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Leng LL, Huang S, Zhou LG. Perceived discrimination among caregivers of children with disabilities in China: Unraveling the effects of social determinants. Soc Sci Med 2024; 351:116991. [PMID: 38833767 DOI: 10.1016/j.socscimed.2024.116991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/05/2024] [Accepted: 05/15/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE Although discrimination has gained increasing attention in research and practice intervention for family caregivers of children with disabilities, little is known about the social determinants that associate with the perceived discrimination among caregivers, especially in non-Western contexts. This study aims to examine the socio-familial and child-level determinants of perceived discrimination among family caregivers of children with disabilities in China. METHOD This study drew from a population-based cross-sectional survey in Shenzhen, China. Proportional quota sampling was conducted to get data from 2500 family caregivers of children with disabilities in rehabilitation service centers (response rate = 94.9%, n = 2373), accounting for 25% of the total population of children with disabilities receiving service in Shenzhen. Latent profile analysis was conducted to categorize three perceived discrimination groups among caregivers (i.e., severe perceived discrimination group, moderate perceived discrimination group, and low perceived discrimination group). The multinomial logistic regression models were conducted to test the association between these social determinants and perceived discrimination. RESULTS Most caregivers (82.9%) reported moderate or severe levels of perceived discrimination. Caregivers of children with moderate and severe impairments and children with mental and multiple disabilities were more vulnerable to perceiving severe social discrimination. Socio-familial characteristics, particularly the intersectionality between gender and employment, influence caregivers' perceived discrimination. CONCLUSION Caregivers of children with disabilities experience pervasive social discrimination in contemporary urban China. Our study demonstrates that the social construction of disablism and the affiliate discrimination against family caregivers of children with disabilities is complex and multidimensional and depends upon the children's disability and the caregivers' socio-demographic characteristics.
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Affiliation(s)
- Ling Li Leng
- The Department of Sociology, Zhejiang University, Hangzhou, China.
| | - Shixin Huang
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong.
| | - Lin Gang Zhou
- Center for Disability Studies, Shenzhen University, Shenzhen, China.
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Krieger B, Moser A, Morgenthaler T, Beurskens AJHM, Piškur B. Parents' Perceptions: Environments and the Contextual Strategies of Parents to Support the Participation of Children and Adolescents with Autism Spectrum Disorder-A Descriptive Population-Based Study from Switzerland. J Autism Dev Disord 2024; 54:871-893. [PMID: 36538129 PMCID: PMC9765345 DOI: 10.1007/s10803-022-05826-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2022] [Indexed: 12/24/2022]
Abstract
Environments have a modifying effect on the participation of children and adolescents with autism spectrum disorder (ASD) in all areas of life. This cross-sectional study investigated parental perspectives on supportive or hindering environments and the daily contextual strategies parents used to enhance their children's participation. Qualitative and quantitative data gathered from 115 parents from German-speaking Switzerland using the participation and environment measure-child and youth (PEM-CY) were analyzed. Results revealed 45 environmental supports and barriers at home, at school, and in the community. Contextual strategies were identified in combination with people, activities, time, objects, and places. Parental perspectives on participation and their contextual strategies should be considered in environmental-based interventions to support the participation of children and adolescents with ASD.
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Affiliation(s)
- Beate Krieger
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina Sulzer Platz 9, 8401, Winterthur, Switzerland.
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands.
| | - Albine Moser
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands
- Research Centre for Autonomy and Participation for People With Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Thomas Morgenthaler
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina Sulzer Platz 9, 8401, Winterthur, Switzerland
| | - Anna J H M Beurskens
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands
| | - Barbara Piškur
- Research Centre for Autonomy and Participation for People With Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Kaelin VC, Saluja S, Bosak DL, Anaby D, Werler M, Khetani MA. Caregiver strategies supporting community participation among children and youth with or at risk for disabilities: a mixed-methods study. Front Pediatr 2024; 12:1345755. [PMID: 38425659 PMCID: PMC10902462 DOI: 10.3389/fped.2024.1345755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/15/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction The purpose of this mixed-methods study is to examine the role of caregiver strategies to support community participation among children and youth with disabilities and those at risk, from the caregiver perspective. For the quantitative phase, we tested the hypothesized positive effect of participation-focused caregiver strategies on the relationship(s) between participation-related constructs and community participation attendance and involvement. For the qualitative phase, we solicited caregiver perspectives to explain the quantitative findings. Methods An explanatory sequential mixed-methods design (QUAN > qual) was used. For the quantitative phase, we conducted secondary analyses of data collected during a second follow-up phase of a longitudinal cohort study, including 260 families of children and youth (mean age: 13.5 years) with disabilities and those at risk [i.e., 120 families of children and youth with craniofacial microsomia (CFM); 140 families of children and youth with other types of childhood-onset disabilities]. Data were collected through the Participation and Environment Measure-Children and Youth, the Pediatric Quality of Life Inventory, and the Child Behavior Checklist and analyzed using structural equation modeling. For the qualitative phase, we conducted semi-structured interviews with eight caregivers of children and youth with disabilities and those at risk (i.e., three caregivers of children and youth with CFM; five caregivers of children and youth with other childhood-onset disabilities). Interviews were transcribed verbatim and inductively content-analyzed. Results Our model reached acceptable to close model fit [CFI = 0.952; RMSEA = 0.068 (90% CI = 0.054-0.082); SRMR = 0.055; TLI = 0.936], revealing no significant effect of the number of participation-focused caregiver strategies on the relationships between participation-related constructs (e.g., activity competence, environment/context) and community participation in terms of attendance and involvement. The qualitative findings revealed three main categories for how caregivers explained these quantitative results: (1) caregiver workload and supports needed for implementing strategies; (2) caregivers careful strategy quality appraisal; and (3) community setting characteristics hindering successful strategy implementation. Discussion The findings suggest that the insignificant effect of the number of caregiver strategies may be explained by the intensified need for caregiver effort and support to develop and implement quality strategies that are responsive to community setting characteristics.
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Affiliation(s)
- Vera C. Kaelin
- Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States
- Computer Science, University of Illinois Chicago, Chicago, IL, United States
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
- Computing Science, Umeå University, Umeå, Sweden
| | - Shivani Saluja
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
| | - Dianna L. Bosak
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, CA, United States
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, CA, United States
| | - Martha Werler
- Epidemiology, Boston University, Boston, MA, United States
| | - Mary A. Khetani
- Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, CA, United States
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Velvin G, Johnsen V, Lidal IB, Berg E. Parental Intervention Program for Preschool children with Rare Diseases - a mixed methods evaluation of parents' experiences and utility. Orphanet J Rare Dis 2023; 18:327. [PMID: 37848938 PMCID: PMC10583464 DOI: 10.1186/s13023-023-02935-8] [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: 07/12/2023] [Accepted: 09/25/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND The purpose of this study was twofold: (i) To assess the parents' experiences and perception of participating in a "Parental Intervention Program for Preschool children with Rare Diseases" (PIPP-RDs). (ii) To evaluate which elements of the PIPP-RDs that the parents emphasized as important for improving their health literacy related to facilitating the transition of their children from kindergarten to school. METHOD A mixed methods evaluation study was conducted ten and eleven months post-intervention, integrating an online quantitative survey combined with individual semi-structured interviews. Twenty-two parents participated in individual interviews, of these 18 also responded to the online questionnaire survey. RESULTS All parents that participated in this study reported that the information conveyed at the program was of great value and utility, 88% reported significantly alleviated stress associated to their child`s school-start, 84% indicated had improved the school-home collaboration and 84% reported that it had encouraged them to establish contact with the school prior to school commencement. From the qualitative data five main themes emerged: (i) Competence and Knowledge Acquisition, (ii) Becoming more Prepared and Relaxed, (iii) Achieved Realistic Expectations, (iv) Enhanced Communication Skills, (v) Increased Health Literacy and Self-Efficacy. The evaluative findings suggest that this invention program has notably improved the parents' aptitude for school interaction, enhanced the adaptions according to children`s needs for accommodations, and has provided reassurance in the school-home collaboration. Parents also described increased self-confidence and self-efficacy in managing the school start for children with RDs. CONCLUSION The highly positive response of participating in PIPP-RDs may not only reflect the merits of the program`s content, but also underscore the significant needs for such support during the transition to school for parents of children with RDs. Comparable initiatives, oriented towards enhancing the health literacy and empowering the parents, are anticipated to yield similarly favourable results. We argue that intervention program amalgamate pertinent information, group discourse, and workshops on school-related issues, alongside opportunities for parents to meet other parents in similar situations.
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Affiliation(s)
- Gry Velvin
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesodden, Norway.
| | - Vigdis Johnsen
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Ingeborg Beate Lidal
- The Institute of Public Health, Norwegian Knowledge Centre for the Health Services, Oslo, Norway
| | - Ellen Berg
- School of Sport Sciences, Department of Teacher Education and Outdoor Life Studies, Oslo, Norway
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Beani E, Menici V, Sicola E, Ferrari A, Feys H, Klingels K, Mailleux L, Boyd R, Cioni G, Sgandurra G. Effectiveness of the home-based training program Tele-UPCAT (Tele-monitored UPper Limb Children Action Observation Training) in unilateral cerebral palsy: a randomized controlled trial. Eur J Phys Rehabil Med 2023; 59:554-563. [PMID: 37462399 PMCID: PMC10664769 DOI: 10.23736/s1973-9087.23.07945-5] [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: 02/24/2023] [Revised: 05/10/2023] [Accepted: 06/09/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND The effects of unilateral cerebral palsy (UCP) are largely observed in the upper limb (UL), which represents the main focus of rehabilitation for this disorder. Thanks to an increment in home training and progress in technology innovative systems have been created. The Tele-UPCAT (Tele-monitored UPper Limb Children Action Observation Training) platform is dedicated to the delivery at home of a program for UL rehabilitation, based on action observation therapy (AOT). AIM This study aimed to investigate the immediate effectiveness of Tele-UPCAT for promoting UL skills in children with UCP and to determine if immediate effects were retained in the medium and long term. DESIGN Tele-UPCAT was conducted on an intention-to-treat basis and was proposed as a randomized, allocation concealed (waitlist controlled) and evaluator-blinded clinical trial with two investigative arms: intensive in-home AOT program and standard care (SC). SETTING This is a home-based AOT program delivered with a customized ICT platform. POPULATION Thirty children (mean age 11.61±3.55 years) with confirmed diagnosis of spastic UCP with predominant UL involvement and cognitive level within or at normal limits were enrolled in this study. Orthopedic surgery or an intramuscular botulinum toxin A injection in the UL within 6 months prior to enrolment represented an exclusion criteria. METHODS Participants were randomized using concealed random allocation. They were assessed according to the study design with the Assisting Hand Assessment (AHA), the Box and Block Test (BBT) and the Melbourne Assessment 2 (MA2). Linear mixed models were used for statistical analysis. RESULTS A significant difference between the AOT and SC groups was identified immediately after the training on the AHA (6.406 [2.73] P=0.021) with an effect size (ES) of 1.99, and for the BBT of the less affected hand (9.826 [4.535] P=0.032) with an ES of 1.44. These effects were sustained at medium and long term. CONCLUSIONS This study supports the effectiveness of AOT home training in promoting UL skills in children with UCP, with immediate effects lasting for 6 months. CLINICAL REHABILITATION IMPACT This should encourage the use of technology for rehabilitative purposes and further applications of the AOT paradigm.
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Affiliation(s)
- Elena Beani
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valentina Menici
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
- University of Pisa, Pisa, Italy
| | - Elisa Sicola
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Adriano Ferrari
- Unit of Children Rehabilitation, IRCCS S. Maria Nuova Hospital, Reggio Emilia, Italy
| | - Hilde Feys
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium
| | - Katrijn Klingels
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium
- Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Hasselt, Belgium
| | - Lisa Mailleux
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium
| | - Roslyn Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Centre for Children's Health Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy -
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Varengue R, Brochard S, Bouvier S, Bailly R, Houx L, Lempereur M, Kandalaft C, Chatelin A, Vagnoni J, Vuillerot C, Gautheron V, Dheilly E, Pons C, Dinomais M, Cacioppo M. Perceived impact of lockdown on daily life in children with physical disabilities and their families during the COVID-19 pandemic. Child Care Health Dev 2022; 48:942-955. [PMID: 34964148 DOI: 10.1111/cch.12952] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 12/11/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The first lockdown during COVID-19 pandemic in France led to an abrupt change in children's daily lives. For children with physical disabilities and their families, activities were limited, access to healthcare and therapy was disrupted, and family organization was altered. The objective was to report the impact of the lockdown on daily life activities and well-being of children with physical disabilities as perceived by caregivers. METHODS Two online national surveys were addressed to the parents of children with physical disabilities (ECHO survey: 6 April to 11 May 2020) and without disabilities (E-COPAIN survey: 24 April to 11 May 2020), confined at home during the lockdown. A lockdown impact score was calculated from difficulties related to children's well-being (morale, behaviour and social interaction) and daily life activities (schooling and physical activity) and compared between groups. Data on family environment, parental stress and concerns were collected. RESULTS One thousand three hundred seventy-six children (9.45 ± 4.78 years, 54% girls) in ECHO survey and 367 children (7.3 ± 4.4 years, 48% girls) in E-COPAIN survey were included. A negative impact of lockdown was found on 81% of children with physical disabilities. Behavioural problems were significantly more frequent (59.5% vs. 47.4%, P < .005) and parental stress was higher (6.1 ± 3.33 vs. 5.3 ± 3.01, P = .005) in the ECHO group. Associated impairments (odds ratio [OR] = 1.45 [1.30-1.62], P < .001), parental stress (OR = 1.09 [1.06-1.12], P < .001) and continuation of rehabilitation (OR = 0.80 [0.72-0.89], P < .001) were determinants of the level of difficulty experienced. CONCLUSIONS The lockdown had a considerable, negative impact on the daily life of children with disabilities and their families. Guiding policymakers with the essential daily life activities and the services to provide for children with physical disabilities would offer valuable insights to manage such a sanitary crisis and allow to identify the most vulnerable population.
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Affiliation(s)
- Roxane Varengue
- Department of Pediatric Neurology, CHU Angers, Angers, France
| | - Sylvain Brochard
- Department of Physical Medicine and Rehabilitation, CHRU Brest, Brest, France.,Departement of Pediatric Physical Medicine and Rehabilitation, Fondation Ildys, Brest, France.,Laboratory of Medical Information Processing (LaTIM), Inserm U1101, University of Western Brittany, Brest, France
| | - Sandra Bouvier
- Department of Physical Medicine and Rehabilitation, CHRU Brest, Brest, France.,Laboratory of Medical Information Processing (LaTIM), Inserm U1101, University of Western Brittany, Brest, France
| | - Rodolphe Bailly
- Departement of Pediatric Physical Medicine and Rehabilitation, Fondation Ildys, Brest, France.,Laboratory of Medical Information Processing (LaTIM), Inserm U1101, University of Western Brittany, Brest, France
| | - Laetitia Houx
- Department of Physical Medicine and Rehabilitation, CHRU Brest, Brest, France.,Departement of Pediatric Physical Medicine and Rehabilitation, Fondation Ildys, Brest, France.,Laboratory of Medical Information Processing (LaTIM), Inserm U1101, University of Western Brittany, Brest, France
| | - Mathieu Lempereur
- Department of Physical Medicine and Rehabilitation, CHRU Brest, Brest, France.,Laboratory of Medical Information Processing (LaTIM), Inserm U1101, University of Western Brittany, Brest, France
| | | | | | - Jacky Vagnoni
- French Federation of Associations of Cerebral Palsy (FFAIMC), Paris, France
| | - Carole Vuillerot
- Department of Pediatric Physical Medicine and Rehabilitation, CHU Lyon, Hospital Woman Mother Child, Bron, France.,Neuromyogène Institute CNRS UMR 5310 INSERM U1217, University of Lyon, Lyon, France
| | - Vincent Gautheron
- Department of Pediatric Physical Medicine and Rehabilitation, CHU Saint-Etienne, Saint-Etienne, France.,UJM Saint-Etienne, Interuniversity Laboratory of Motricity Biology, EA7424, University of Lyon, Saint-Etienne, France
| | - Elea Dheilly
- Departement of Pediatric Physical Medicine and Rehabilitation, Fondation Ildys, Brest, France.,Laboratory of Medical Information Processing (LaTIM), Inserm U1101, University of Western Brittany, Brest, France
| | - Christelle Pons
- Department of Physical Medicine and Rehabilitation, CHRU Brest, Brest, France.,Departement of Pediatric Physical Medicine and Rehabilitation, Fondation Ildys, Brest, France.,Laboratory of Medical Information Processing (LaTIM), Inserm U1101, University of Western Brittany, Brest, France
| | - Mickael Dinomais
- Department of Physical Medicine and Rehabilitation, CHU Angers-Les Capucins, Angers, France.,Angevin Systems Engineering Research Laboratory (LARIS) EA7315, University of Angers, Angers, France
| | - Marine Cacioppo
- Department of Physical Medicine and Rehabilitation, CHRU Brest, Brest, France.,Departement of Pediatric Physical Medicine and Rehabilitation, Fondation Ildys, Brest, France.,Laboratory of Medical Information Processing (LaTIM), Inserm U1101, University of Western Brittany, Brest, France
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Ouellet B, Best KL, Wilson D, Miller WC. Exploring the Influence of a Community-Based Peer-Led Wheelchair Skills Training on Satisfaction with Participation in Children and Adolescents with Cerebral Palsy and Spina Bifida: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11908. [PMID: 36231211 PMCID: PMC9564843 DOI: 10.3390/ijerph191911908] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Peer-led approaches improve satisfaction with participation, wheelchair skills and wheelchair use self-efficacy in adults, but the evidence is limited in children. This pilot study aimed to explore the influence of community-based, peer-led, group wheelchair training program (i.e., Seating To Go) on satisfaction with participation (primary outcome), wheelchair skills, and wheelchair use self-efficacy in children and adolescents with cerebral palsy and spina bifida. METHODS A single group pre-post design was used. Invitations were shared online and diffused by clinicians and advocacy and provider groups to recruit a convenience sample of eight pediatric wheelchair users. Participants completed the Seating To Go program in groups that were facilitated by adult wheelchair users. Satisfaction with participation (Wheelchair Outcome Measure-Young People), wheelchair skills (Wheelchair Skills Test), wheelchair use self-efficacy (Wheelchair Use Confidence Scale), and perceived wheelchair skills capacity (Wheelchair Skills Test Questionnaire; proxy rating: parents) were evaluated before and after the Seating To Go program. Descriptive statistics and nonparametric longitudinal data analysis were conducted to explore changes in all outcomes from baseline to post-intervention. RESULTS Pediatric wheelchair users (ranging in age from 5 to 15 years) and their parents reported statistically significant improvements in satisfaction with participation. The improvements in wheelchair skills and wheelchair confidence were also statistically significant, but not the parents' perception of their children's wheelchair skills. CONCLUSIONS A community-based peer-led approach to wheelchair skills training seems promising for improving wheelchair outcomes in pediatric wheelchair users. Further controlled studies with larger samples are warranted.
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Affiliation(s)
- Béatrice Ouellet
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire en Santé et en Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
| | - Krista L. Best
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire en Santé et en Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
| | - Deb Wilson
- Seating To Go—Geneva Healthcare, Hamilton 3204, New Zealand
| | - William C. Miller
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- G.F. Strong Rehabilitation Centre—Rehabilitation Research Lab, Vancouver, BC V5Z 2G9, Canada
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8
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Liebenberg A, Geiger M, Visagie S. Parental experiences on the role of wheelchairs in the lives of their children with mobility impairments: a qualitative exploration in Dubai. Disabil Rehabil Assist Technol 2022; 17:310-317. [DOI: 10.1080/17483107.2020.1782488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Anjanet Liebenberg
- Department of Global Health, Centre for Rehabilitation studies, Stellenbosch University, Stellenbosch, South Africa
| | - Martha Geiger
- Department of Global Health, Centre for Rehabilitation studies, Stellenbosch University, Stellenbosch, South Africa
| | - Surona Visagie
- Department of Global Health, Centre for Rehabilitation studies, Stellenbosch University, Stellenbosch, South Africa
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Ammann-Reiffer C, Graser JV. Walking activities beyond gait training: Priorities in everyday life for parents and adolescents in pediatric neurorehabilitation. J Pediatr Rehabil Med 2022; 15:311-321. [PMID: 35527582 PMCID: PMC9277693 DOI: 10.3233/prm-201513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE This study aimed to gain knowledge about which walking-related everyday life activities and situations are relevant for parents of children with a neuromotor disorder and adolescents undergoing inpatient neurorehabilitation. METHODS Two focus group interviews with purposive samples were performed, one with seven parents of children with acquired or congenital neuromotor disorders, and one with four adolescents undergoing inpatient neurorehabilitation. Data were analyzed with a qualitative descriptive research approach. RESULTS Parents identified 120 activities that they considered as relevant in their everyday life and the adolescents identified 113 activities. Based on these activities, ten different categories that have a direct relation to walking in everyday life were identified. "Dealing with obstacles," "moving in public areas," "moving in a group," and "walking in general" were perceived as the highest priority categories by the focus group participants. CONCLUSION Activities incorporating walking tasks related to moving in a group or public areas and dealing with obstacles are perceived as meaningful by adolescents and parents in their everyday life. Addressing these categories in the goal setting process with families could facilitate the definition of walking-related goals aimed at increasing children's and adolescents' independence in daily life.
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Affiliation(s)
- Corinne Ammann-Reiffer
- Swiss Children's Rehab - Research Department, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Judith V Graser
- Swiss Children's Rehab - Research Department, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
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Kurt G, Kurt V, Ülger Ö. Family and personal factors associated with the participation of children with special needs in leisure activities: A Turkish perspective. Arch Pediatr 2021; 29:121-127. [PMID: 34955304 DOI: 10.1016/j.arcped.2021.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/20/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The primary aims of the current study were to describe the participation patterns in leisure activities of children between the ages of 6 and 15 years with special needs and to analyze family behavior and personal factors that affect participation. MATERIAL AND METHODS Overall, 112 children with special needs aged 6-15 years and their families participated in the present study. Children's sociodemographic characteristics, participation patterns in leisure activities, family behavior, and quality of life were evaluated. RESULTS In this study, it was observed that children participated in recreational activities the most and in physical activities the least. Most of the families reported that they did not have an influence on determining the activity. The findings showed correlations between leisure activities and age, gender, and socioeconomic status (p < 0.05). CONCLUSION The findings suggest that (a) children's participation in activities outside the home and (b) family guidance are insufficient. Thus, rehabilitation professionals can inform families about activities appropriate for children, positive family behavior, and social support programs.
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Affiliation(s)
- Gamze Kurt
- Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Kutahya Health Science University, Kutahya, Turkey.
| | - Vedat Kurt
- Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Kutahya Health Science University, Kutahya, Turkey
| | - Özlem Ülger
- Faculty of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Parents' Experience in Children's Friendship Training Programme for Their Children with Autism Spectrum Disorder: A Qualitative Inquiry. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8090763. [PMID: 34572194 PMCID: PMC8466490 DOI: 10.3390/children8090763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/25/2021] [Accepted: 08/29/2021] [Indexed: 11/19/2022]
Abstract
Background: Children’s Friendship Training (CFT) is a parent-assisted intervention programme that introduces children to basic sets of social rules to help them understand social contexts with specific guidance from their parents. It has been reported in several empirical studies that the friendship skills of children with autism spectrum disorder were enhanced after participating in CFT. However, previous studies only focused on the effectiveness of the training without exploring it from the parent’s perspective. As such, the objective of this study is to highlight the parents’ experience in assisting in the implementation of CFT. Purpose: To explore the parents’ experiences with autism spectrum disorder (ASD) in CFT and examine the experiences using the CFT as a theoretical framework. Methodology: In this study, eight parents and their school-aged children with ASD participated in 12 CFT sessions. Upon completing the CFT, the parents participated in a focus group interview. The interview session was video recorded and transcribed with the parents’ consent. Thematic analysis was employed in analysing the collected data as outlined in six different phases. Results: The generated data revealed the similarities and differences in parents’ experiences in the CFT. The current study has identified four main themes: (1) fear and resistance; (2) awareness, learning, and adjustment; (3) change is hard; and (4) identifying support. Conclusions: The findings highlighted the processes that these parents experienced and encountered while attending the CFT programme, it is important to consider these processes based on how they might impact the effectiveness of the programme. The programme’s effectiveness is reliant on the ability to work closely with parents to understand their challenges and explore the type of support they need. This study has analysed the crucial factors that provide an overview of parents’ encounters in their participation in CFT.
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Anaby D, Khetani M, Piskur B, van der Holst M, Bedell G, Schakel F, de Kloet A, Simeonsson R, Imms C. Towards a paradigm shift in pediatric rehabilitation: Accelerating the uptake of evidence on participation into routine clinical practice. Disabil Rehabil 2021; 44:1746-1757. [PMID: 33832391 DOI: 10.1080/09638288.2021.1903102] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Evidence for the importance of focusing on participation to promote health and wellbeing in childhood-onset disability exists, but practice is slow to change. This paper provides a knowledge translation roadmap to accelerate uptake of participation evidence into day-to-day practice. MATERIALS AND METHODS A structured roadmap to guide knowledge translation initiatives for implementing participation-based practices in co-creation with service users was developed based on elements from: the Five-factorframework for predicting implementation outcomes, the Cultural Cone framework, and the Knowledge-to-Action model. RESULTS Guiding principles paired with examples of multi-component knowledge implementation strategies to facilitate readiness for change by stakeholders at the micro (e.g., client/family, service providers), meso (e.g., administrators within organisations such as rehabilitation centres, hospitals, schools) and macro (e.g., local and governmental policy, regulatory bodies) levels are introduced. Solution-based strategies are provided to facilitate "readiness to change" for each stakeholder group. The strategies are examples for successful implementation of evidence-based interventions/approaches that can be contextualized across settings. CONCLUSIONS The knowledge translation roadmap can assist children and families, service providers, administrators, and policymakers to bridge existing knowledge-to-practice gaps surrounding participation. Partnering and collaborating through a "family-clinician-manager-community leader-policymaker" synergy is key for achieving strategic practice change focussed on participation.Implications for RehabilitationSound evidence surrounding the topic of participation, including effective assessments and interventions, is available and ready for use.Shifting towards participation-focused practices for children and youth with disabilities requires a systemic multi-level KT approach.Our Participation-KT roadmap, comprised of a framework and a list of principles and strategies for implementation, can be used to guide all stakeholders to foster a shift in practice.Forming partnerships and working collaboratively with all stakeholders is key for successful implementation.
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Affiliation(s)
- D Anaby
- School of Physical and Occupation Therapy, McGill University, Quebec, Canada
| | - M Khetani
- University of Illinois at Chicago, Chicago, IL, USA
| | - B Piskur
- Research Center Autonomy and Participation, Faculty of Health Care, Zuyd University of Applied Sciences, Heerlen, Netherlands
| | - M van der Holst
- Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, Netherlands.,Basalt Rehabilitation Center, The Hague, Netherlands
| | - G Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA, USA
| | - F Schakel
- Basalt Rehabilitation Center, The Hague, Netherlands
| | - A de Kloet
- Basalt Rehabilitation Center, The Hague, Netherlands.,The Hague University of Applied Sciences, The Haag, Netherlands
| | - R Simeonsson
- University of North Carolina, Chapel hill, NC, USA
| | - C Imms
- Faculty of Medicine Dentistry and Health Sciences Melbourne, University of Melbourne, Parkville, Australia
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Ong SY, Roslan S, Ahmad NA, Ayub AFM, Ping CL, Zaremohzzabieh Z, Ahrari S. A Mixed-Methods Evaluation of Parent-Assisted Children's Friendship Training to Improve Social Skills and Friendship Quality in Children with Autism in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2566. [PMID: 33806563 PMCID: PMC7967648 DOI: 10.3390/ijerph18052566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 11/30/2022]
Abstract
Background: This study evaluates the effectiveness of parent-assisted children's friendship training intervention for enhancing friendship quality and social skills among children with autism spectrum disorders (ASD). We conducted a quasi-experimental study to investigate the effective outcomes of social skills and friendship quality in the pre-and post-parent-assisted CFT intervention phases; Methods: to conduct a 12-week field session, 30 children with their parents were selected. The Social Skills Improvement System Rating Scales and the Quality of Play Questionnaire-Parent were used to assess the effectiveness of the parent-assisted children's friendship training during pre-and post-intervention. A semi-structured interview with parents was conducted at the end of the session; Results: findings revealed that intervention improved the social skills of these children. Additionally, the friendship quality of children with ASD improved before and after the intervention, however, engagement remained unchanged. Parents also showed some sort of improvement after the session as they reported a heightened sense of fear and resistance, awareness, learning and adjustment, change is not easy, and identifying support; Conclusions: there was clear evidence that children with ASD benefitted from parent-assisted CFTs in terms of social skills and friendship quality. However, larger and controlled studies are required to draw firm conclusions about this kind of intervention.
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Affiliation(s)
- Sing Yee Ong
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
| | - Samsilah Roslan
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
| | - Nor Aniza Ahmad
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
| | - Ahmad Fauzi Mohd Ayub
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
| | - Chen Lee Ping
- Department of Psychology, School of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia;
| | - Zeinab Zaremohzzabieh
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
| | - Seyedali Ahrari
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
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Arfa S, Solvang PK, Berg B, Jahnsen R. Challenges and facilitators in supporting sustainable participation after rehabilitation: Experiences of immigrant parents and their children with disabilities. Scand J Occup Ther 2020; 29:631-644. [PMID: 33300814 DOI: 10.1080/11038128.2020.1856183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Children with immigrant backgrounds and disabilities have lower rates of social participation compared with their non-immigrant counterparts. However, rehabilitation programmes offer an opportunity to promote a physically active lifestyle and increase home and community participation of children with disabilities. OBJECTIVES By exploring immigrant families' experiences of participation and associated challenges and facilitators after rehabilitation, the study intended to contribute to the development of potential pathways in supporting sustainable community-based participation. METHODS The study used a qualitative approach with semi-structured interviews. RESULTS The costs and lack of information, necessary skills, and local activities were among the barriers that families experienced after the rehabilitation. Local and rehabilitation professionals were not always aware of or prepared to address the challenges faced by families trying to become physically active. Parents expressed their needs for support and continuation of services after rehabilitation for moving towards an active lifestyle. Participation patterns among children highlighted the potential role of support contacts as facilitators for participation in physical activities among the families. CONCLUSIONS Establishing an efficient collaboration between local and rehabilitation professionals with identifying potential future challenges, adjusting the interventions, clarifying roles and responsibilities, and providing supportive follow-up services may support sustainable community-based participation among immigrant families.
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Affiliation(s)
- Shahrzad Arfa
- Research Department, Beitostølen Healthsports Center, Beitostølen, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Per Koren Solvang
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Berit Berg
- Department of Social Work, Norwegian University of Science and Technology, Trondheim, Norway
| | - Reidun Jahnsen
- Research Department, Beitostølen Healthsports Center, Beitostølen, Norway.,Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway.,Research Center for Habilitation and Rehabilitation Models and Services, CHARM, Institute of Health and Society, University of Oslo, Oslo, Norway
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15
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Sjöberg L, Hermansson L, Lindner H, Fredriksson C. Swedish parents' experiences of their role in treatment for children with congenital limb reduction deficiency: Decision-making and treatment support. Child Care Health Dev 2020; 46:723-732. [PMID: 32789897 PMCID: PMC7589220 DOI: 10.1111/cch.12802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 08/07/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Parents of children with congenital limb reduction deficiency have an essential role in making treatment decisions during their child's first years of life. Treatment options usually concern surgical and/or prosthetic treatment. To tailor treatment options to fit different family values and priorities, the family-centred approach indicates the importance of understanding the parental role in partnership with health care professionals. The aim of this study was to describe parents' experiences of their role in decision-making and treatment for children with congenital limb reduction deficiency. METHODS A descriptive design with a qualitative approach was used. Semi-structured interviews were conducted with 17 parents (12 mothers and 5 fathers) of children with upper and/or lower limb deficiency (mean age 5.9 years). The interview data were analysed using qualitative content analysis with an inductive approach. RESULTS Two major themes emerged from the data. The first theme, being a decision maker for someone else, was described as an ambivalent parental role, including collaboration within the family and with health care professionals. The second theme, becoming and being a treatment supporter in the child's everyday life, was made up of four categories: being a supporter of the child in everyday activities, mentoring the child to handle encounters with others, becoming a coordinator of information and being an 'extended arm' of the health care provision for the child. CONCLUSIONS This study enhances our understanding of the parental role in decision-making and treatment for children with congenital limb reduction deficiency. The results may contribute to the continued development of the family-centred service approach by providing guidelines for treatment programmes, with the goal of improving decision support and broadening the support for parents during treatment for these children.
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Affiliation(s)
- Lis Sjöberg
- School of Health SciencesÖrebro UniversityÖrebroSweden
| | - Liselotte Hermansson
- School of Health SciencesÖrebro UniversityÖrebroSweden,Department of Prosthetics and Orthotics, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden,University Health Care Research Center, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Helen Lindner
- School of Health SciencesÖrebro UniversityÖrebroSweden
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Dada S, Bastable K, Halder S. The Role of Social Support in Participation Perspectives of Caregivers of Children with Intellectual Disabilities in India and South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6644. [PMID: 32933056 PMCID: PMC7558089 DOI: 10.3390/ijerph17186644] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 12/21/2022]
Abstract
Caregivers are an intrinsic component of the environment of children with intellectual disabilities. However, caregivers' capacity to support children's participation may be linked to the social support that they, as caregivers, receive. Social support may increase participation, educational, psychological, medical and financial opportunities. However, there is a lack of information on social support in middle-income countries. The current study described and compared the social support of caregivers of children with intellectual disabilities by using the Family Support Survey (FSS) in India and South Africa. The different types of social support were subsequently considered in relation to participation, using the Children's Assessment of Participation and Enjoyment (CAPE). One hundred caregiver-child dyads from India and 123 from South Africa participated in this study. The data were analysed using non-parametric measures. Indian caregivers reported greater availability of more helpful support than did the South African caregivers. Social support was associated with children's participation diversity (India) and intensity (South Africa). The child-/caregiver-reported participation data showed different associations with participation. Results from this study suggest that perceived social support of caregivers differs between countries and is associated with their child's participation. These factors need to be considered when generalising results from different countries.
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Affiliation(s)
- Shakila Dada
- Centre for Augmentative and Alternative Communication, Humanities Faculty, University of Pretoria, Pretoria 0002, South Africa;
| | - Kirsty Bastable
- Centre for Augmentative and Alternative Communication, Humanities Faculty, University of Pretoria, Pretoria 0002, South Africa;
| | - Santoshi Halder
- Department of Education, University of Calcutta, Alipore Campus, 1 Reformatory St., Kolkata 700027, India;
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Jarvis JM, Fayed N, Fink EL, Choong K, Khetani MA. Caregiver dissatisfaction with their child's participation in home activities after pediatric critical illness. BMC Pediatr 2020; 20:415. [PMID: 32878614 PMCID: PMC7466418 DOI: 10.1186/s12887-020-02306-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 08/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pediatric critical care is often accompanied by a variety of functional impairments. Preliminary evidence suggests children's participation in home activities has a slow trajectory post-pediatric intensive care unit (PICU) discharge, however, additional and more granular knowledge on specific problematic activities is needed to inform patient-centric rehabilitative care. The objectives of this study are to identify common home activities in which caregivers' report dissatisfaction and to determine predictors of caregivers' dissatisfaction with their child's participation in home activities post-PICU discharge. METHODS Secondary analyses of data from a prospective cohort study, the Wee-Cover study, using a subsample of caregivers (N = 170) of children 1-17 years, admitted to a PICU ≥48 h with data on our primary outcome measure from at least one time point. Data were gathered at enrollment and at 3 and 6 months post-PICU discharge. Caregivers reported on their dissatisfaction with their child's participation in home activities via the Participation and Environment Measure. Common activities were identified by plotting caregiver dissatisfaction for each activity pre-and post-PICU, reporting activities in which ≥50% of caregivers reported dissatisfaction with post-PICU, and assessing for significantly different dissatisfaction levels between time-points for each activity. Predictors of caregiver dissatisfaction were assessed using Poisson generalized estimated equation models. RESULTS There was variability in reported dissatisfaction across all activities; ≥50% of caregivers reported dissatisfaction with five activities, including getting clean, personal care management, and mealtime for younger children and household chores and homework for school-aged children and youth. Four activities had significantly higher caregiver dissatisfaction post-PICU: sleep (children < 5 years), homework, indoor play and games, and computer/video games (children ≥5 years). Home environmental support and the interaction of having participation-focused strategies with receiving PICU-based rehabilitation services were negatively associated with caregiver dissatisfaction. Increased caregiver stress and functional performance were associated with increased dissatisfaction. CONCLUSIONS Individualized PICU-based rehabilitation services to determine family priorities and develop participation-focused strategies, specifically those increasing environmental supports within the home, may ease the family's transition home post-PICU. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT02148081 05/28/2014.
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Affiliation(s)
- Jessica M Jarvis
- Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor Street, AHSB 316A, Chicago, IL, 60612, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nora Fayed
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Ericka L Fink
- Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Karen Choong
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Mary A Khetani
- Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor Street, AHSB 316A, Chicago, IL, 60612, USA.
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18
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Krieger B, Piškur B, Schulze C, Beurskens A, Moser A. Environmental pre-requisites and social interchange: the participation experience of adolescents with autism spectrum disorder in Zurich. Disabil Rehabil 2020; 43:3789-3802. [PMID: 32356476 DOI: 10.1080/09638288.2020.1753248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Aim: Participation of adolescents with autism spectrum disorder hardly occurs in settings outside of home and school. Little is known about how their participation is influenced by environmental factors. This study explored how and why adolescents with autism spectrum disorder perceive aspects of their environment as facilitators or barriers to their participation outside of home and school.Method: This explanatory case study explored the participation experiences of adolescents with autism spectrum disorder (15-21 years) from Zurich and surroundings with in-depth interviews and photo-elicitation, using photos made by the participants during activities outside of home and school. Data was analysed with a 7-step procedure.Result: The presence of two main themes seemed necessary to facilitate participation outside of home and school: "environmental prerequisites to attend activities", which consists of five subthemes, such as "the company of trusted persons" and "the provision of knowledge and information", and "social interchange and engagement", which consists of three subthemes and describes how actual involvement can be supported.Conclusion: Our findings highlight the influence of trusted persons on adolescents with autism spectrum disorder, and the need to extend the support network for these adolescents to other individuals, services and society so that their participation in activities can be encouraged.IMPLICATIONS FOR REHABILITATIONAdolescents with autism spectrum disorder perceive every kind of participation outside of home and school as social.We recommend using the company of trusted persons to encourage adolescents with autism spectrum disorder to actively participate outside of home and school.Rehabilitation professionals should promote environment-based approaches to achieve participation of adolescents with autism spectrum disorder.Rehabilitation professionals should actively approach, acknowledge and gently guide adolescents with autism spectrum disorder to support engagement in participation.
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Affiliation(s)
- Beate Krieger
- School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland.,Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Barbara Piškur
- Research Centre for Autonomy and Participation for People with Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Christina Schulze
- School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Anna Beurskens
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands.,Research Centre for Autonomy and Participation for People with Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Albine Moser
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands.,Research Centre for Autonomy and Participation for People with Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Coussens M, Van Driessen E, De Baets S, Van Regenmortel J, Desoete A, Oostra A, Vanderstraeten G, Waelvelde HV, Van de Velde D. Parents' perspectives on participation of young children with attention deficit hyperactivity disorder, developmental coordination disorder, and/ or autism spectrum disorder: A systematic scoping review. Child Care Health Dev 2020; 46:232-243. [PMID: 31867727 DOI: 10.1111/cch.12735] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 12/12/2019] [Accepted: 12/14/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND During the early years of a child's life, participation is essential for learning and development. Children with disabilities are at risk for decreased participation. The interplay between environment and participation is identified as one of the most important factors influencing successful participation. The objective of this scoping review was to synthesize peer-reviewed literature about barriers and facilitators of participation according to the perspective of parents of children younger than 6 years with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and/ or Developmental Coordination Disorder (DCD). METHODS The scoping review followed Arksey and O'Malley's framework. Relevant studies were identified by a comprehensive search of scientific databases (PubMed and Web of Science). Studies describing perspectives of parents regarding their child's participation, written in English, and published between 2001 and September 2017 were included. RESULTS A total of 854 articles were retrieved, with 13 meeting the criteria. Elements contributing to perceived barriers and facilitators were identified and organized according to the International Classification of Functioning, Child-Youth framework. Concepts contained in these studies were linked to "activities and participation" (general tasks and demands, such as bedtime and dinner routines, and social, civic life, such as play and leisure). Environment-focused factors identified were situated on "support and relationships, " "attitudes, " and "services, systems, and policies." CONCLUSION The review revealed guidelines focusing on family-centred care, communication with, and providing information to parents with young children with developmental disabilities (ADHD, DCD, and/ or ASD).
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Affiliation(s)
- Marieke Coussens
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Evy Van Driessen
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Stijn De Baets
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Jasmine Van Regenmortel
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Annemie Desoete
- Department of Experimental Clinical and Health Psychology, University of Ghent, Ghent, Belgium
| | - Ann Oostra
- Department of Paediatrics and Medical Genetics, University of Ghent, Ghent, Belgium
| | - Guy Vanderstraeten
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Hilde Van Waelvelde
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Dominique Van de Velde
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
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Beckers LWME, Smeets RJEM, van der Burg JJW. Therapy-related stress in parents of children with a physical disability: a specific concept within the construct of parental stress. Disabil Rehabil 2019; 43:1185-1192. [PMID: 31424960 DOI: 10.1080/09638288.2019.1646815] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this article is to conceptualise the phenomenon of therapy-related parental stress in parents of children with a physical disability. METHODS Three models related to parental stress were reviewed, i.e., general parental stress, burden of caregiving in parents of children with physical disabilities, and experiences of these parents with their child's therapy. RESULTS The proposed definition of therapy-related parental stress is "the subjective stress and subsequent changes of functioning and health experienced by a parent of a child with a physical disability in response to paramedical therapies (i.e., physical, occupational, and/or speech and language therapy)". A theoretical model is proposed to describe the process of therapy-related parental stress. Available questionnaires will most likely not be valid and responsive to capture the (changes in) stress parents experience related to therapy their child receives. CONCLUSIONS This article provides a first definition of therapy-related parental stress and a theoretical model to visualise the processes with regard to this topic. Empirical testing of the presented components and their coherence is needed to confirm or improve the model. A questionnaire that specifically measures the concept of therapy-related parental stress is needed, along with evaluating therapy-related parental stress in clinical practice and research.Indications for rehabilitationIt is imperative to recognise paramedical therapies (i.e., physical, occupational, and speech and language therapy) as a potential stressor for parents of children with a physical disability, both in paediatric rehabilitation practice and research.A definition and theoretical model of therapy-related parental stress is proposed and the need for measures to evaluate this phenomenon is argued.The authors provide a starting point for the evidence base of the concept of therapy-related parental stress.
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Affiliation(s)
- Laura W M E Beckers
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.,Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, the Netherlands
| | - Rob J E M Smeets
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.,CIR Revalidatie, Eindhoven, the Netherlands
| | - Jan J W van der Burg
- Department of Paediatric Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands.,School of Pedagogical and Educational Sciences, Radboud University, Nijmegen, the Netherlands
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Caregiver Strategy Use to Promote Children's Home Participation After Pediatric Critical Illness. Arch Phys Med Rehabil 2019; 100:2144-2150. [PMID: 31278925 DOI: 10.1016/j.apmr.2019.05.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/28/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The primary objectives are to assess the most common type of caregiver strategy (remedial vs compensatory) reported for supporting their child's home participation after critical illness and identify themes in compensatory strategies described, with a secondary objective to describe themes in strategy use as reported by caregivers of children who did and did not receive pediatric intensive care unit (PICU) rehabilitation services. DESIGN Qualitative substudy of the Wee-Cover prospective cohort study. SETTING Two PICU sites. PARTICIPANTS Wee-Cover enrolled caregivers (N=180) of children 1-17 years of age, who were admitted to a PICU for ≥48 hours. This study excluded participants missing relevant data (n=12). INTERVENTION Not applicable. MAIN OUTCOME MEASURES Qualitative data were gathered from open-ended questions on strategies within the Participation and Environment Measure at PICU discharge and 3 and 6 months post-PICU discharge. Strategies were classified as remedial or compensatory pending their content fit with 1 of 5 environmental chapters in the International Classification of Functioning, Disability, and Health-Children and Youth Version. Data on PICU-based rehabilitation services were obtained prospectively from electronic medical records and dichotomized (yes or no). RESULTS Most caregiver strategies were compensatory, with more than half (60%) of the strategies pertaining to fostering supportive relationships. In contrast, strategies addressing the child's natural environment (12%), services (3%), and attitudes of others in the home (1%) were least commonly described. Similar themes were identified for caregivers whose children did and did not receive PICU rehabilitation services. CONCLUSIONS Caregivers identify a range of strategies to facilitate their child's participation in home activities post-PICU discharge, but primarily report on strategies for addressing supports and relationships in the child's home environment. Results highlight areas warranting caregiver education to support the child's participation after critical illness.
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Williams U, Law M, Hanna S, Gorter JW. Personal, environmental, and family factors of participation among young children. Child Care Health Dev 2019; 45:448-456. [PMID: 30786039 DOI: 10.1111/cch.12651] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 02/17/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study is to assess the influences of environment, population characteristics, and service utilization on participation frequency and involvement in the home setting among children 0 to 5 years. METHOD Data were collected from parents of 236 children (mean age 3 years and 5 months, SD = 1.30, girls = 152 and boys = 84) using a children's treatment centre in Ontario through an online survey. Two path models measuring home frequency and home involvement were assessed using structural equation modelling. The exogenous factors in the models included child's age, child's sex, child's complexity, number of environmental barriers, income, mother's participation, and service utilization. In addition to participation as the primary outcome, each model explored predictors of service utilization and mother's participation. RESULTS The involvement model (R2 = 0.46) explained more variance than the frequency model (R2 = 0.33). Age (0.35, P < 0.001) and barriers (0.07, P = 0.001) predicted participation frequency in the home, χ2 (9) = 8.51, P < 0.4, root mean square error of approximation (RMSEA) = 0.00, comparative fit index (CFI) = 1.00. The home involvement model, χ2 (6) = 9.79, P < 0.13, RMSEA = 0.06, CFI = 0.97, showed that increasing age (0.09, P < 0.001), lower complexity (0.13, P = 0.001), and higher mother's participation (0.057, P = 0.001) were significantly related to higher participation. An increase in child's age or complexity significantly influenced service utilization across both models. Complexity reduced mother's participation in both the frequency and involvement models. CONCLUSIONS This study is one of the first in Canada to examine participation of young children. The aggregation of each unit factor, particularly barriers and complexity, can accrue a large impact on the child's and mother's participation. The potential to mediate this impact by removing environmental barriers and promoting mother's participation merits further study.
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Affiliation(s)
- Uzma Williams
- CanChild, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Mary Law
- CanChild, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Steven Hanna
- CanChild, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- CanChild, Department of Pediatrics, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Irvin DW, Bard A, Wallisch A, Little LM. Measuring Social Communication in the Community: Novel Tools for Advancing Family Participation. Am J Occup Ther 2019; 72:7206205060p1-7206205060p7. [PMID: 30760398 DOI: 10.5014/ajot.2018.026310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Natural contexts and family involvement are key features of effective intervention approaches. However, the measurement of community participation and parent engagement with children remains complex. Therefore, we examined the feasibility of combining use of the Language ENvironment Analysis (LENA®) system and a global positioning system (GPS; i.e., Qstarz® BT-Q1000XT). The LENA is a small speech recognition device that captures and quantifies full-day recordings of the natural language environment. The Qstarz BT-Q1000XT is a wearable GPS data logger that allows identification of the locations a person visits. The marrying of these measures allows for an accurate representation of community settings that afford children greater social communication opportunities. Our results show that the combination of measures provides meaningful social communication location data. Also, the participating caregiver reported that the collection of measures was feasible across community settings.
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Affiliation(s)
- Dwight W Irvin
- Dwight W. Irvin, PhD, is Assistant Research Professor, Juniper Gardens Children's Project, University of Kansas, Kansas City;
| | - Anna Bard
- Anna Bard, BA, is Disability Program Specialist II, Human Development Institute, University of Kentucky, Lexington
| | - Anna Wallisch
- Anna Wallisch, PhD, OTR/L, is Postdoctoral Fellow, Juniper Gardens Children's Project, University of Kansas, Kansas City
| | - Lauren M Little
- Lauren M. Little, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, College of Health Sciences, Rush University, Chicago
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Gebeyehu F, Sahile A, Ayalew M. Burden, Social Support, and Life Satisfaction Among Caregivers of Children With Intellectual Disability: The Case of Felege Abay and Shembt Primary Schools, Bahir Dar, Ethiopia. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2019; 39:147-153. [DOI: 10.1177/0272684x18819974] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study was conducted to examine the burden, social support, and life satisfaction among caregivers of children with intellectual disability. The level of burden, social support, and life satisfaction of caregivers; the relationship among burden level, social support, and life satisfaction; and burden level difference across sociodemographic characteristics of the participants were the objectives of this study. With inclusion criteria of availability, willingness, and pertinent priority of being parents, grandparents, and siblings of the child, 74 caregivers were selected using comprehensive sampling technique. Descriptive statistics, one sample t test, Pearson correlation coefficient, independent sample t test, and one-way analysis of variance, were used for data analysis. The findings revealed that caregivers are experiencing much level of burden with inadequate social support and have pitiable satisfaction in their life. Burden is negatively correlated with social support and life satisfaction, but social support is positively correlated with satisfaction in life. Some of the sociodemographic variables, such as sex and school, were showing significant differences in the experiences of burden level, while all other sociodemographic variables used in this study were not having significant difference. The result implied that caregivers are in need of social support so as to outweigh the level of burden and enhance their satisfaction in life.
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Bowman S, Evans C. It's Not Just Me. Parents' Perceptions of a Multi-Disciplinary Therapy Group for Infants with Disabilities. Phys Occup Ther Pediatr 2019; 39:502-513. [PMID: 30880538 DOI: 10.1080/01942638.2019.1577785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aim: To explore parent perceptions of Baby Club, a therapeutic program involving physiotherapy, occupational therapy, and speech and language therapy for infants with physical disabilities under 2 years and to better understand how the group addresses child and family needs. Methods: A qualitative descriptive design using semi-structured interviews and a brief demographics questionnaire. Eight parents who attended a Baby Club program between 2017 and 2018 were recruited from ErinoakKids Centre for Treatment and Development. Interviews were audio-recorded, transcribed, and de-identified. A content analysis approach was used with an inductive process to generate a coding scheme. Investigators developed overarching themes. Results: Three themes representing parents' perceptions of Baby Club were identified: (1) Learning Together through Play and Fun; (2) I'm Not the Only One - Sharing and Support; (3) The Value of Therapist Time and Expertise. Conclusions: Baby Club provides parents and infants with opportunities to learn new skills through play, providing enriching social experiences and networking in a supportive therapeutic group environment.
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Affiliation(s)
- Susan Bowman
- a Department of Physical Therapy, University of Toronto , Toronto , Ontario , Canada.,b ErinoakKids Centre for Treatment & Development , Mississauga , Ontario , Canada
| | - Catherine Evans
- a Department of Physical Therapy, University of Toronto , Toronto , Ontario , Canada
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26
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Kapoor R, De Carlo K, Raman L, Thibadeau J, Kancherla V. Needs assessment survey for children and adults with spina bifida in Georgia. J Pediatr Rehabil Med 2019; 12:383-392. [PMID: 31744034 DOI: 10.3233/prm-190567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
PURPOSE We conducted a needs assessment among parents/guardians of children and independent adults with spina bifida, served by the Spina Bifida Association of Georgia (SBAGA). The objective was to assess if SBAGA is adequately meeting the needs of its constituents and to identify challenges and opportunities to improve services. METHODS The survey targeted all members of SBAGA in 2017. Survey questions were drafted separately for parents/guardians of children, and independent adults with spina bifida. Both closed- and open-ended response options were provided. The survey was pilot-tested, and administered in English and Spanish, using email, post, or in person. RESULTS A total of 119 individuals completed the survey. For parents/guardians (n= 96), the most important needs were bladder and bowel education, social and communication skills education, medical support, and transition and independence training. Independent adults (n= 23) responded that they mostly needed bladder and bowel education, medical support, and transition and independence training. Location of the SBAGA events and transportation to the events were the most frequent limiting factors for both groups. CONCLUSIONS Our survey findings highlighted that SBAGA services are valued overall. The survey findings will be used to guide quality improvement of current programs, and develop programs addressing emerging needs and challenges.
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Affiliation(s)
- Renuka Kapoor
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Lisa Raman
- Spina Bifida Association of Georgia, Atlanta, GA, USA
| | | | - Vijaya Kancherla
- Spina Bifida Association of Georgia, Atlanta, GA, USA.,Center for Spina Bifida Prevention, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Killeen H, Shahin S, Bedell GM, Anaby DR. Supporting the participation of youth with physical disabilities: Parents' strategies. Br J Occup Ther 2018. [DOI: 10.1177/0308022618808735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Little is known about strategies used by parents to explicitly promote the participation in meaningful occupations of transition-age youth. This descriptive study explored the type and scope of parents' strategies to facilitate the participation of youth living with a physical disability. Methods Twenty-two parents of youths (12 to 18 years) with mobility restriction reported strategies used at home, school, and in the community by completing the Participation and Environment Measure for Children and Youth at two time points. Content analysis was conducted. Strategies were extracted and coded, and sub-categories were identified and organised into the three domains (person, occupation, environment) of the Canadian Model of Occupational Performance – Engagement. Findings Overall, 241 strategies were reported, of which 130 were distinct. The strategies encompassed all three domains of the Canadian Model of Occupational Performance – Engagement, with an emphasis on youths' immediate physical environment and no reference to institutional policies at the macro level. The majority of strategies focused on facilitating youths' participation in the school setting through collaboration, advocacy, and involvement. Conclusion Findings can increase our understanding of the range of actions parents take in supporting participation of transition-age youth. Occupational therapists can build on those strategies and, through family-centred practice, jointly promote youth participation and inclusion.
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Affiliation(s)
- Hazel Killeen
- Lecturer Above the Bar, Discipline of Occupational Therapy, National University of Ireland, Ireland
| | - Saeideh Shahin
- PhD student and Research Assistant, School of Physical and Occupational Therapy, McGill University, Canada
| | - Gary M Bedell
- Professor and Chair, Department of Occupational Therapy, Tufts University, USA
| | - Dana R Anaby
- Associate Professor, School of Physical and Occupational Therapy, McGill University, Canada
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Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tunçalp Ö, Straus SE. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med 2018; 169:467-473. [PMID: 30178033 DOI: 10.7326/m18-0850] [Citation(s) in RCA: 13109] [Impact Index Per Article: 2184.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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Affiliation(s)
- Andrea C Tricco
- St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada (A.C.T., S.E.S.)
| | - Erin Lillie
- St. Michael's Hospital, Toronto, Ontario, Canada (E.L., W.Z.)
| | - Wasifa Zarin
- St. Michael's Hospital, Toronto, Ontario, Canada (E.L., W.Z.)
| | - Kelly K O'Brien
- University of Toronto, Toronto, Ontario, Canada (K.K.O., H.C.)
| | | | | | - David Moher
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (D.M., C.G.)
| | - Micah D J Peters
- University of South Australia and University of Adelaide, Adelaide, South Australia, Australia (M.D.P.)
| | - Tanya Horsley
- Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada (T.H.)
| | - Laura Weeks
- Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario, Canada (L.W., T.C.)
| | | | - Elie A Akl
- American University of Beirut, Beirut, Lebanon (E.A.A.)
| | - Christine Chang
- Agency for Healthcare Research and Quality, Rockville, Maryland (C.C.)
| | | | | | - Lisa Hartling
- University of Alberta, Edmonton, Alberta, Canada (L.H.)
| | | | | | - Chantelle Garritty
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (D.M., C.G.)
| | - Simon Lewin
- Norwegian Institute of Public Health, Oslo, Norway, and South African Medical Research Council, Cape Town, South Africa (S.L.)
| | | | | | | | | | - Jo Moriarty
- King's College London, London, United Kingdom (J.M.)
| | - Tammy Clifford
- Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario, Canada (L.W., T.C.)
| | - Özge Tunçalp
- World Health Organization, Geneva, Switzerland (E.V.L., Ö.T.)
| | - Sharon E Straus
- St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada (A.C.T., S.E.S.)
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Everyday Activities for Children with Mitochondrial Disorder: A Retrospective Chart Review. Occup Ther Int 2018; 2018:5716947. [PMID: 29977174 PMCID: PMC6011071 DOI: 10.1155/2018/5716947] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 05/22/2018] [Indexed: 01/14/2023] Open
Abstract
Background Engagement in everyday activities is important for the health and wellbeing of children. Children with mitochondrial disorders have impaired energy production leading to limitations in activity. It is unknown which activities these children perform and if the nature of activities of low-functioning children differs from average-functioning children. Therefore, this pilot study explored the activities reported in patient records of a heterogeneous group of children with genetically confirmed mitochondrial disorders. Methods A retrospective qualitative directed content analysis by health care professionals reported activities (as part of their professional reasoning obligations) in hospital patient records of children with mitochondrial disorder. Results Seventeen patient records, presenting notes on capacities and performed activities, showed an overview of everyday activities that covered the categories: self-care, house chores, therapy, school, computing, hobby, play, sports, and mobility/transport. The activity categories of low-functioning children did not differ from average-functioning children, although descriptions of specific activities differed between groups. Conclusion This pilot exploration indicates that the types of activities that children with mitochondrial disorders perform are not necessarily linked to the child's impairments. However, differences in levels of independence, assistive device usage, and energy costs seem to exist. Future research should address the child's perspective on, and meaning of, activity performances.
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Saquetto MB, de Santana Bispo A, da Silva Barreto C, Gonçalves KA, Queiroz RS, da Silva CM, Gomes Neto M. Addition of an educational programme for primary caregivers to rehabilitation improves self-care and mobility in children with cerebral palsy: a randomized controlled trial. Clin Rehabil 2018; 32:878-887. [PMID: 29493280 DOI: 10.1177/0269215518757051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess whether the addition of an education programme for primary caregivers to rehabilitation improves daily functioning in children with cerebral palsy. DESIGN A randomized, single-blind, controlled study. SETTING This study was conducted in a rehabilitation centre in Salvador, Brazil. PARTICIPANTS A total of 63 boys and girls with cerebral palsy, at 1-12 years of age, with Gross Motor Function Classification Systems I-V, were randomly assigned to two groups: educational programme for primary caregivers and conventional rehabilitation ( n = 29) or conventional rehabilitation alone ( n = 31). INTERVENTION Each group received 12 sessions of 30 minutes of conventional rehabilitation and 12 sessions of 45 minutes to intervention group. MEASUREMENTS Gross Motor Function Classification System, Gross Motor Function Measure and daily functioning with the Pediatric Evaluation of Disability Inventory were assessed by a blinded assessor. The clinical outcomes were obtained at the completion of treatment (12 weeks). RESULTS Of the 63 patients included, 60 (mean ± SD age: 4.6 ± 2.74 years) completed the protocol. The combined education and rehabilitation, as compared with conventional rehabilitation alone, yielded significantly greater benefit in the self-care domain of the Functional Skills Scale (mean change 1.74 versus 5; P = 0.001), self-care (mean change 5.52 versus 13.99; P = 0.017) and the mobility domain of the Caregiver Assistance Scale of Pediatric Evaluation of Disability Inventory (mean change 0.87 versus 17.88; P = 0.002). CONCLUSION Self-care and mobility improved in children with cerebral palsy with the addition to conventional rehabilitation of an educational programme for primary caregivers.
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Affiliation(s)
- Micheli Bernardone Saquetto
- 1 Departamento de Fisioterapia, Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,2 Grupo de Pesquisa em Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | | | | | - Katiuce Almeida Gonçalves
- 2 Grupo de Pesquisa em Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,3 Departamento de Saúde I, Curso de Fisioterapia, Universidade Estadual do Sudoeste da Bahia, Jequié, Brazil
| | - Rodrigo Santos Queiroz
- 2 Grupo de Pesquisa em Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,3 Departamento de Saúde I, Curso de Fisioterapia, Universidade Estadual do Sudoeste da Bahia, Jequié, Brazil
| | - Cássio Magalhães da Silva
- 1 Departamento de Fisioterapia, Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,2 Grupo de Pesquisa em Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | - Mansueto Gomes Neto
- 1 Departamento de Fisioterapia, Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,2 Grupo de Pesquisa em Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,4 Programa de Pós Graduação em Medicina e Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,5 The GREAT Group (GRupo de Estudos em ATividade física), São Paulo, Brazil
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Jindal P, MacDermid JC, Rosenbaum P, DiRezze B, Narayan A. Perspectives on rehabilitation of children with cerebral palsy: exploring a cross-cultural view of parents from India and Canada using the international classification of functioning, disability and health. Disabil Rehabil 2017; 40:2745-2755. [PMID: 28747138 DOI: 10.1080/09638288.2017.1356383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To explore parents' perspectives on rehabilitation of their child with cerebral palsy and their information needs. METHODS Semistructured interviews were conducted with parents of children with CP from India (n = 11) and Canada (n = 7). Data were analyzed through an interpretive description approach using the International Classification of Functioning, Disability and Health framework. RESULTS Body Structure and Function: Indian parents were more focused on fixing body structure and function challenges, and independent walking, than Canadian parents. Activity and Participation: All Canadian children were actively involved in school and fun activities in the community. Due to lack of accessible services, Indian children had less school and community participation. Environmental factors: accessible communities, occupational therapy services and greater use of assistive devices enabled Canadian children. Social and cultural beliefs, lack of access to services and inaccessible communities were the barriers experienced by Indian parents. Information needs: both groups needed information to make their child more functional. CONCLUSION Canadian parents experience a more enabling environment and express a more social view of their child's health, suggesting both education on the International Classification of Functioning, Disability and Health principles and services are needed to better enable and empower Indian parents. There remains a need for healthcare professionals and services in both countries to be more family-centered. Implications for rehabilitation To help parents in rehabilitating their children with cerebral palsy (CP), in India, there is a need to (1) incorporate ICF education into medical curricula and clinical practice; (2) increase the availability of skilled healthcare professionals and centers; (3) make infrastructural and policy reforms to make the society more accessible for the disabled children. Education, counseling and awareness about CP might help both groups of parents, society, and HCPs to change their beliefs and attitudes regarding CP and its rehabilitation. Both countries would benefit from user-friendly and transparent policies. This will help parents to become more aware of them and use them in the rehabilitation process.
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Affiliation(s)
- Pranay Jindal
- a School of Rehabilitation Science , McMaster University , Hamilton , Canada.,b CanChild Centre for Childhood Disability Research , McMaster University , Hamilton , Canada
| | - Joy C MacDermid
- a School of Rehabilitation Science , McMaster University , Hamilton , Canada
| | - Peter Rosenbaum
- a School of Rehabilitation Science , McMaster University , Hamilton , Canada.,b CanChild Centre for Childhood Disability Research , McMaster University , Hamilton , Canada.,c Department of Paediatrics , McMaster University , Hamilton , Canada
| | - Briano DiRezze
- a School of Rehabilitation Science , McMaster University , Hamilton , Canada.,b CanChild Centre for Childhood Disability Research , McMaster University , Hamilton , Canada
| | - Amitesh Narayan
- d Department of Physiotherapy , Kasturba Medical College, Manipal University , Mangalore , India
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Hahn-Markowitz J, Berger I, Manor I, Maeir A. Impact of the Cognitive–Functional (Cog–Fun) Intervention on Executive Functions and Participation Among Children With Attention Deficit Hyperactivity Disorder: A Randomized Controlled Trial. Am J Occup Ther 2017; 71:7105220010p1-7105220010p9. [DOI: 10.5014/ajot.2017.022053] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. We examined the effect of the Cognitive–Functional (Cog–Fun) occupational therapy intervention on executive functions and participation among children with attention deficit hyperactivity disorder (ADHD).
METHOD. We used a randomized, controlled study with a crossover design. One hundred and seven children age 7–10 yr diagnosed with ADHD were allocated to treatment or wait-list control group. The control group received treatment after a 3-mo wait. Outcome measures included the Behavior Rating Inventory of Executive Function (BRIEF) and the Canadian Occupational Performance Measure (COPM).
RESULTS. Significant improvements were found on both the BRIEF and COPM after intervention with large treatment effects. Before crossover, significant Time × Group interactions were found on the BRIEF.
CONCLUSION. This study supports the effectiveness of the Cog–Fun intervention in improving executive functions and participation among children with ADHD.
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Affiliation(s)
- Jeri Hahn-Markowitz
- Jeri Hahn-Markowitz, PhD, OTR, is Member, Cognitive Functional Rehabilitation Laboratory, School of Occupational Therapy, Hadassah and Hebrew University of Jerusalem, Jerusalem, Israel, and Occupational Therapist, Private Practice, Israel;
| | - Itai Berger
- Itai Berger, MD, is Director, Neuro-Cognitive Center, Paediatric Neurology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Iris Manor
- Iris Manor, MD, is Medical Director, Attention Deficit Hyperactivity Disorder Clinic, Geha Mental Health Center, Petah Tikva, Israel
| | - Adina Maeir
- Adina Maeir, PhD, is School Chair and Director of Graduate Studies, School of Occupational Therapy, Hadassah and Hebrew University of Jerusalem, Jerusalem, Israel
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Aplin T, Thornton H, Gustafsson L. The unique experience of home for parents and carers of children with disabilities. Scand J Occup Ther 2017; 25:260-266. [DOI: 10.1080/11038128.2017.1280079] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tammy Aplin
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Heloise Thornton
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
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34
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Piškur B, Beurskens AJHM, Ketelaar M, Jongmans MJ, Casparie BM, Smeets RJEM. Daily actions, challenges, and needs among Dutch parents while supporting the participation of their child with a physical disability at home, at school, and in the community: a qualitative diary study. BMC Pediatr 2017; 17:12. [PMID: 28077123 PMCID: PMC5225511 DOI: 10.1186/s12887-016-0768-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 12/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parents have a vital influence on the participation of their child with a physical disability. The aim of this study is to gain insight into parents' own daily actions, challenges, and needs while supporting their child with a physical disability at home, at school, and in the community. An additional objective of this study is to refine the preliminary thematic framework previously identified in a scoping review. METHODS A qualitative research inquiry was performed based on using a diary over a 7-day period to gather data. To systematically organise data into a structured format, content analysis has been applied using both inductive and deductive reasoning guided by the existing preliminary thematic framework. RESULTS Analysis of the eligible diaries shows that the actions mentioned by the 47 parents describe several efforts to enhance participation of their children with a physical disability by using, enabling, or changing the social and physical environment, or by supporting their child to perform or engage in meaningful activities. Those parents' actions are primarily a result of challenges caused by restrictions in social and physical environments. Parental responses highlighted, above all, the need for environments designed for all people. Based on the findings a redefined thematic framework is presented. CONCLUSIONS Parents' actions, challenges, and needs are mainly directed towards the social or/and physical environment. The presented thematic framework can offer practitioners knowledge to support parents. More work is necessary to provide tailored approaches. Paediatric rehabilitation may need to address the importance of the environment on the participation of a child with a physical disability.
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Affiliation(s)
- Barbara Piškur
- Research Centre Autonomy and Participation for Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Science, Nieuw Eyckholt 300, 6419 DJ, Heerlen, The Netherlands. .,Department of Occupational Therapy, Faculty of Health, Zuyd University of Applied Science, Nieuw Eyckholt 300, 6419 DJ, Heerlen, The Netherlands. .,Department of Rehabilitation Medicine, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,Department of Neonatology, Wilhemina Children's Hospital, University Medical Centre Utrecht, AB 3508, Utrecht, The Netherlands.
| | - Anna J H M Beurskens
- Research Centre Autonomy and Participation for Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Science, Nieuw Eyckholt 300, 6419 DJ, Heerlen, The Netherlands.,Department of General Practice, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Marjolijn Ketelaar
- Brain Centre Rudolf Magnus and Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Rembrandtkade 10, 3583 TM, Utrecht, The Netherlands.,Partner of NetChild, University Network for Childhood Disability Research in the Netherlands, Utrecht, The Netherlands
| | - Marian J Jongmans
- Partner of NetChild, University Network for Childhood Disability Research in the Netherlands, Utrecht, The Netherlands.,Department of Child, Family and Education Studies, Faculty of Social and Behavioral Sciences, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands.,Department of Neonatology, Wilhemina Children's Hospital, University Medical Centre Utrecht, AB 3508, Utrecht, The Netherlands
| | - Barbara M Casparie
- Research Centre Autonomy and Participation for Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Science, Nieuw Eyckholt 300, 6419 DJ, Heerlen, The Netherlands.,BOSK, The Dutch Association of People with Disabilities and Their Parents, 3502 GJ, Utrecht, The Netherlands
| | - Rob J E M Smeets
- Department of Rehabilitation Medicine, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,Adelante Centre of Expertise in Rehabilitation, Zandbergsweg 111, 6432 CC, Hoensbroek, The Netherlands
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Alsem MW, van Meeteren KM, Verhoef M, Schmitz MJWM, Jongmans MJ, Meily-Visser JMA, Ketelaar M. Co-creation of a digital tool for the empowerment of parents of children with physical disabilities. RESEARCH INVOLVEMENT AND ENGAGEMENT 2017; 3:26. [PMID: 29238612 PMCID: PMC5724239 DOI: 10.1186/s40900-017-0079-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 11/08/2017] [Indexed: 05/15/2023]
Abstract
PLAIN ENGLISH SUMMARY Parents of children with physical disabilities do a lot to support their child in daily life. In doing this they are faced with many challenges. These parents have a wide range of unmet needs, especially for information, on different topics. It is sometimes hard for them to get the right information at the right moment, and to ask the right questions to physicians and other healthcare professionals. In order to develop a digital tool to help parents formulate questions and find information, we thought it would be crucial to work together in a process of co-creation with parents, researchers, IT-specialists and healthcare professionals. In close collaboration with them we developed a tool that aims to help parents ask questions, find information and take a more leading role in consultations with healthcare professionals, called the WWW-roadmap (WWW-wijzer in Dutch).In two groups of parents (one group with and one group without experience of using the tool), we will study the effects of using this tool, on consultations with physicians. We expect that using the tool will result in better empowerment, satisfaction and family-centred care. BACKGROUND Parents of children with physical disabilities do much to support their child in daily life. In doing so, they are faced with many challenges. These parents have a wide range of unmet needs, especially for information, on various topics. Getting timely and reliable information is very difficult for parents, whereas being informed is a major requirement for the process of empowerment and shared decision-making. This paper describes the development of a digital tool to support parents in this process. During its development, working together with parents was crucial to address relevant topics and design a user-centred intervention. METHODS In co-creation with parents, healthcare professionals, IT-professionals and researchers, a digital tool was developed, the 'WWW-roadmap' ['WWW-wijzer' in Dutch]. This digital tool aims to enable parents to explore their questions (What do I want to know?), help in their search for information (Where can I find the information I need), and refer to appropriate professionals (Who can assist me further?).During the process, we got extensive feedback from a parent panel consisting of parents of children with physical disabilities, enabling us to create the tool 'with' rather than 'for' them. This led to a user-friendly and problem-driven tool. DISCUSSION The WWW-roadmap can function as a tool to help parents formulate their questions, search for information and thus prepare for consultations with healthcare professionals, and to facilitate parental empowerment and shared-decision making by parent and professional. Effects of using the WWW-roadmap on consultations with professionals will be studied in the future.
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Affiliation(s)
- M. W. Alsem
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Rembrandtkade 10, 3583 TM Utrecht, the Netherlands
- Department of Rehabilitation Medicine, Academic Medical Centre, Amsterdam, the Netherlands
| | - K. M. van Meeteren
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Rembrandtkade 10, 3583 TM Utrecht, the Netherlands
| | - M. Verhoef
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Rembrandtkade 10, 3583 TM Utrecht, the Netherlands
| | - M. J. W. M. Schmitz
- Zuyd University of Applied Science, Research Centre for Data Intelligence, ICT Faculty, Heerlen, the Netherlands
| | - M. J. Jongmans
- Department of Child, Family & Education Studies, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
- Department of Neonatology, Wilhelmina Children’s hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J. M. A. Meily-Visser
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Rembrandtkade 10, 3583 TM Utrecht, the Netherlands
| | - M. Ketelaar
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Rembrandtkade 10, 3583 TM Utrecht, the Netherlands
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Jahiel RI. A Structural and Conceptual Modification of the International Classification of Function, Disability and Health (ICF). Rehabil Process Outcome 2015. [DOI: 10.4137/rpo.s13340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Current criticisms of the International Classification of Function, Disability and Health (ICF) are focused on its activity/participation component and on its conceptual basis. I propose structural and conceptual changes. (1) The components would be body structure, body function, intent, actual environment, and participation. (2) Intent would be linked to the concept of self-agency, and its codes would have two qualifiers associating it with capability and strength of willed activity. (3) All activity/participation codes of the original ICF would be moved to the modified ICF's participation component. This component is based on interaction between intent and environment, and it is linked to the concept of joint agency. (4) A new entity, scene setting, represents the sum total of all components' codes involved in a given act of participation. (5) Additional constructs are suggested to elucidate the relations between intent and environment that allow enactment of a given act of participation. The modified ICF is consistent with current concepts of disability and unambiguous in distinctions between body function, activity, and participation. There are no significant alterations in the original ICF codes.
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Affiliation(s)
- Rene I. Jahiel
- École Libre des Hautes Études, New York, NY, USA
- Department of Medicine, New York University, New York, NY, USA
- University of Connecticut Health Center, Farmington, CT, USA
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Nota A, Chikwanha TM, January J, Dangarembizi N. Factors contributing to defaulting scheduled therapy sessions by caregivers of children with congenital disabilities. Malawi Med J 2015; 27:25-8. [PMID: 26137195 DOI: 10.4314/mmj.v27i1.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Defaulting scheduled rehabilitation therapy may result in increased adverse outcomes such as permanent disability and increased healthcare costs. Concomitantly, there is evidence to suggest that early and continued rehabilitation of children with congenital disabilities can improve outcomes significantly. This study was conducted to determine factors contributing to caregivers' defaulting scheduled rehabilitation therapy sessions. METHODS A descriptive cross sectional study was carried out at Chitungwiza Central Hospital, a tertiary facility offering in and outpatient rehabilitation services in Zimbabwe. Caregivers of children who had congenital disabilities (N=40) and who had a history of defaulting treatment but were available during the data collection period responded to an interviewer administered questionnaire. Data were analysed for means and frequencies using STATA 13. RESULTS Factors that contributed to caregivers defaulting scheduled therapy included economic constraints (52%), child related factors (43%), caregiver related factors (42%), service centred factors (30%) and psychosocial factors(58%). Majority of the caregivers (98%) were motivated to attend therapy by observable improvements in their children. Other motivators were incentives given in the rehabilitation department (45%), availability of rehabilitation personnel to provide the required services (48%) and psychosocial support from fellow caregivers, families and the rehabilitation staff (68%). Although all the caregivers could not distinguish occupational therapy from physiotherapy services they all reported that therapy was important. CONCLUSIONS A combination of psychosocial, economic, child centred and service centred factors contributed to caregivers defaulting scheduled therapy. Interventions that may potentially improve caregiver attendance to scheduled therapy include community outreach services, efficient rehabilitation service provision at the hospitals, and facilitation of income generating programmes for caregivers.
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Affiliation(s)
- A Nota
- Chitungwiza Central Hospital, Zimbabwe
| | - T M Chikwanha
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe
| | - J January
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe
| | - N Dangarembizi
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe
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Piškur B, Meuser S, Jongmans MJ, Ketelaar M, Smeets RJEM, Casparie BM, Haarsma FA, Beurskens AJHM. The lived experience of parents enabling participation of their child with a physical disability at home, at school and in the community. Disabil Rehabil 2015; 38:803-812. [DOI: 10.3109/09638288.2015.1061612] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Effects of Caregiving on the Families of Children and Adults with Disabilities. Phys Med Rehabil Clin N Am 2015; 26:1-19. [DOI: 10.1016/j.pmr.2014.09.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Piškur B, Beurskens AJHM, Jongmans MJ, Ketelaar M, Smeets RJEM. What do parents need to enhance participation of their school-aged child with a physical disability? A cross-sectional study in the Netherlands. Child Care Health Dev 2015; 41:84-92. [PMID: 24797584 DOI: 10.1111/cch.12145] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim was to provide an overview of the number, domains and priority of needs as expressed by parents in supporting participation of their school-aged child with a physical disability. Additionally, this study investigated whether the number of needs within each domain is related to the child's gross motor function level, parent's perceived own general health, family socio-economic status and family type. METHOD A cross-sectional study with a total of 146 participants (84.9% mothers) who completed a survey including the Family Needs Inventory - Paediatric Rehabilitation, the Gross Motor Function Classification System Family Report Questionnaire, the General Health Questionnaire and a demographic questionnaire. A need has been operationalized as 'a family's, parent's or other family member's expressed desire for information, services and supports related to their family'. Descriptive statistics and correlation analysis were applied. RESULTS Parents (n = 146; response rate 27%) varied in the number of expressed needs (range 0-124; mean = 35.9; median = 30; SD = 25.6). Highest mean percentage scores were found for the domains 'Laws, regulations and fees' (36%), 'Leisure time' (35.6%) and 'Aids, adaptations, facilities and resources' (33.8%). Seven single needs were expressed by 50% or more of the parents. All domains of needs showed a positive correlation with perceived parental general health. The domains 'Laws, regulations and fees', 'Day care & school', 'Emotional and mental support' and 'Raising my child' correlated negatively with family socio-economic status; and child's gross motor function level correlated positively with the domains 'Aids, adaptations, facilities and resources', 'Practical support at home' and 'Leisure time'. CONCLUSIONS As parents have a major influence on participation of children with a physical disability, meeting their individual needs should become an objective for service providers and policy makers. Family-centred service might be more effective by putting a greater emphasis on changing the environment.
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Affiliation(s)
- B Piškur
- Research Centre Autonomy and Participation for Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Science, Heerlen, The Netherlands; Department of Occupational Therapy, Faculty of Health, Zuyd University of Applied Science, Heerlen, The Netherlands; Department of Rehabilitation Medicine, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Partner of NetChild, University Network for Childhood Disability Research in the Netherlands, Utrecht, The Netherlands
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Shikako-Thomas K, Kolehmainen N, Ketelaar M, Bult M, Law M. Promoting leisure participation as part of health and well-being in children and youth with cerebral palsy. J Child Neurol 2014; 29:1125-33. [PMID: 24907136 DOI: 10.1177/0883073814533422] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/03/2014] [Indexed: 11/15/2022]
Abstract
Participation in leisure is a human right and is central to the health of children and youth. The World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth supported a change in thinking about what outcomes are most relevant in the context of children's health and places participation as one of the constituent elements of health. Participation is also a fundamental rehabilitation and health promotion outcome for children with cerebral palsy as identified by youth, parents, and health professionals. Several studies have identified individual and environmental factors related to participation in leisure; new studies are now determining the best interventions to promote participation. This article summarizes recent findings and proposes important topics for neurologists to consider in exploring leisure pursuits with children with cerebral palsy and their families and in working with rehabilitation professionals to promote engagement in leisure opportunities as part of integrated care.
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Affiliation(s)
- Keiko Shikako-Thomas
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Niina Kolehmainen
- Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, United Kingdom
| | - Marjolijn Ketelaar
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands Partner of NetChild, Network for Childhood Disability Research in the Netherlands, Utrecht, the Netherlands
| | - Maureen Bult
- Utrecht University, Faculty of Social Sciences, Department of Pedagogical and Educational Sciences, Utrecht, the Netherlands
| | - Mary Law
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
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Khetani MA, Cliff AB, Schelly C, Daunhauer L, Anaby D. Decisional Support Algorithm for Collaborative Care Planning using the Participation and Environment Measure for Children and Youth (PEM-CY): A Mixed Methods Study. Phys Occup Ther Pediatr 2014; 35:231-252. [PMID: 24670061 DOI: 10.3109/01942638.2014.899288] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACT Aims: The purpose of this study was to explore the utility of the Participation and Environment Measure for Children and Youth (PEM-CY) for collaborative care planning with parents of children with disabilities. Methods: An explanatory sequential mixed methods approach was employed to examine how community-based service providers interpret and apply PEM-CY case results to set goals and formulate care plans with parents. We used two distinct, interactive phases that included collection and summary of PEM-CY data in Phase One (quantitative) and sequential collection and analysis of interview data during Phase Two (qualitative). Twenty-three parents of children with disabilities (mean age = 10.7 years) completed the PEM-CY community section during Phase One (quan). Four PEM-CY case reports were used with seven providers who were interviewed during Phase Two (QUAL). Results: Providers identified a four-step decisional support algorithm for leveraging PEM-CY case results in care planning: (1) parent rank orders activities in which change is desired, (2) child preferences are incorporated, (3) provider clarifies parent and child goals, and (4) activity-specific supports, barriers, and strategies are identified. Conclusions: Further validation and refinement of the decisional support algorithm with parents and children when applied to PEM-CY home and school reports is discussed.
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Affiliation(s)
- Mary A Khetani
- 1Department of Occupational Therapy, Colorado State University, Fort Collins, CO, USA
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Baldwin P, King G, Evans J, McDougall S, Tucker MA, Servais M. Solution-focused coaching in pediatric rehabilitation: an integrated model for practice. Phys Occup Ther Pediatr 2013; 33:467-83. [PMID: 23611310 DOI: 10.3109/01942638.2013.784718] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This article describes the conceptual basis and key elements of a transdisciplinary model for solution-focused coaching in pediatric rehabilitation (SFC-peds). The model exemplifies a strengths-based, relational, and goal-oriented approach to clinical practice. It provides a distinct shift from a problem-oriented, therapist-directed approach to a possibilities-oriented approach where client empowerment takes precedence. The model facilitates client change through a method of working with client strengths and resources that involves the use of strategic questions to co-construct therapy intervention. Through client-therapist collaboration, therapy goals and plans are developed that align with client hopes, priorities, and readiness for change. SFC supports client self-determination and capacity for change through customized therapy goals and plans that are meaningful for the child and family. Implications for therapists include the need for relational expertise, practical coaching skills, and expertise in facilitating change. The need for research on the effectiveness of this approach in pediatric rehabilitation is discussed.
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Einaudi MA, Gire C, Loundou A, Le Coz P, Auquier P. Quality of life assessment in preterm children: physicians' knowledge, attitude, belief, practice--a KABP study. BMC Pediatr 2013; 13:58. [PMID: 23601174 PMCID: PMC3637183 DOI: 10.1186/1471-2431-13-58] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 04/15/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The sequelae of extremely preterm birth have an impact on the quality of life (QoL) of these children. Standardized assessment of their QoL is rarely done in France. The aim of this study is to examine among all the types of physicians involved in the management of children born extremely preterm, their knowledge, use in routine practice and expectations concerning QoL assessment of these children using standardized questionnaires. METHODS Prospective survey among heads of obstetric, neonatal medicine and paediatric neurology departments, by means of questionnaires. Two qualitative methods were used: focus groups and Delphi method. RESULTS Seventy-eight physicians participated (obstetricians 24%, neonatologists 58%, paediatric neurologists 18%). The physicians considered QoL a relevant concept which they assessed subjectively. They expressed a need for information on methods of assessment. An ideal QoL questionnaire was described. Expectations regarding availability of QoL data were expressed from a medical, family and societal perspective. The impact of QoL measurement on the ethical aspect of decision-making was approached, in particular the potential impact of this tool on the decision made. Expectations were found to differ between specialties. CONCLUSION This original study reports the perspective of experts on taking into consideration the QoL of children born extremely preterm. This is a subjective notion that is difficult to implement and which may influence therapeutic choices.
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Affiliation(s)
- Marie-Ange Einaudi
- Timone University Hospital, Espace Ethique Méditerranéen; Aix-Marseille University, UMR 7268 Anthropologie bio-culturelle, Droit, Éthique & Santé (ADÉS), Marseille, France.
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