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Oliveira RHS, Mancini MC, Figueiredo PRP, Abrahão LC, Reis EA, Gordon AM, Brandão MB. Individualized telehealth home programme for children with cerebral palsy during the COVID-19 pandemic. Dev Med Child Neurol 2024. [PMID: 39240105 DOI: 10.1111/dmcn.16072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 07/16/2024] [Accepted: 07/29/2024] [Indexed: 09/07/2024]
Abstract
AIM To analyse the effects of an individualized telehealth home programme on the performance of functional goals of children and adolescents with cerebral palsy (CP) during the COVID-19 pandemic. METHOD A prospective single-group intervention study with children/adolescents with CP (n = 144; median age = 92 months [Q1 = 44.0, Q3 = 148.8]; 74 males, 70 females), representing all Gross Motor Function Classification System (GMFCS) levels participated in a 4-month home programme in Brazil. An interdisciplinary team encouraged families to choose a functional goal to be trained. The Canadian Occupational Performance Measure (COPM) was used at pre-intervention (T1), post-intervention (T2), and 3-month follow-up (T3). The differences in COPM scores at T1, T2, and T3 were evaluated using Friedman's test. The effect size was calculated using Cohen's d. Univariate analysis was included. RESULTS Significant improvements were observed after the intervention, with maintenance of scores after 3 months (p < 0.001, dperformance = 1.33; dsatisfaction = 1.31). None of the tested variables (child's abilities, age, caregiver's educational level, perception of family-centredness, and type of goal) were significantly related to the change scores. INTERPRETATION The individualized remote telehealth home programme can be a potential intervention, especially for children with CP classified in GMFCS levels IV and V. Also, this intervention provided a possible solution to help some children and their families in performing prioritized functional goals during the pandemic period.
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Affiliation(s)
- Rachel H S Oliveira
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marisa C Mancini
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Priscilla R P Figueiredo
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Associação Mineira de Reabilitação, Belo Horizonte, Minas Gerais, Brazil
| | - Leonardo C Abrahão
- Associação Mineira de Reabilitação, Belo Horizonte, Minas Gerais, Brazil
| | - Edna A Reis
- Departamento de Estatística-LabEst/CECiDa, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Marina B Brandão
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Leite HR, de Sousa Junior RR, Souto DO, Medeiros E Silva JM, de Lima AFB, de Miranda Drumond C, Policiano EBC, Marques AC, de Carvalho Chagas PS, Longo E. Identificação de ingredientes de intervenções não invasivas para crianças deambuladoras com paralisia cerebral usando as minhas palavras favoritas: uma revisão de escopo. Dev Med Child Neurol 2024. [PMID: 39208157 DOI: 10.1111/dmcn.16078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
ResumoObjetivoMapear os ingredientes das intervenções não invasivas fornecidas às crianças deambuladoras com Paralisia Cerebral (PC).MétodoOs artigos foram selecionados e as características dos estudos extraídas. Os ingredientes das intervenções foram descritos em termos do Sistema de Especificação de Taxonomia de Reabilitação (RTSS) e vinculados às minhas palavras favoritas. Os resultados foram interpretados e validados por meio da abordagem de Envolvimento de pacientes e do Publico em Pesquisa (EPP).ResultadosSessenta e um artigos foram incluídos, dos quais 55,5% foram classificados como ensaios clínicos randomizados. Os estudos selecionados incluíram um total de 2187 crianças (a idade média variou de 3 meses a 5,9 anos), a maioria de países desenvolvidos. Os estudos incluídos investigaram um total de 27 intervenções, que juntas apresentaram ingredientes representando todas as minhas palavras favoritas, na seguinte ordem de frequência: “Saúde” (ex., treinamento de força e resistência), “Funcionalidade” (ex., prática ativa e repetitiva de uma tarefa), “Família” (ex., terapia focada no contexto), “Diversão” (ex., inclusão de atividades amistosas para crianças), “Amigos” (ex., atividades em grupo) e “Futuro” (ex., compartilhamento de informações didáticas). Assim, os ingredientes relacionados à palavra “Futuro” foram os relatados com menos frequência.InterpretaçãoTerapeutas e famílias precisam estar cientes da correspondência mais apropriada entre as metas elencadas por meio das minhas palavras favoritas e os objetivos, ingredientes e alvos das intervenções. Finalmente, “Diversão”, “Amigos” e “Futuro” devem ser abordadas como desfechos potenciais em estudos futuros.
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Leite HR, de Sousa Junior RR, Souto DO, Medeiros E Silva JM, de Lima AFB, de Miranda Drumond C, Policiano EBC, Marques AC, de Carvalho Chagas PS, Longo E. F-words ingredients of non-invasive interventions for young ambulant children with cerebral palsy: A scoping review. Dev Med Child Neurol 2024. [PMID: 39187986 DOI: 10.1111/dmcn.16074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 07/25/2024] [Accepted: 07/27/2024] [Indexed: 08/28/2024]
Abstract
AIM To map the ingredients of non-invasive interventions provided to young ambulant children with cerebral palsy. METHOD Articles were screened and each study's characteristics extracted. The intervention ingredients were described in terms of the Rehabilitation Treatment Specification System and linked to the 'F-words'. Results were interpreted and validated by a patient and public involvement group. RESULTS Sixty-one papers were included, of which 55.5% were classified as randomized controlled trial design studies. The selected studies included a total of 2187 children (mean age range 3 months to 5 years 11 months), most from high-income countries. The included studies investigated a total of 27 interventions, which together presented ingredients representing all F-words, in the following order of frequency: 'fitness' (e.g. strength and endurance training), 'functioning' (e.g. active and repetitive practice of a task), 'family' (e.g. context-focused therapy), 'fun' (e.g. inclusion of child-friendly activities), 'friends' (e.g. group activities), and 'future' (e.g. didactic information sharing). Thus, ingredients related to the F-word 'future' were the most infrequently reported. INTERPRETATION Therapists and families need to be aware of the most appropriate match between the F-word goals, ingredients, and targets. Finally, 'fun', 'friends', and 'future' should be addressed as potential outcomes in future studies.
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Affiliation(s)
- Hércules Ribeiro Leite
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Rodrigues de Sousa Junior
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Deisiane Oliveira Souto
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Arthur Felipe Barroso de Lima
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carolyne de Miranda Drumond
- Graduate Program in Rehabilitation Sciences and Physical and Functional Performance, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | | | - Ariane Cristina Marques
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paula Silva de Carvalho Chagas
- Graduate Program in Rehabilitation Sciences and Physical and Functional Performance, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Egmar Longo
- Graduate Program in Decision Models and Health, Universidade Federal da Paraíba, Paraíba, Brazil
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Al-Otaibi SL, Algabbani MF, Alboraih AM, AlAbdulwahab SS. Effectiveness of Family-Professional Collaboration on Functional Goals Achievement of Children with Cerebral Palsy and Caregivers' Quality of Life and Burden: A Randomized Comparative Study. J Clin Med 2024; 13:4057. [PMID: 39064097 PMCID: PMC11277485 DOI: 10.3390/jcm13144057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/29/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Family-professional collaboration is important to enhance the outcomes for children with cerebral palsy and their caregivers. Aims: This study examined the effect of implementing a family-professional collaboration practice model on children with cerebral palsy and their caregivers. Materials and methods: A randomized, single-blind comparative study included 28 physical therapists, 44 children with cerebral palsy between the ages of 2 and 12 years old, and their caregivers. Physical therapists in the experimental group received training in how to implement collaboration in their therapy sessions over the course of two sessions (3 h each). The children's achievement goal-range rate was measured using the Goal Attainment Scaling, the caregivers' quality of life was assessed using the World Health Organization Quality of Life-Brief, and the caregiver burden was evaluated using the Zarit Burden Interview. Results: All children showed improvement on the Goal Attainment Scaling change rate (p = 0.002), with no significant differences between groups (p < 0.44). However, a group × time interaction was observed. The Children Goal Attainment Scaling rate decreased between the two assessment sessions for children in the control group, while the Goal Attainment Scaling change rate was steady for the experimental group. There were no main effects of time and group or interaction of time × group reported on World Health Organization Quality of Life-Brief domains and no main effect of time on the Zarit Burden Interview, but there was a main effect between groups (p = 0.03), with partial eta square = 0.11 in favor of the experimental group. Conclusions: The family-professional collaboration practice model could be a potential practice to positively improve the outcomes in children with cerebral palsy and their caregivers.
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Affiliation(s)
- Sarah L. Al-Otaibi
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia (S.S.A.)
| | - Maha F. Algabbani
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia (S.S.A.)
| | - Azza M. Alboraih
- Research and Scientific Center, Sultan Bin Abdulaziz Humanitarian City, Riyadh 13571, Saudi Arabia
| | - Sami S. AlAbdulwahab
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia (S.S.A.)
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Arnevik Austrheim K, Skagen C, Rieber J, Melfald Tveten K. Practice, play, repeat - individualized outcomes after the "intensity matters!"-program for children with disabilities - a descriptive multicase study. Disabil Rehabil 2024; 46:2847-2852. [PMID: 37452469 DOI: 10.1080/09638288.2023.2233905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/28/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE To examine and categorize individual outcomes after the "Intensity matters!"-program, a new, cross-professional intensive intervention for children with disabilities across Norway. MATERIALS AND METHODS 84 children and their parents/legal guardian were enrolled in this multicase study. Participants were active in defining goals, and hereby the content of the intervention. The pre-settled goals were grouped into the categories of body functions and structure, activities and participation inspired by the components of the International Classification of Functioning, Disability, and Health (ICF). The pre-settled goals were assessed pre- and post-intervention by using The Canadian Occupational Performance Measure (COPM). A clinically important change was predefined as a change ≥2 points. RESULTS 1004 pre-settled goals were categorized into focus areas, where 62.4% were categorized as activity; functional mobility (n = 626). Post-intervention assessment of the COPM ratings of child performance and satisfaction showed a mean change of 3.7 (range -0.25;8.5) and 3.8 (range 0.25;10), respectively. CONCLUSION The majority of participants in the "Intensity Matters!"-program had a clinically important change in their individual goals after only three weeks of intervention. This study supports the use of client-centered measures in rehabilitation for children with disabilities, but a further examination of long-term outcome is warranted.
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Affiliation(s)
| | - C Skagen
- Children's Physiotherapy Center, Bergen, Norway
| | - J Rieber
- Children's Physiotherapy Center, Bergen, Norway
| | - K Melfald Tveten
- Children's Physiotherapy Center, Bergen, Norway
- Department of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
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Montpetit-Tourangeau K, Kairy D, Ahmed S, Anaby D, Bussières A, Lamontagne MÈ, Rochette A, Shikako-Thomas K, Thomas A. A strategic initiative to facilitate knowledge translation research in rehabilitation. BMC Health Serv Res 2020; 20:973. [PMID: 33097043 PMCID: PMC7585309 DOI: 10.1186/s12913-020-05772-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 09/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While there is a growing body of literature supporting clinical decision-making for rehabilitation professionals, suboptimal use of evidence-based practices in that field persists. A strategic initiative that ensures the relevance of the research and its implementation in the context of rehabilitation could 1) help improve the coordination of knowledge translation (KT) research and 2) enhance the delivery of evidence-based rehabilitation services offered to patients with physical disabilities. This paper describes the process and methods used to develop a KT strategic initiative aimed at building capacity and coordinating KT research in physical rehabilitation and its strategic plan; it also reports the initial applications of the strategic plan implementation. METHODS We used a 3-phase process consisting of an online environmental scan to identify the extent of KT research activities in physical rehabilitation in Quebec, Canada. Data from the environmental scan was used to develop a strategic plan that structures KT research in physical rehabilitation. Seven external KT experts in health science reviewed the strategic plan for consistency and applicability. RESULTS Sixty-four KT researchers were identified and classified according to the extent of their level of involvement in KT. Ninety-six research projects meeting eligibility criteria were funded by eight of the fourteen agencies and organizations searched. To address the identified gaps, a 5-year strategic plan was developed, containing a mission, a vision, four main goals, nine strategies and forty-two actions. CONCLUSION Such initiatives can help guide researchers and relevant key stakeholders, to structure, organize and advance KT research in the field of rehabilitation. The strategies are being implemented progressively to meet the strategic initiative's mission and ultimately enhance users' rehabilitation services.
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Affiliation(s)
- Katherine Montpetit-Tourangeau
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada. .,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.
| | - Dahlia Kairy
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
| | - Sara Ahmed
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, Quebec, H3A 1A2, Canada
| | - Dana Anaby
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Room 408, Hamilton, Ontario, L8S 1C7, Canada
| | - André Bussières
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Département Chiropratique, Université du Québec à Trois-Rivières, 3351, boul. Des Forges, C. P. 500, Trois-Rivières, Quebec, G9A 5H, Canada
| | - Marie-Ève Lamontagne
- Département de réadaptation, Université Laval, Quebec, Quebec, G1V 0A6, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de Réadaptation en Déficience Physique de Québec, 525 Boul Wilfrid-Hamel, Quebec, Quebec, G1M 2S8, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
| | - Keiko Shikako-Thomas
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Room 408, Hamilton, Ontario, L8S 1C7, Canada
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, 1110 Pine Avenue West, Montreal, Quebec, H3G 1A3, Canada
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Mathews SB, Mozolic-Staunton B, Jefford E, Salehi N. Canadian Occupational Performance Measure and Early Intervention: A Scoping Review. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2020. [DOI: 10.1080/19411243.2020.1744210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Skye B. Mathews
- School of Health and Human Sciences, Southern Cross University, Coolangatta, Queensland, Australia
| | - Beth Mozolic-Staunton
- School of Health and Human Sciences, Southern Cross University, Coolangatta, Queensland, Australia
| | - Elaine Jefford
- School of Health and Human Sciences, Southern Cross University (Midwifery) New South Wales, Lismore, Australia
| | - Nasim Salehi
- School of Health and Human Sciences, Southern Cross University, Coolangatta, Queensland, Australia
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Al-Nemr A, Abdelazeim F. Task and environmental modifications for children with cerebral palsy: a systematic review. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1783744] [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)
- Alaa Al-Nemr
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Faten Abdelazeim
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Abstract
OBJECTIVE The purpose of this study was to explore the practices physical therapists and occupational therapists use in early intervention (EI) for infants with or at risk for cerebral palsy (CP). METHODS A survey was disseminated nationally to EI providers using an online anonymous link. RESULTS Two hundred sixty-nine therapists completed at least 50% of the survey. Four percent of therapists use the General Movement Assessment to predict CP, 57% reported infants at risk for CP receive therapy once a week, 89% identified parents' goals as the most important factor in customizing the EI program, and 75% provide parents with home programs. However, 73% never or rarely use outcome measures to prioritize parents' goals; 31% provide parents with individualized home program and more than 60% never assess environmental enrichment. CONCLUSION Therapists do not incorporate sufficient strategies for goal-oriented interventions, comprehensive parent education, and optimum environmental enrichment.
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Goal setting in paediatric rehabilitation for children with motor disabilities: a scoping review. Clin Rehabil 2018; 32:954-966. [DOI: 10.1177/0269215518758484] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: The three objectives of this scoping review were to (1) identify key conceptual/theoretical frameworks and the extent to which they are used to inform goal setting related to rehabilitation goal setting with children with motor disabilities, (2) describe research that has evaluated goal setting processes and outcomes, and (3) summarize the purposes of goal setting described in paediatric rehabilitation literature. Methods: The scoping review process described by Arksey and O’Malley was used to guide article selection and data extraction. Results: A total of 62 articles were included in the final review. While the concept of family-centered care was well represented, theoretical frameworks specific to goal setting (i.e. goal setting theory described by Locke and Latham, mastery motivation, social cognitive, personal construct, and self-determination theories) were rarely addressed. No articles reviewed addressed prominent behavior change theory. With the exception of the description of tools specifically designed for use with children, the role of the child in the goal setting process was generally absent or not well described. Few studies ( n = 6) discussed the linkage between goals and intervention strategies explicitly. Only two studies in the review evaluated outcomes associated with goal setting. The primary purpose for goal setting identified in the literature was to develop goals that are meaningful to families ( n = 49). Conclusion: The results highlight significant gaps in the literature explicating a sound theoretical basis for goal setting in paediatric rehabilitation and research evaluating the effects of goal qualities and goal setting processes on the achievement of meaningful outcomes.
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Welch V, Doull M, Yoganathan M, Jull J, Boscoe M, Coen SE, Marshall Z, Pardo JP, Pederson A, Petkovic J, Puil L, Quinlan L, Shea B, Rader T, Runnels V, Tudiver S. Reporting of sex and gender in randomized controlled trials in Canada: a cross-sectional methods study. Res Integr Peer Rev 2017; 2:15. [PMID: 29451565 PMCID: PMC5803639 DOI: 10.1186/s41073-017-0039-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/26/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Accurate reporting on sex and gender in health research is integral to ensuring that health interventions are safe and effective. In Canada and internationally, governments, research organizations, journal editors, and health agencies have called for more inclusive research, provision of sex-disaggregated data, and the integration of sex and gender analysis throughout the research process. Sex and gender analysis is generally defined as an approach for considering how and why different subpopulations (e.g., of diverse genders, ages, and social locations) may experience health conditions and interventions in different or similar ways.The objective of this study was to assess the extent and nature of reporting about sex and/or gender, including whether sex and gender analysis (SGA) was carried out in a sample of Canadian randomized controlled trials (RCTs) with human participants. METHODS We searched MEDLINE from 01 January 2013 to 23 July 2014 using a validated filter for identification of RCTs, combined with terms related to Canada. Two reviewers screened the search results to identify the first 100 RCTs that were either identified in the trial publication as funded by a Canadian organization or which had a first or last author based in Canada. Data were independently extracted by two people from 10% of the RCTs during an initial training period; once agreement was reached on this sample, the remainder of the data extraction was completed by one person and verified by a second. RESULTS The search yielded 1433 records. We screened 256 records to identify 100 RCTs which met our eligibility criteria. The median sample size of the RCTs was 107 participants (range 12-6085). While 98% of studies described the demographic composition of their participants by sex, only 6% conducted a subgroup analysis across sex and 4% reported sex-disaggregated data. No article defined "sex" and/or "gender." No publication carried out a comprehensive sex and gender analysis. CONCLUSIONS Findings highlight poor uptake of sex and gender considerations in the Canadian RCT context and underscore the need for better articulated guidance on sex and gender analysis to improve reporting of evidence, inform policy development, and guide future research.
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Affiliation(s)
- V. Welch
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
- University of Ottawa, Ontario, Canada
| | - M. Doull
- School of Nursing, University of British Columbia, T223-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - M. Yoganathan
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
| | - J. Jull
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario Canada
| | - M. Boscoe
- Research Sex/gender, Health Equity, Primary Care Consultant, 906 Bowron Court, North Vancouver, BC V7H 2S7 Canada
| | - S. E. Coen
- Department of Geography and Planning, Queen’s University, Mackintosh-Corry Hall, Kingston, Ontario K7L 3 N6 Canada
| | - Z. Marshall
- Renison University College, University of Waterloo, 240 Westmount Road North, Waterloo, Ontario N2L 3G4 Canada
| | - J. Pardo Pardo
- Cochrane Musculoskeletal, University of Ottawa, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, ON K1H 8L6 Canada
| | - A. Pederson
- B.C. Women’s Hospital + Health Centre, E305, 4500 Oak Street, Vancouver, BC V6H 3E1 Canada
| | - J. Petkovic
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
- University of Ottawa, Ontario, Canada
| | - L. Puil
- Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia, 2176 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada
| | - L. Quinlan
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
| | - B. Shea
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
- University of Ottawa, Ontario, Canada
| | - T. Rader
- Canadian Agency for Drugs and Technology in Health, 865 Carling Ave, Ottawa, Ontario Canada
| | - V. Runnels
- Globalization and Health Equity Research Unit, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, 850 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3 Canada
| | - S. Tudiver
- Gender and Health Consultant, 161 Northwestern Avenue, Ottawa, Ontario K1Y 0 M1 Canada
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Robertson CMT, DeForge SM, Dosman CF. Goal setting within a tertiary-level early developmental intervention program. Paediatr Child Health 2017; 22:184-189. [PMID: 29479211 PMCID: PMC5804939 DOI: 10.1093/pch/pxx043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To determine the domains of parent-therapist collaboratively set goals for intervention within a family-centered, tertiary-level early developmental intervention (EDI) program. To report changes in ratings for performance and satisfaction of performance pre- and postintervention for the set goals. METHODS This study includes all children with complex developmental disabilities (30 ± 3 months of age, 61% boys) registered in a tertiary-level EDI program from 2009 to 2012 whose parents completed the Canadian Occupational Performance Measure (COPM) to evaluate goal setting. The International Classification of Functioning, Disability and Health: Children & Youth version (ICF-CY) domain for each goal was recorded. Pre- and postintervention ratings for individual and averaged goals per child were calculated. Positive changes in ratings were determined by an increase of ≤2 and presented as a proportion and as means (standard deviation). Student t test, Fisher Exact and chi-square tests compared groups. RESULTS Of 483 individual goals set for 168 children, 65.4% were in the ICF-CY activity domain, 16.4% participation, 10.3% body function, 7.4% environment and 0.4% body structure. Positive changes in ratings for performance occurred in 70%; for satisfaction, 68%, with no difference in relation to domain. Positive changes in average ratings per child showed: performance, 67%; satisfaction, 66%. CONCLUSION Intervention goals for disabled children within tertiary-level EDI are primarily those of activity, not participation as ICF-CY recommends; two-thirds of goals show positive change. These results suggest the need for further evaluation of goal setting within EDI programs with the expectation of increasing goals of participation and improving ratings for performance and satisfaction.
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Affiliation(s)
- Charlene M T Robertson
- Division of Developmental Pediatrics, Department of Pediatrics, University of Alberta, Edmonton, Alberta
- Department of Pediatrics, Glenrose Rehabilitation Hospital, Edmonton, Alberta
| | - Shannon M DeForge
- Department of Pediatrics, Glenrose Rehabilitation Hospital, Edmonton, Alberta
| | - Cara F Dosman
- Division of Developmental Pediatrics, Department of Pediatrics, University of Alberta, Edmonton, Alberta
- Department of Pediatrics, Glenrose Rehabilitation Hospital, Edmonton, Alberta
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Costa UM, Brauchle G, Kennedy-Behr A. Collaborative goal setting with and for children as part of therapeutic intervention. Disabil Rehabil 2016; 39:1589-1600. [PMID: 27385635 DOI: 10.1080/09638288.2016.1202334] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This study explored collaborative goal setting with children, parents, and teachers, and children's reasons for their goals based on their perceived self-efficacy, using the Austrian-German Perceived Efficacy and Goal Setting System (AG-PEGS). METHOD Thirty-eight children from age 5 to 10 years (referred to occupational therapists because of difficulties in performing everyday activities), their parents and teachers participated in this mixed methods study. Participants' goals were analyzed using descriptive statistics and content analysis. Data were grouped into thematic categories, and attributed to health factors according to the International Classification of Functioning, Disability, and Health-Children & Youth Version (ICF-CY). RESULTS Children's responses underlined the significance of self-efficacy and participation for a child's health and well-being. They gave priority to their independence, competence, and joy in meaningful everyday activities and indicated social motives such as belonging to and being accepted by others for their mainly participation-oriented goals. Parents' main concerns were related to school task performance, whereas teachers mainly chose body functions and school activities to be the focus of occupational therapy intervention. CONCLUSIONS Exploring clients' priorities, the meanings they attributed to activities in daily life, and their underlying motives for goals should be part of therapeutic intervention. Children and their caregivers are valid and important sources for therapeutic goal setting. Basic human needs, e.g., for relatedness, competence (self-efficacy), autonomy, and meaningful personal orientation, should be considered when prioritizing goals for intervention. Implications for Rehabilitation Children are a valid and important source for therapeutic goal setting. Children's goals focused on activities and participation in all life areas, and half of the parents' goals on activities as relevant for productivity (followed by self-care and leisure), while teachers tended to prioritize goals at the body functions and structures level. The experience of their task performance affecting participation, and the basic needs for independence, relatedness (belonging to and being accepted by others), competence (self-efficacy), and joy through engagement in personally meaningful activities are main motives for children with developmental disabilities to choose their goals for intervention. A client-centred approach in working with children with developmental disabilities requires time and attention for exploring meaning-attributed activities for children and their proxies when collaboratively setting goals.
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Affiliation(s)
- Ursula M Costa
- a Department of Occupational Therapy , University of Applied Sciences Tyrol , Innsbruck , Austria
| | | | - Ann Kennedy-Behr
- a Department of Occupational Therapy , University of Applied Sciences Tyrol , Innsbruck , Austria.,c Division of Occupational Therapy , School of Health and Sport Sciences, University of the Sunshine Coast , Australia
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Kruijsen-Terpstra AJA, Ketelaar M, Verschuren O, Gorter JW, Vos RC, Verheijden J, Jongmans MJ, Visser-Meily A. Efficacy of three therapy approaches in preschool children with cerebral palsy: a randomized controlled trial. Dev Med Child Neurol 2016; 58:758-766. [PMID: 26880083 DOI: 10.1111/dmcn.12966] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/29/2015] [Indexed: 12/01/2022]
Abstract
AIM To examine the efficacy of child-focused, context-focused, and regular care approaches, delivered in a rehabilitation setting by physical or occupational therapists to preschool children with cerebral palsy (CP), in optimizing the child's self-care and mobility capabilities. METHOD A multicentre randomized controlled trial clustered at therapist level was conducted in 13 rehabilitation centres. It included 68 children with CP (38 males, 30 females; mean age 3y, SD 6mo, range 1y 11mo-4y), classified as Gross Motor Function Classification System levels I to IV, who were already receiving therapy. Children received a child-focused, context-focused, or regular care approach during a 6-month period. Self-care and mobility capabilities were assessed with the Functional Skills Scale of the Pediatric Evaluation of Disability Inventory. RESULTS The child-focused, context-focused, and regular care approaches all resulted in significant but similar improvements in self-care (regular: reference; child-focused: β=-0.11, 95% confidence interval [CI] -0.68 to 0.46; context-focused: β=0.13, CI -0.38 to 0.64) and mobility (regular: reference; child-focused: β=-0.09, CI=-0.93 to 0.75; and context-focused: β=0.14, CI -0.65 to 0.94) capabilities. INTERPRETATION The results suggest that the three therapy approaches were equally efficacious for preschool children with CP. Depending on a child's individual situation each approach can be selected.
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Affiliation(s)
- Anne J A Kruijsen-Terpstra
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Marjolijn Ketelaar
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Olaf Verschuren
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Rimke C Vos
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Johannes Verheijden
- BOSK, Association of People with a Physical Disability, Utrecht, the Netherlands
| | - Marian J Jongmans
- Faculty of Social and Behavioural Sciences, Department of Child, Family & Education Studies, Utrecht University, Utrecht, the Netherlands
| | - Anne Visser-Meily
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
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