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Araneda R, Sizonenko SV, Newman CJ, Dinomais M, Le Gal G, Ebner-Karestinos D, Paradis J, Klöcker A, Saussez G, Demas J, Bailly R, Bouvier S, Nowak E, Guzzetta A, Riquelme I, Brochard S, Bleyenheuft Y. Protocol of changes induced by early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (e-HABIT-ILE) in pre-school children with bilateral cerebral palsy: a multisite randomized controlled trial. BMC Neurol 2020; 20:243. [PMID: 32532249 PMCID: PMC7291688 DOI: 10.1186/s12883-020-01820-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/03/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Cerebral palsy (CP), which is the leading cause of motor disability during childhood, can produce sensory and cognitive impairments at different degrees. Most recent therapeutic interventions for these patients have solely focused on upper extremities (UE), although more than 60% of these patients present lower extremities (LE) deficits. Recently, a new therapeutic concept, Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE), has been proposed, involving the constant stimulation of UE and LE. Based on motor skill learning principles, HABIT-ILE is delivered in a day-camp setting, promoting voluntary movements for several hours per day during 10 consecutive week days. Interestingly, the effects of this intervention in a large scale of youngsters are yet to be observed. This is of interest due to the lack of knowledge on functional, neuroplastic and biomechanical changes in infants with bilateral CP. The aim of this randomized controlled study is to assess the effects of HABIT-ILE adapted for pre-school children with bilateral CP regarding functional, neuroplastic and biomechanical factors. METHODS This international, multicentric study will include 50 pre-school children with CP from 12 to 60 months of age, comparing the effect of 50 h (2 weeks) of HABIT-ILE versus regular motor activity and/or customary rehabilitation. HABIT-ILE presents structured activities and functional tasks with continuous increase in difficulty while the child evolves. Assessments will be performed at 3 period times: baseline, two weeks later and 3 months later. The primary outcome will be the Gross Motor Function Measure 66. Secondary outcomes will include Both Hands Assessment, Melbourne Assessment-2, Semmes-Weinstein Monofilament Test, algometry assessments, executive function tests, ACTIVLIM-CP questionnaire, Pediatric Evaluation of Disability Inventory (computer adaptative test), Young Children's Participation and Environment Measure, Measure of the Process of Care, Canadian Occupational Performance Measure, neuroimaging and kinematics. DISCUSSION The results of this study should highlight the impact of a motor, intensive, goal-directed therapy (HABIT-ILE) in pre-school children at a functional, neuroplastic and biomechanical level. In addition, this changes could demonstrated the impact of this intervention in the developmental curve of each child, improving functional ability, activity and participation in short-, mid- and long-term. NAME OF THE REGISTRY Evaluation of Functional, Neuroplastic and Biomechanical Changes Induced by an Intensive, Playful Early-morning Treatment Including Lower Limbs (EARLY-HABIT-ILE) in Preschool Children With Uni and Bilateral Cerebral Palsy (HABIT-ILE). TRIAL REGISTRATION NCT04017871 REGISTRATION DATE: July 12, 2019.
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Affiliation(s)
- Rodrigo Araneda
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
| | - Stephane V. Sizonenko
- Division of Child Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - Christopher J. Newman
- Paediatric Neurology and Neurorehabilitation Unit, University Hospital of Lausanne, Lausanne, Switzerland
| | - Mickael Dinomais
- Département de Médecine Physique et de Réadaptions, CHU Angers-Capucins, Angers, France
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, Université d’Angers, Angers, France
| | - Gregoire Le Gal
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - Daniela Ebner-Karestinos
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
| | - Julie Paradis
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Anne Klöcker
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
- Haute Ecole Léonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - Geoffroy Saussez
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
| | - Josselin Demas
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, Université d’Angers, Angers, France
- Institut Régional de Formation aux Métiers de Rééducation et de Réadaptation (IFM3R), Nantes, France
| | - Rodolphe Bailly
- Pediatric rehabilitation department, Fondation Ildys, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Western Britany University, Brest, France
| | - Sandra Bouvier
- University Hospital of Brest, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Western Britany University, Brest, France
| | - Emmanuel Nowak
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy and Research Institute on Health Sciences (UINICS-Idisba), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Sylvain Brochard
- University Hospital of Brest, Brest, France
- Pediatric rehabilitation department, Fondation Ildys, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Western Britany University, Brest, France
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
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Araneda R, Sizonenko SV, Newman CJ, Dinomais M, Le Gal G, Nowak E, Guzzetta A, Riquelme I, Brochard S, Bleyenheuft Y. Functional, neuroplastic and biomechanical changes induced by early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (e-HABIT-ILE) in pre-school children with unilateral cerebral palsy: study protocol of a randomized control trial. BMC Neurol 2020; 20:133. [PMID: 32290815 PMCID: PMC7155331 DOI: 10.1186/s12883-020-01705-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/27/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Cerebral palsy (CP) causes motor, cognitive and sensory impairment at different extents. Many recent rehabilitation developments (therapies) have focused solely on the upper extremities (UE), although the lower extremities (LE) are commonly affected. Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) applies the concepts of motor skill learning and intensive training to both the UE and LE. It involves constant stimulation of the UE and LE, for several hours each day over a 2-week period. The effects of HABIT-ILE have never been evaluated in a large sample of young children. Furthermore, understanding of functional, neuroplastic and biomechanical changes in infants with CP is lacking. The aim of this study is to carry out a multi-center randomized controlled trial (RCT) to evaluate the effects of HABIT-ILE in pre-school children with unilateral CP on functional, neuroplastic and biomechanical parameters. METHODS This multi-center, 3-country study will include 50 pre-school children with CP aged 1-4 years. The RCT will compare the effect of 50 h (two weeks) of HABIT-ILE versus usual motor activity, including regular rehabilitation. HABIT-ILE will be delivered in a day-camp setting, with structured activities and functional tasks that will be continuously progressed in terms of difficulty. Assessments will be performed at 3 intervals: baseline (T0), two weeks later and 3 months later. Primary outcomes will be the Assisting Hand Assessment; secondary outcomes include the Melbourne Assessment-2, executive function assessments, questionnaires ACTIVLIM-CP, Pediatric Evaluation of Disability Inventory, Young Children's Participation and Environment Measure, Measure of the Process of Care, Canadian Occupational Performance Measure, as well as neuroimaging and kinematics measures. DISCUSSION We expect that HABIT-ILE will induce functional, neuroplastic and biomechanical changes as a result of the intense, activity-based rehabilitation process and these changes will impact the whole developmental curve of each child, improving functional ability, activity and participation in the short-, mid- and long-term. Name of the registry: Changes Induced by Early HABIT-ILE in Pre-school Children With Uni- and Bilateral Cerebral Palsy (EarlyHABIT-ILE). TRIAL REGISTRATION Trial registration number: NCT04020354-Registration date on the International Clinical Trials Registry Platform (ICTRP): November 20th, 2018; Registration date on NIH Clinical Trials Registry: July 16th, 2019.
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Affiliation(s)
- R Araneda
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200, Brussels, Belgium
| | - S V Sizonenko
- Division of Child Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - C J Newman
- Paediatric Neurology and Neurorehabilitation Unit, University Hospital of Lausanne, Lausanne, Switzerland
| | - M Dinomais
- CHU Angers, Département de Médecine Physique et de Réadaptions, CHU Angers-Capucins, Angers, France
- Université d'Angers, Laboratoire Angevin de Recherche en Ingénierie des Systèmes, (LARIS) - EA7315, Angers, France
| | - G Le Gal
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - E Nowak
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - A Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I Riquelme
- Department of Nursing and Physiotherapy and Research Institute on Health Sciences (UINICS-Idisba), University of the Balearic Islands, Palma de Mallorca, Spain
| | - S Brochard
- University Hospital of Brest, Brest, France
- Western Britany University, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Pediatric rehabilitation department, Fondation Ildys, Brest, France
| | - Y Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200, Brussels, Belgium.
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Dekker C, van Haastregt JCM, Verbunt JAMCF, de Jong JR, van Meulenbroek T, Pernot HFM, van Velzen AD, Bastiaenen CHG, Goossens MEJB. Pain-related fear in adolescents with chronic musculoskeletal pain: process evaluation of an interdisciplinary graded exposure program. BMC Health Serv Res 2020; 20:213. [PMID: 32171308 PMCID: PMC7071667 DOI: 10.1186/s12913-020-5053-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 02/28/2020] [Indexed: 12/20/2022] Open
Abstract
Background For studying the effectiveness of treatment, it is important to check whether a new treatment is performed as originally described in the study-protocol. Objectives To evaluate whether an interdisciplinary graded exposure program, for adolescents with chronic musculoskeletal pain reporting pain-related fear, was performed according to protocol, and whether it is feasible to implement the program in rehabilitation care. Methods A process evaluation where quantitative and qualitative data on participant characteristics (adolescents, parents and therapists), attendance and participants’ opinion on the program were collected, by means of registration forms, questionnaires and group interviews. To evaluate treatment fidelity, audio and video recordings of program sessions were analyzed. Results Thirty adolescents were offered the program, of which 23 started the program. Adolescents attended on average 90% of the sessions. At least one parent per adolescent participated in the program. Analysis of 20 randomly selected recordings of treatment sessions revealed that treatment fidelity was high, since 81% of essential treatment elements were offered to the adolescents. The program was considered client-centered by adolescents and family-centered by parents. Treatment teams wished to continue offering the program in their center. Conclusion The interdisciplinary graded exposure program was performed largely according to protocol, and therapists, adolescents and their parents had a favorable opinion on the program. Implementation of the program in rehabilitation care is considered feasible. Trial registration Clinicaltrials.gov ID: NCT02181725 (7 February 2014).
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Affiliation(s)
- C Dekker
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Functioning and Rehabilitation, Maastricht University, Universiteitssingel 40, 6229, ET, Maastricht, the Netherlands
| | - J C M van Haastregt
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - J A M C F Verbunt
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Functioning and Rehabilitation, Maastricht University, Universiteitssingel 40, 6229, ET, Maastricht, the Netherlands. .,Adelante, Center of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands.
| | - J R de Jong
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Functioning and Rehabilitation, Maastricht University, Universiteitssingel 40, 6229, ET, Maastricht, the Netherlands.,Adelante, Center of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands
| | - T van Meulenbroek
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Functioning and Rehabilitation, Maastricht University, Universiteitssingel 40, 6229, ET, Maastricht, the Netherlands.,Adelante, Center of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands
| | - H F M Pernot
- Medicine, Laurentius Hospital Roermond, Roermond, the Netherlands
| | | | - C H G Bastiaenen
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Functioning and Rehabilitation, Maastricht University, Maastricht, the Netherlands
| | - M E J B Goossens
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Functioning and Rehabilitation, Maastricht University, Universiteitssingel 40, 6229, ET, Maastricht, the Netherlands.,Department of Clinical Psychological Sciences, Experimental Psychopathology, Maastricht University, Maastricht, the Netherlands
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An M, Kim JG, Kim J. Measure of processes of care (MPOC): Translation and validation for use in Korea. Child Care Health Dev 2018; 44:545-551. [PMID: 29913052 DOI: 10.1111/cch.12577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 04/11/2018] [Accepted: 04/13/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The measure of processes of care (MPOC) is a widely used instrument to assess parents' perception of the extent to which healthcare services they and their child receive are family centred. The purpose of this study was to examine the reliability and validity of the Korean translation of the MPOC (Korean MPOC). METHODS The Korean MPOC was completed by 198 parents of children receiving rehabilitation services in five provinces in South Korea. According to the Canadian validation procedures, analyses for internal consistency, construct and concurrent validity, and test-retest reliability were performed. RESULTS The Korean MPOC demonstrated adequate internal consistency, with Cronbach's alpha ranging from .85 to .98. Confirmative analyses of the scale structure support the construct validity of the Korean MPOC. The Pearson correlations r between the MPOC scale scores and Client Satisfaction Inventory score ranged from .60 to .83, supporting the concurrent validity of the Korean MPOC. The intraclass correlation coefficients were greater than .80 for all five scales, demonstrating good test-retest reliability. CONCLUSIONS The Korean MPOC has good psychological properties and can be recommended for evaluation of processes of paediatric rehabilitation in Korea.
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Affiliation(s)
- M An
- Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - J G Kim
- Department of Physical Therapy, U1 University, Chungcheongbuk-do, Korea
| | - J Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Daegudae-ro, Jillyang-eup, Gyeongsan-si, Gyeongsangbuk-do, Korea
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Quality of life of Hurler syndrome patients after successful hematopoietic stem cell transplantation. Blood Adv 2017; 1:2236-2242. [PMID: 29296871 DOI: 10.1182/bloodadvances.2017011387] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/11/2017] [Indexed: 11/20/2022] Open
Abstract
Hurler syndrome (HS) is a lysosomal storage disease characterized by multisystem morbidity and death in early childhood. Hematopoietic stem cell transplantation (HSCT) results in long-term survival, although with significant residual disease burden. How this residual disease affects the health-related quality of life is unknown. Therefore, we conducted a multicenter cohort study on functional and psychosocial health and compared the outcomes to normative data using the Child Health Questionnaire and Pediatric Outcomes Data Collection Instrument. Perception of care was evaluated by the Measure of Processes of Care questionnaire. Sixty-three HS patients receiving HSCT with at least 3 years of follow-up after HSCT were included. The influence of potential predictors was analyzed using linear regression analysis, and correlation analysis was performed using Spearman rank correlation. Functional health of transplanted HS patients was significantly diminished compared with normative data (median physical summary z score, -2.4 [range, -3.5 to -1.6]; median global functioning z score, -3.2 [range, -4.8 to -1.8]). Psychosocial health was comparable or only slightly reduced compared with healthy peers (median psychosocial summary z score, 0.15 [range, -0.7 to 0.8]). A higher obtained lysosomal enzyme level post-HSCT predicted for superior functional health. Overall, parents were satisfied with the care received. Functional health of transplanted HS patients appeared significantly more affected than psychosocial health. To improve functional health, the use of only noncarrier donors and striving to achieve full-donor chimerism, both resulting in higher enzyme levels, is advised. Assessing the health-related quality of life could play an important role in evaluating outcomes of HS patients receiving novel (cell) therapies, including autologous gene-transduced HSCT.
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Joachim KC, Wilk P, Ryan BL, Speechley KN. Family-centered care in children with epilepsy: Evaluating the Measure of Processes of Care (MPOC-20). Epilepsia 2016; 57:1660-1668. [DOI: 10.1111/epi.13494] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Kariym C. Joachim
- Department of Epidemiology & Biostatistics; Western University; London Ontario Canada
- Children's Health Research Institute; Lawson Health Research Institute; London Ontario Canada
| | - Piotr Wilk
- Department of Epidemiology & Biostatistics; Western University; London Ontario Canada
- Children's Health Research Institute; Lawson Health Research Institute; London Ontario Canada
- Department of Paediatrics; Western University; London Ontario Canada
| | - Bridget L. Ryan
- Department of Epidemiology & Biostatistics; Western University; London Ontario Canada
- Department of Family Medicine; Western University; London Ontario Canada
| | - Kathy N. Speechley
- Department of Epidemiology & Biostatistics; Western University; London Ontario Canada
- Children's Health Research Institute; Lawson Health Research Institute; London Ontario Canada
- Department of Paediatrics; Western University; London Ontario Canada
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Dekker C, Goossens MEJB, Bastiaenen CHG, Verbunt JAMCF. Study protocol for a multicentre randomized controlled trial on effectiveness of an outpatient multimodal rehabilitation program for adolescents with chronic musculoskeletal pain (2B Active). BMC Musculoskelet Disord 2016; 17:317. [PMID: 27464953 PMCID: PMC4964076 DOI: 10.1186/s12891-016-1178-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 07/21/2016] [Indexed: 11/10/2022] Open
Abstract
Background Chronic musculoskeletal pain (CMP) in adolescents can influence functioning and well-being, and has negative consequences for families and society as well. According to the Fear Avoidance Model, fear of movement and pain catastrophizing can influence the occurrence and maintenance of chronic pain complaints and functional disability. Primary objective is to evaluate the effectiveness of a multimodal rehabilitation program in reducing functional disability for adolescents with CMP compared with care as usual. Methods/Design Pragmatic multicentre parallel group randomized controlled trial. Randomization by minimization (ratio 1:1) and treatment allocation will be concealed, computer-generated and performed by an independent organization. After randomization, data collection and researchers remain blinded. Inclusion of 124 adolescents and their parents is intended. This sample size is based on a 25 % difference in group mean on the primary outcome, with α = 5 %, β = 80 % and expected 15 % loss to follow up. Study population are adolescents (12–21 years) with CMP with an indication for outpatient rehabilitation treatment in the Netherlands. The intervention group receives a Multimodal Rehabilitation Program (MRP), a multidisciplinary outpatient individual rehabilitation program. MRP consists of 2 different treatment approaches: A graded exposure module or a combination module of graded exposure and physical training. Selection of a module depends on the needs of the patient. To both modules a parent module is added. The control group receives care as usual, which is the care currently provided in Dutch rehabilitation centres. Treatment duration varies between 7 and 16 weeks, depending on treatment allocation. Self-reported measurements are at baseline, and at 2, 4, 10 and 12 months after start of treatment. Intention to treat analysis for between group differences on all outcome variables will be performed. Primary outcome is functional disability (Functional Disability Inventory). Secondary outcome variables are fear of pain, catastrophizing, perceived harmfulness, pain intensity, depressive symptoms, and quality of life. Total direct and indirect costs and health related quality of life will be measured. Process evaluation focuses on protocol adherence, patient centeredness and treatment expectations. Discussion A pragmatic approach was chosen, to ensure that results obtained are most applicable to daily practice. Trial registration Clinicaltrials.gov ID: NCT02181725 (7 February 2014). Funded by Fonds Nuts Ohra, Stichting Vooruit, and Adelante.
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Affiliation(s)
- Carolien Dekker
- Department of Rehabilitation Medicine, CAPHRI, Program Functioning and Rehabilitation, Maastricht University, Postbus 616, 6200 MD, Maastricht, The Netherlands.
| | - Mariëlle E J B Goossens
- Department of Rehabilitation Medicine, CAPHRI, Program Functioning and Rehabilitation, Maastricht University, Postbus 616, 6200 MD, Maastricht, The Netherlands.,Department of Clinical Psychological Sciences, EPP, Maastricht University, Maastricht, The Netherlands
| | - Caroline H G Bastiaenen
- Department of Epidemiology, CAPHRI, Program Functioning and Rehabilitation, Maastricht University, Maastricht, The Netherlands
| | - Jeanine A M C F Verbunt
- Department of Rehabilitation Medicine, CAPHRI, Program Functioning and Rehabilitation, Maastricht University, Postbus 616, 6200 MD, Maastricht, The Netherlands.,Maastricht University Medical Centre, Maastricht, The Netherlands.,Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
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Stefánsdóttir S, Thóra Egilson S. Diverging perspectives on children’s rehabilitation services: a mixed-methods study. Scand J Occup Ther 2015; 23:374-82. [DOI: 10.3109/11038128.2015.1105292] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Groleger Sršen K, Vidmar G, Zupan A. Validity, internal consistency reliability and one-year stability of the Slovene translation of the Measure of Processes of Care (20-item version). Child Care Health Dev 2015; 41:569-80. [PMID: 25297060 DOI: 10.1111/cch.12198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Measure of Processes of Care (MPOC) was developed as a self-administered questionnaire for parents to report on behaviours of healthcare providers. The original (MPOC-56) and the 20-item version (MPOC-20) have established reliability and validity, but the instrument must be rechecked whenever translated and applied in a different social and cultural setting. The aim of our study was to evaluate validity, internal consistency reliability and 1-year stability of the Slovene translation of MPOC-20. METHODS Parents of children who were admitted as inpatients or outpatients of several hospitals and health centres were invited to participate. MPOC-20, the Client Satisfaction Questionnaire (CSQ-8) and a separate question on stress and worries were sent by mail. Descriptive item analysis was performed. Cronbach's alpha coefficient and corrected item-total correlations were used to assess internal consistency for each of the five MPOC-20 subscales. To evaluate validity, we correlated the MPOC-20 subscale scores with CSQ-8 scores and a stress alleviation rating. Assessment with MPOC-20 was performed again 1 year later and we used paired-samples tests to compare mean scores of both assessments. RESULTS Parents of 235 children participated in the study (80% mothers). They reported high general satisfaction as 15 out of the 20 MPOC-20 mean item scores were above 5 (out of 7) and none was below 4. The mean MPOC-20 mean subscale scores were 5.83 (SD 1.10) for Coordinated and Comprehensive Care for Child and Family, 5.62 (SD 1.12) for Respectful and Supportive Care, 5.45 (SD 1.23) for Enabling and Partnership, 5.33 (SD 1.61) for Providing Specific Information about the Child and 4.59 (SD 1.65) for Providing General Information. The ranking order of the mean rating of the MPOC-20 subscales was similar to previous studies. The parents reported that they felt their stress and worries had been notably or slightly reduced through the process of care in the last year in more than two-thirds of the cases. All the MPOC-20 subscales (as well as the CSQ-8 scale) showed high internal consistency: the corrected item-total correlations were far above the lower limit for item's acceptance of 0.3. After 1 year (66 returned questionnaires) none of the mean subscale scores changed statistically significantly (P-values 0.159-0.910). CONCLUSION The Slovene translation of the MPOC-20 can be considered as a valid and reliable instrument that shows good stability over a period of 1 year, and as such it can be adopted in clinical practice.
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Affiliation(s)
- K Groleger Sršen
- Department for Children Rehabilitation, University Rehabilitation Institute, Ljubljana, Republic of Slovenia
| | - G Vidmar
- Biostatistics and Scientific Informatics, University Rehabilitation Institute, Ljubljana, Republic of Slovenia
| | - A Zupan
- University Rehabilitation Institute, Ljubljana, Republic of Slovenia
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Wang M, Petrini MA, Guan Q. Evaluation of family-centred services from parents of Chinese children with cerebral palsy with the Measure of Processes of Care. Child Care Health Dev 2015; 41:408-15. [PMID: 25081418 DOI: 10.1111/cch.12183] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Family-centred service (FCS) has become essential to parents of children with cerebral palsy (CP) and professionals in Chinese paediatric rehabilitation services. FCS practice meets the unique needs of the child and family, through facilitation of optimal service provision delivered by professionals, and ensures service systems to be flexible, appropriate and actively responsive to the family needs. Parents used the Measure of Processes of Care 20 (MPOC-20) questionnaire to evaluate and verify the efficacy of use in China. The aims of the present study were twofold: to assess the validity and reliability of the Chinese MPOC-20, and investigate the range of parents' satisfaction with service provision in an FCS practice using the MPOC-20. METHODS The Chinese MPOC-20 was selected to assess parent satisfaction with service provision of professionals in FCS practice. Participants were parents of children under 8 years of age with CP, who had received rehabilitation services between May 2012 and May 2013, and were receiving rehabilitation services in May 2013 at a hospital outpatient department and a rehabilitation centre. RESULTS The reliability and validity of the Chinese MPOC-20 were confirmed. Parents evaluated FCS practice with the MPOC-20 survey. Respectful and supportive care was rated with the highest score and providing general information the lowest. Parents according to the data were dissatisfied with the lack of information. CONCLUSIONS Parents fairly evaluated service provision of professionals in FCS practice with the Chinese MPOC-20. Professionals received feedback reports of parents, summaries of the inadequacy of service delivery, and developed and implemented ameliorated measures in the FCS policy to strive to provide exemplary service.
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Affiliation(s)
- M Wang
- Department of Critical Care and Community Nursing, School of Nursing, Jilin Medical College, Changchun, Jilin, China
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McDowell BC, Duffy C, Parkes J. Service use and family-centred care in young people with severe cerebral palsy: a population-based, cross-sectional clinical survey. Disabil Rehabil 2015; 37:2324-9. [PMID: 25738910 DOI: 10.3109/09638288.2015.1019649] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess healthcare use and family perception of family-centred care in children and young adults with severe cerebral palsy (CP) within a geographical region of the UK. METHOD Young people (4-27years) with severe forms of CP; Gross Motor Function Classification System levels IV and V, were recruited via an established case register. Data were collected in the participant's home using a standardised background proforma and validated questionnaires. The Measure of Processes of Care was used to assess the family's perception of family-centred care. RESULTS One-hundred and twenty-three children, young people and their families/guardians participated. Results showed high accessing of specialist services in childhood with a considerable decrease in young adults. Use of generalist services remained relatively constant. The reported use of formal respite services and support groups/youth clubs was relatively poor. Family-centred care was poor in the area of "providing general information" (2.8 ± 1.73) but more moderate in the areas of "providing specific information about the young person" (4.2 ± 1.94), "enabling and partnership" (4.2 ± 1.9), "co-ordinated and comprehensive care" (4.3 ± 1.95) and "respectful and supportive care" (4.7 ± 1.75). CONCLUSIONS The accessing of specialist services and respite care notably decreases amongst adolescents with severe forms of CP and the perception of family-centred care amongst families was fair at best. In particular, the results highlight the need for families to be provided with more general information and advice. Implications for Rehabilitation In a quest to enhance the rehabilitation process in young people with severe forms of cerebral palsy: Commissioners and service providers need to a adopt a more rationalised, needs led approach to service provision across the lifespan of people with severe forms of cerebral palsy, to include an effective and efficient transitional period. Habilitation specialists working with young adults need to continue to recognise the importance of family-centred care in managing this complex and chronic condition. Professionals working within the healthcare system must provide better communication and improve their dissemination of information to the families of children and young people with complex needs.
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Affiliation(s)
- B C McDowell
- a Belfast Health and Social Care Trust, Musgrave Park Hospital, Stockman's Lane , Belfast , Northern Ireland , UK and
| | - C Duffy
- a Belfast Health and Social Care Trust, Musgrave Park Hospital, Stockman's Lane , Belfast , Northern Ireland , UK and
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- b School of Nursing and Midwifery, Queen's University Belfast , Belfast , Northern Ireland , UK
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Cunningham BJ, Rosenbaum PL. Measure of processes of care: a review of 20 years of research. Dev Med Child Neurol 2014; 56:445-52. [PMID: 24283936 DOI: 10.1111/dmcn.12347] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2013] [Indexed: 01/18/2023]
Abstract
AIM This article reviews literature on findings from the Measure of Processes of Care (MPOC) to assess family-centred services. METHOD Systematic searches for papers citing MPOC in both PubMed and Web of Science identified 107 articles. Fifty-five met the criterion for inclusion in this review in that they reported MPOC data. RESULTS Over the past 20 years MPOC has been used in settings additional to the children's treatment centres for which it was designed; used in 11 countries and translated into 14 languages; and used to measure change in respondents' perceptions over time. MPOC findings have also informed our understanding of the provision of family-centred services. Overall, parents report that service providers do a good job of providing respectful, comprehensive services in partnership with families, but that there remain limitations in the provision of general information, an area for improvement. Finally, MPOC has been shown to correlate with various other measures related to the provision of family-centred services. INTERPRETATION The MPOC 'family' of measures can be used to assess both families' and service providers' experiences and perceptions of the family-centredness of services received/provided. Opportunities abound for further research enquiries.
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Affiliation(s)
- Barbara J Cunningham
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
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13
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Patients' priorities regarding outpatient physiotherapy care: A qualitative and quantitative study. ACTA ACUST UNITED AC 2013; 18:155-64. [DOI: 10.1016/j.math.2012.09.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Revised: 09/18/2012] [Accepted: 09/21/2012] [Indexed: 11/18/2022]
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Hagen AK, Bjorbækmo WS. Parents evaluation of the processes of care in child rehabilitation: a reliability study of the Norwegian translation of MPOC-20. Child Care Health Dev 2012; 38:48-53. [PMID: 21198778 DOI: 10.1111/j.1365-2214.2010.01192.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The objective was to assess the reliability of the Norwegian translation of the Canadian Measure of Processes of Care-20 (MPOC-20) questionnaire for use in child rehabilitation in Norway. MPOC-20 is a standardized questionnaire with 20 items and 5 scales that assesses to what extent parents experience that the services offered to them and their children are in line with the ideologies and principles of the family-centred service (FCS). METHODS The translation of MPOC-20 was performed according to international standards for translation of questionnaires. A pilot study was carried out with representatives from four patient advocacy organizations. A test-retest reliability study was performed. MPOC-20 (N) was sent to the participants twice with 2- to 6-week intervals. Participants were 36 parents of 25 children aged 0-18 years. Response rate was 41.8%. RESULTS The intraclass correlations (ICCs) for test-retest scores ranged 0.78-0.86. The internal consistency expressed as Cronbach's alpha ranged 0.62-0.93; the score was high for four of the scales and acceptable for the fifth 'Providing specific information'. These findings strongly suggest that the five scales of MPOC-20 (N) have good test-retest reliability. Average scores of each scale did not differ significantly between the first and second rating, indicating that the average scores of the ratings are stable. CONCLUSIONS The Measure of Processes of Care-20 (N) appears to be reliable and useful in the Norwegian context, and can be recommended for evaluation of the processes of child rehabilitation(1) in Norway.
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Affiliation(s)
- A-K Hagen
- Østfold Hospital Trust, Child habilitation Centre, Fredrikstad, Norway.
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15
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Rosenbaum P. Family and quality of life: key elements in intervention in children with cerebral palsy. Dev Med Child Neurol 2011; 53 Suppl 4:68-70. [PMID: 21950398 DOI: 10.1111/j.1469-8749.2011.04068.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Modern thinking about children's health, as embodied in the framework of the World Health Organization's International Classification of Functioning, Disability and Health - Child and Youth Version, requires that we be attentive to the 'context' of children's lives, namely their families and the well-being of their families. Family-centred services provide both a guide to the 'processes' of service by service providers and measurable evidence-based outcomes that link better 'processes' with better parental 'outcomes'. This brief paper provides an overview of these topics, arguing that the themes we address in services, and the way we do that, can have important effects on families, and by extension, on their children.
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Affiliation(s)
- Peter Rosenbaum
- Faculty of Health Sciences, Institute for Applied Health Sciences, McMaster University, Hamilton, ON, Canada.
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Camden C, Swaine B, Tétreault S, Brodeur MM. Reorganizing pediatric rehabilitation services to improve accessibility: do we sacrifice quality? BMC Health Serv Res 2010; 10:227. [PMID: 20687932 PMCID: PMC2924331 DOI: 10.1186/1472-6963-10-227] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Accepted: 08/05/2010] [Indexed: 11/10/2022] Open
Abstract
Background The impact of a pediatric rehabilitation service delivery reorganization to improve access to services on parents' and service providers' perception of service quality was evaluated. Child-, family-, service- and service provider-related characteristics possibly associated with these perceptions were explored. Methods Perceptions were measured using the Measure of Processes of Care tools and open ended questions before (2007), during (2008) and following (2009) service reorganization. Child and family characteristics, services received and service provider data were documented. Mean MPOC scores were compared over time (ANOVAs and Generalized Estimating Equations) and t-tests, correlations and ANOVAs determined whether the characteristics influenced scores. Results Families' (n = 222) and service providers' (n = 129) perceptions of quality were high in 2007 (3.67 to 6.31/7) and remained high over the next 2 years (p ≥ 0.16). Two MPOC domain scores (Respectful care and Providing general information) were consistently scored the highest (mean ≥ 5.66/7) and the lowest (mean ≤ 4.75/7), respectively. Families with more education and those with children 12-21 years old tended to attribute lower MPOC scores. Participants were generally satisfied with the new service model and recommendations included improving information exchange. Conclusions Results suggest that it is possible to reorganize pediatric rehabilitation services while maintaining quality.
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Affiliation(s)
- Chantal Camden
- Estrie Rehabilitation Center, Sherbrooke, Québec, Canada.
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Mak WW, Kwok YT. Internalization of stigma for parents of children with autism spectrum disorder in Hong Kong. Soc Sci Med 2010; 70:2045-2051. [DOI: 10.1016/j.socscimed.2010.02.023] [Citation(s) in RCA: 191] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 12/10/2009] [Accepted: 02/12/2010] [Indexed: 11/27/2022]
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Saloojee GM, Rosenbaum PR, Westaway MS, Stewart AV. Development of a measure of family-centred care for resource-poor South African settings: the experience of using a modified version of the MPOC-20. Child Care Health Dev 2009; 35:23-32. [PMID: 19055651 DOI: 10.1111/j.1365-2214.2008.00914.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Measure of Processes of Care (MPOC) is a widely used tool to assess parents' self-reported experiences of family-centred behaviours of paediatric rehabilitation services. It has never been used in resource-constrained settings or in a cross-cultural environment where cultural and language differences may complicate effective implementation of family-centred services. In this study, the MPOC-20 was used as the starting point for the development of a measure of family-centred care in disadvantaged South African settings. The objective was to establish to what extent the MPOC-20 needed to be adapted for these settings. METHODS After modifying MPOC-20 through focus groups, the adapted scale was translated into six local languages. Trained interviewers administered the scale to a convenience sample of 267 caregivers of children aged between 1 and 18 years with a diagnosis of cerebral palsy living in poorly resourced areas in two provinces in South Africa. RESULTS The modified MPOC-20 was neither reliable nor valid in the new setting. Cronbach's alpha for each of the sub-scales varied between 0.30 and 0.66 while for the test-retest reliability, the Intraclass Correlation Coefficients were between 0.51 and 0.61. The first two criteria for item convergent validity were not met. Repeated multi-trait scaling identified eight items that when combined into a scale [named the MPOC-8(SA)] had acceptable reliability and validity. Factor analysis of the MPOC-8(SA) yielded two factors: an interpersonal factor and an informational factor. CONCLUSIONS Although extreme caution has to be used when using measures created in one socio-cultural setting in a different context, the MPOC-20 provides a useful starting point for the development of a measure of family-centred care in a poor resourced setting. Caregivers in different settings have more in common than they have differences. However, the process of asking the questions and the words used to capture caregivers' experiences needs to be different.
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Affiliation(s)
- G M Saloojee
- School of Therapeutic Sciences, University of the Witwatersand, Johannesburg, South Africa.
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Siebes RC, Nijhuis BJG, Boonstra AM, Ketelaar M, Wijnroks L, Reinders-Messelink HA, Postema K, Vermeer A. A family-specific use of the Measure of Processes of Care for Service Providers (MPOC-SP). Clin Rehabil 2007; 22:242-51. [DOI: 10.1177/0269215507081568] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To examine the validity and utility of the Dutch Measure of Processes of Care for Service Providers (MPOC-SP) as a family-specific measure. Design: A validation study. Setting: Five paediatric rehabilitation settings in the Netherlands. Main measures: The MPOC-SP was utilized in a general (reflecting on services provided for all clients and clients' families) and family-specific way (filled out in reference to a particular child and his or her family). Subjects: Professionals providing rehabilitation and educational services to children with cerebral palsy. Methods: For construct validity, Pearson's product-moment correlation coefficients (r ) between the scales were calculated. The ability of service providers to discriminate between general and family-specific ratings was examined by exploration of absolute difference scores. Results: One hundred and sixteen service professionals filled out 240 family-specific MPOC-SPs. In addition, a subgroup of 81 professionals filled out a general MPOC-SP. For each professional, family-specific and general scores were paired, resulting in 151 general—family-specific MPOC-SP pairs. The construct validity analyses confirmed the scale structure: 21 items (77.8%) loaded highest in the original MPOC-SP factors, and all items correlated best and significantly with their own scale score (r 0.565 to 0.897; P<0.001). Intercorrelations between the scales ranged from r = 0.159 to r = 0.522. In total, 94.4% of the mean absolute difference scores between general and family-specific scale scores were larger than the expected difference. Conclusion: Service providers were able to discriminate between general and family-specific MPOC-SP item ratings. The family-specific MPOC-SP is a valid measure that can be used for individual evaluation of family-centred services and can be the impetus for family-related quality improvement.
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Affiliation(s)
- RC Siebes
- Department of General and Special Education, Utrecht University, Utrecht,
| | - BJG Nijhuis
- Center for Rehabilitation and Northern Center for Health Care Research, University Medical Center Groningen, University of Groningen, Groningen
| | - AM Boonstra
- Rehabilitation Centre 'Revalidatie Friesland', Beetsterzwaag,
| | - M. Ketelaar
- Rehabilitation Centre and University Medical Centre, Department of Rehabilitation, Rudolf Magnus Institute of Neuroscience, Utrecht
| | - L. Wijnroks
- Department of General and Special Education, Utrecht University, Utrecht
| | | | - K. Postema
- Center for Rehabilitation and Northern Center for Health Care Research, University Medical Center Groningen, University of Groningen, Groningen
| | - A. Vermeer
- Department of General and Special Education, Utrecht University, Utrecht, The Netherlands
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Siebes RC, Wijnroks L, Ketelaar M, van Schie PEM, Vermeer A, Gorter JW. One-year stability of the Measure of Processes of Care. Child Care Health Dev 2007; 33:604-10. [PMID: 17725783 DOI: 10.1111/j.1365-2214.2007.00726.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.
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Affiliation(s)
- R C Siebes
- Langeveld Institute for the Study of Education and Development in Childhood and Adolescence, Utrecht University, Utrecht, The Netherlands.
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