descriptive and comparative cross-sectional study conducted in Serbia included 48 children with CP and 74 children with TD, aged 7-12 years. Parents completed the Child Participation in Family Activities (Child-PFA) questionnaire. Mann-Whitney U test was used for data analysing. RESULTS Children with CP experienced less diverse and less frequent family activities compared to children with TD, with more pronounced differences in the diversity of family activities than in their frequency. In the occurring family activities, children with CP were present in a comparable proportion as children with TD. Once in an activity, children with CP were less engaged. CONCLUSIONS Our results confirmed that children with CP do not have the same opportunities to participate and be engaged in everyday family life activities as children with TD. Greater efforts are needed to address these differences and facilitate access to and engagement of children with CP in a variety of family activities.IMPLICATIONS FOR REHABILITATIONIn comparison to children with typical development, family activities are less diverse and less frequent in families of children with cerebral palsy, and children are less engaged, specifically when activities include family's or children's social network.In line with current practice, this study confirms the importance of addressing opportunities for children with cerebral palsy to be often and more engaged in everyday family life activities.Professionals should support a family context that optimizes the engagement of children with cerebral palsy in activities with other family members, thus providing them everyday natural learning opportunities.
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Affiliation(s)
- Milena Milićević
- Institute of Criminological and Sociological Research, Belgrade, Serbia
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Coussens M, Vitse F, Desoete A, Vanderstraeten G, Van Waelvelde H, Van de Velde D. Participation of young children with developmental disabilities: parental needs and strategies, a qualitative thematic analysis. BMJ Open 2021; 11:e042732. [PMID: 33795296 PMCID: PMC8021744 DOI: 10.1136/bmjopen-2020-042732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/17/2021] [Accepted: 03/09/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Participation refers to a person's involvement in activities and roles that provide interaction with others as well as engagement in family and community activities. Young children with developmental disabilities (DD) such as attention deficit hyperactive disorder, autism spectrum disorder and developmental coordination disorder are limited in their participation compared with their typically developing peers. This study aimed to obtain information regarding parental needs and strategies used to enable their child's participation. DESIGN A thematic inductive approach with in-depth interviews was used to explore parental experiences. Eleven women and two men, between 30 and 40 years of age, who had a child (4-9 years old) with a DD diagnosis based on Diagnostic and Statistical Manual of Mental Disorders criteria, participated in semistructured interviews. RESULTS Two central themes emerged: parental needs and parental strategies used to enable their child's participation. Parental needs were the following: increasing awareness, ameliorating parental burden, providing tailored interventions and supporting parents in finding suitable leisure activities. Parental strategies aimed at increasing their child's resiliency, attaining maximal fit between activity requirements and child capacity, and creating inclusive opportunities and awareness. CONCLUSIONS Understanding what families' needs are and how families use and integrate strategies within the context of their daily lives provides practitioners with insights needed to support families' resiliency in promoting their children's participation. The results have implications for professionals as this information can be used to inform, refine, or tailor participation-based and family-centred services.
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Affiliation(s)
- Marieke Coussens
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Floris Vitse
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Annemie Desoete
- Faculty of Psychology and Educational Sciences, Ghent University, Gent, Belgium
| | - Guy Vanderstraeten
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Hilde Van Waelvelde
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Dominique Van de Velde
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
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Edelstein H, Schippke J, Sheffe S, Kingsnorth S. Children with medical complexity: a scoping review of interventions to support caregiver stress. Child Care Health Dev 2017; 43:323-333. [PMID: 27896838 DOI: 10.1111/cch.12430] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 09/27/2016] [Accepted: 10/22/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Caring for children with chronic and complex medical needs places extraordinary stress on parents and other family members. A scoping review was undertaken to identify and describe the full range of current interventions for reducing caregiver stress. METHODS Applying a broad definition of caregiver stress, a systematic search of three scientific databases (CINAHL, Embase and Ovid Medline), a general internet search and hand searching of key peer-reviewed articles were conducted. Inclusion criteria were as follows: (i) published in English between 2004-2016; (ii) focused on familial caregivers, defined as parents, siblings or extended family; (iii) targeted children/youth with medical complexity between the ages of 1-24 years; and (iv) described an intervention and impact on caregiver stress. Data on type of intervention, study design and methods, measures and overall findings were extracted. RESULTS Forty-nine studies were included from a list of 22 339 unique titles. Six domains of interventions were found: care coordination models (n = 23); respite care (n = 8); telemedicine (n = 5); peer and emotional support (n = 6); insurance and employment benefits (n = 4); and health and related supports (n = 3). Across studies, there was a wide variety of designs, outcomes and measures used. CONCLUSIONS Positive findings of reductions in caregiver stress were noted within an emerging body of evidence on effective interventions for families of children with medical complexity. A commonality across domains was a significant focus on streamlining services and reducing the burden of care related to varied pressures experienced, including time, finances, care needs and service access, among others. There was non-conclusive evidence however around which of the six identified intervention domains or combination thereof are most effective for reducing stress. These promising findings demonstrate that stress reduction is possible with the right support and that multiple interventions may be effective in reducing burdens of care experienced by families of children with medical complexity.
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Affiliation(s)
- H Edelstein
- Evidence to Care, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - J Schippke
- Evidence to Care, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - S Sheffe
- Evidence to Care, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - S Kingsnorth
- Evidence to Care, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, and Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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von Granitz H, Reine I, Sonnander K, Winblad U. Do personal assistance activities promote participation for persons with disabilities in Sweden? Disabil Rehabil 2016; 39:2512-2521. [DOI: 10.1080/09638288.2016.1236405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Heléne von Granitz
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ieva Reine
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Karin Sonnander
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ulrika Winblad
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Boren T, Granlund M, Wilder J, Axelsson AK. Sweden's LSS and Social Integration: An Exploration of the Relationship between Personal Assistant Type, Activities, and Participation for Children with PIMD. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2016. [DOI: 10.1111/jppi.12146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Mats Granlund
- Jönköping University; Jönköping Sweden
- Oslo University; Oslo Norway
| | | | - Anna Karin Axelsson
- Jönköping University; Jönköping Sweden
- Swedish Institute for Disability Research (SIDR); Jönköping Sweden
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