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"It makes me a better person": The unique experiences of parenting multiple children who experience neurodevelopmental disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 147:104697. [PMID: 38377706 DOI: 10.1016/j.ridd.2024.104697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/20/2024] [Accepted: 02/10/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Much research has explored how raising a child with a neurodevelopmental disability influences parents' well-being. However, little research has focused on the unique experiences of parenting multiple children with neurodevelopmental disabilities. We explored the unique experiences of parenting multiple children with neurodevelopmental disabilities with a focus on mothers' well-being and social participation. METHODS Ten mothers who parent multiple children with neurodevelopmental disabilities participated in semi-structured interviews. Interviews were analyzed using a reflexive thematic approach. RESULTS Three themes were identified: 'Knowledge is power' described positive influences of enhanced disability knowledge and advocacy with each child who experienced disability. 'Shifts in wellbeing' acknowledged these mothers' exhaustion, decreased time for self-care, and invisible work, yet also increased feelings of empowerment, purpose and empathy for others. '(Dis)Connection and engagement with others' reflected struggles of balancing responsibilities, social and community participation, and experiences with isolation. Yet, mothers' also experienced enhanced disability community and family connections, and a sense of meaning and purpose. CONCLUSIONS AND IMPLICATIONS Findings highlighted challenges, and many rewarding and unique experiences of parenting multiple children with neurodevelopmental disabilities. Health, education and social service practitioners are encouraged to acknowledge parent's challenges, but also celebrate and draw on families' strengths and knowledge.
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Strategies Used by Professionals in Pediatric Rehabilitation to Engage the Child in the Intervention Process: A Scoping Review. Phys Occup Ther Pediatr 2024:1-28. [PMID: 38213190 DOI: 10.1080/01942638.2023.2290038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/25/2023] [Indexed: 01/13/2024]
Abstract
AIM To investigate strategies used by professionals in pediatric rehabilitation to engage children in every step of the intervention process, including assessment, goal setting, planning and implementation of the intervention, and results evaluation. METHODS A scoping literature review was conducted, and seven databases were searched, including CINAHL and MEDLINE, ProQuest Central, PsycINFO, Social Science Premium Collection, PubMed, and Web of Science. A citation search of included articles was completed. Predetermined criteria, quality standards, and PIO framework guided the selection process. Results were presented in relation to Self-Determination Theory (SDT) and the contextual model of therapeutic change. RESULTS In total, 20 studies were included in the review. Pediatric professionals reported that therapeutic use of self and their own engagement in the intervention facilitated the establishment of a supportive relationship. Providing clear explanations about their role and therapy rationale developed positive expectations. By making the child feel successful within-session and outside-session activities, professionals enhanced child mastery. Professionals' strategies were abstractly described. CONCLUSIONS Further research is needed to investigate strategies that are effective in the different steps of the intervention. More observational, longitudinal studies are required to capture fluctuations in in-session engagement.
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Collaboration: How does it work according to therapists and parents of young children? A systematic review. Child Care Health Dev 2024; 50:e13167. [PMID: 37724049 DOI: 10.1111/cch.13167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 05/18/2023] [Accepted: 08/06/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Collaboration between therapists and parents of children with developmental disabilities is a key element of family-centred care. In practice, collaboration appears to be challenging for both parents and therapists. This systematic review aims to make explicit how therapists can optimise their collaboration with parents of young children with developmental disabilities, according to the perspectives of parents and therapists. METHODS A systematic review was conducted using the following databases: Medline (PubMed), CINAHL (OVID) and PsychINFO (OVID). Those papers were selected, which focused on collaboration using a two-way interaction between therapists and parents, exploring the perspectives of therapists and/or parents of children between 2 and 6 years. Papers needed to be published in English or Dutch between 1998 and July 2021. Included papers were synthesised using a qualitative analysis approach by two researchers independently. Results sections were analysed line-by-line, and codes were formulated and discussed by all authors. Codes were aggregated, resulting in a synthesis of specific collaboration strategies in combined strategy clusters. RESULTS The search generated 3439 records. In total, 24 papers were selected. Data synthesis resulted in an overview of specific strategies organised into five clusters: (1) continuously invest time in your collaboration with parents, (2) be aware of your important role in the collaboration with parents, (3) tailor your approach, (4) get to know the family and (5) empower parents to become a collaborative partner. CONCLUSIONS This systematic review resulted in an overview of concrete strategies for therapists to use in their collaboration with parents of children with developmental disabilities. The strategies formulated enable therapists to consciously decide how to optimise their collaboration with each individual parent. Making these strategies explicit facilitates change of practice from therapist-led and child-centred towards family-centred care.
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Using the capability, opportunity, and motivation model of behaviour to assess provider perception of implementing solution-focused goal-setting in paediatric rehabilitation. J Child Health Care 2023:13674935231194501. [PMID: 37585268 DOI: 10.1177/13674935231194501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Adoption of family and child goal-setting in paediatric rehabilitation is important to positive long-term outcomes. Solution-focused coaching (SFC) has been identified as a promising approach to ensuring this type of goal-setting occurs, while the actual implementation of SFC by health care providers (HCPs) is low. This study utilized the capacity, opportunity, and motivation model of behaviour change (COM-B) to identify which strengths and difficulties health care providers (HCPs) perceived with respect to SFC goal-setting in paediatric rehabilitation. A self-report survey was developed and administered to HCPs at a paediatric rehabilitation hospital. Each survey question was based upon a COM-B sub-component. Demographic information was collected from HCPs, and descriptive statistics were used to rank perceived COM-B components from strongest to weakest. Results indicate HCPs view the provision of SFC goal-setting as an important practice, while they also perceive difficulties to actual delivery due to: lack of adequate individual skill, lack of experience with this type of goal-setting, and insufficient preparation for clients to engage in sharing their goals. HCPs also perceived lack of organizational processes to support the practice within their teams. Recommendations for intervention are provided.
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Indicators of life success from the perspective of individuals with traumatic brain injury: a scoping review. Disabil Rehabil 2023; 45:330-343. [PMID: 35037526 DOI: 10.1080/09638288.2021.2025274] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE The purpose was to synthesize qualitative literature and identify indicators of life success (positive life outcomes and experiences) that can help in understanding resiliency in the context of traumatic brain injury (TBI). METHODS This scoping review involved searching nine online databases for population (TBI) and context (qualitative literature). Searches retrieved 42 852 articles and, after two-stage screening, 76 articles met the inclusion criteria of reporting indicators of life success from the perspective of individuals with TBI. RESULTS Most studies were conducted in North America, Australia, or Europe. Participants were people living with TBI (mild to severe), of all age ranges. Positive life experiences were organized within four domains: understanding of oneself and one's life, social relationships and interaction, doing (engagement in activities, sense of control and accomplishment), and hope for the future. CONCLUSIONS The positive life experiences reflect both processes and outcomes (indicators of success) and highlight the need for a multidimensional approach when seeking to understand resiliency following TBI. The transactional framework of life experiences can be applied in future TBI resiliency research to understand how individuals negotiate adversity through experiences promoting understanding of oneself and the world, social relationships, engagement in activity and hope. Implications for rehabilitationRehabilitation services should consider how to afford opportunities for engagement in activity, social interaction, meaning making (i.e., coming to new understandings), and hope.With respect to engaging in activity and social relationships, having social interaction, being understood, being active and productive, having autonomy, and having accomplishments, reflect important experiences to enable within rehabilitation services.Rehabilitation professionals should consider how providing opportunities for their clients to have positive life experiences may contribute toward an adaptive and empowered mindset.
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Initial Development and Evaluation of the My Family's Accessibility and Community Engagement (MyFACE) Tool for Families of Children With Disabilities. Am J Occup Ther 2022; 76:23315. [PMID: 35767512 DOI: 10.5014/ajot.2022.048009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Parental perceptions and experiences of community inclusion influence the community participation of families and children with a disability, although no measurement tools exist. OBJECTIVE To describe the initial development of the My Family's Accessibility and Community Engagement (MyFACE) tool. DESIGN MyFACE measures parental perceptions of community accessibility and engagement of families raising a child with a disability. Items represent common community activities rated on a 5-point Likert scale. COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guided content validity, construct validity, and internal reliability testing. SETTING Australia. PARTICIPANTS Seventy-seven mothers of children with a disability provided data, with 69 complete data sets. RESULTS The nine-item MyFACE had excellent content and construct validity and good internal reliability (Cronbach's α = .85). Hypothesis testing correlated MyFACE with maternal factors (mental health and healthy behavior) and child factors (psychosocial issues). Three predictors together explained 27% of the variance in a significant model, F(3, 61) = 7.09, p < .001. The most important predictor was maternal depressive symptoms. CONCLUSIONS AND RELEVANCE Initial evaluation of the MyFACE tool suggests sound psychometric properties warranting further development. What This Article Adds: The MyFACE tool provides clinicians and researchers with a way to measure parental perceptions of community inclusion. Maternal depressive symptoms were predictive of MyFACE scores, indicating that to be effective, family participation may require clinicians to address maternal mental health and children's participation restrictions.
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A Study on the Use of Milieu Teaching to Promote Overseas Marketers’ Communication Skills and Confidence in Language Learning. Front Psychol 2022; 13:923812. [PMID: 35814133 PMCID: PMC9257129 DOI: 10.3389/fpsyg.2022.923812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/25/2022] [Indexed: 11/29/2022] Open
Abstract
Language plays an extremely important role for people in terms of engaging in various learning activities. Due to the progress of network technologies, it is an immediate goal for enterprises to take a completely new development direction with the application of network technology. Nevertheless, they encounter many difficulties in carrying out overseas marketing such as localization transformation, jet lag, lack of professional marketers, problems with sellers’ product quality, problems with customers’ credit checks, international payment problems, and logistics and delivery problems. These problems mainly result from a difference in language families. The current study was conducted as an experimental study with the participation of overseas marketers in Hebei province. Milieu teaching was implemented with an experimental group and traditional teaching was maintained in the control group for a 20-week (3 h per week) experimental procedure. The research results revealed significantly positive effects of (1) milieu teaching on communication skills, (2) milieu teaching on language learning confidence, and (3) communication skills on language learning confidence. Based on the results, it can be stated that the study is expected to help effectively enhance the communication skills and language learning confidence of overseas marketers to achieve the goals of promoting oral expression and language-use skills.
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Solution-Focused Coaching to Support Clinicians' Professional Development: An Analysis of Relational Strategies and Co-constructed Outcomes. Dev Neurorehabil 2022; 25:205-216. [PMID: 34860149 DOI: 10.1080/17518423.2021.2011458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To explore solution-focused coaching (SFC) as a means to enhance pediatric rehabilitation practitioners' development of listening skills. METHODS Six clinicians each participated in two SFC sessions with an experienced coach who used a practice model developed for pediatric rehabilitation (SFC-peds). The transcribed interviews were analyzed by inductive content analysis to identify the coach's use of relational strategies and the nature of what was being co-constructed in the sessions. RESULTS The coach used six relational strategies (e.g., supporting reflective and critical thinking). Through dialogue and reflection, the coach and clinician co-constructed four important outcomes, including shared meaning, awareness and discovery of strengths and values, discovery of strategies and opportunities, and forward movement. CONCLUSIONS The study informs our understanding of the relational processes and benefits of SFC conversations. These conversations appear to provide an optimal learning space to enhance professional development, by facilitating the co-creation of meaning, awareness, and intentionality.
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Solution-Focused Coaching for Friendship in Pediatric Rehabilitation: A Case Study of Goal Attainment, Client Engagement, and Coach Stances. Phys Occup Ther Pediatr 2022; 42:154-171. [PMID: 34266361 DOI: 10.1080/01942638.2021.1947435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIMS To examine goal attainment, engagement, and the stances used by coaches providing a solution-focused coaching intervention (SFC-peds) for young people with cerebral palsy pursuing friendship goals. METHODS The case study involved two clients with cerebral palsy (a young child and his mother, and a youth) and their service providers. An interpretive descriptive approach was used to analyze quantitative and qualitative data. Friendship goal attainment was assessed by the Canadian Occupational Performance Measure and goal attainment scaling, and client engagement was assessed using the Pediatric Rehabilitation Intervention Measure of Engagement-Service Provider version. Information from post-intervention client interviews was used to identify coach stances and relationships with client engagement. RESULTS Participants met their friendship goals and were considered to be highly engaged by their coaches. Four coach stances were identified: Respectful Inquiry, a Strengths Presupposition, Implementation Curiosity, and Inspiring Commitment. These stances, and aligned tactics, engaged clients on affective, cognitive, and behavioral levels, and impacted the client's stance toward their goal. CONCLUSIONS SFC-peds appears to be an effective and engaging approach for young people with disabilities working on friendship goals. The findings illustrate how the coach's stances and tactics engage clients, thus impacting the client's own stances toward change.
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Further psychometric evaluation of the My Family's Accessibility and Community Engagement (My FACE) tool: Mothers' ratings of perceptions of community accessibility and engagement for their child with disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 114:103955. [PMID: 33894506 DOI: 10.1016/j.ridd.2021.103955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/28/2021] [Accepted: 04/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND/AIM My Family's Accessibility and Community Engagement (My FACE) measures mothers' perceptions of community accessibility and engagement for families raising children with a disability. This study investigated the construct validity including the factor structure and internal reliability of the MyFace scale. METHODS Construct validity was evaluated using hypothesis testing. Structural validity was confirmed with factor analysis. Internal reliability was measured using Cronbach alpha. The nine-item MyFACE includes items representing common community destinations. A 5-point Likert scale measured perceptions of need for change and inclusion. RESULTS Mothers (N = 83) completed an online survey with MyFACE, maternal and childhood disability scales. Hypothesis testing revealed correlations with MyFACE: Depression Anxiety Stress Scales (DASS)-stress (r = -.25, n = 72, p = .037), DASS-anxiety (r = -.41, n = 70, p < .001,), and DASS-depression (r = -.27, n = 72, p = .023,) scales. MyFACE scores correlated with mothers' total Health Promoting Activity Scale (HPAS) scores (r = .40, n = 74, p < .001). HPAS was the strongest predictor of variation in MyFACE scores F(5, 66) = 5.68, p < .001. Factor analysis demonstrated unidimensionality. Internal reliability was excellent (Cronbach alpha = .80). CONCLUSIONS The MyFACE tool is psychometrically sound. Compared to child factors, maternal mental health and health promoting behaviour had more influence on mothers' perceptions of family community accessibility and engagement. The MyFACE measures a unique, previously unmeasurable family construct.
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Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence. Child Psychiatry Hum Dev 2021; 52:515-532. [PMID: 32748274 PMCID: PMC8113221 DOI: 10.1007/s10578-020-01036-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/28/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022]
Abstract
Auto-aggressive behaviour, especially treatment refractory suicidality in adolescents with psychiatric disorders, may be challenging to clinicians. In search of therapeutic possibilities, we have integrated current opinions regarding causality and interdependency of suicidality and auto-aggressive behaviour across disorders within the HiTOP framework. We propose a developmental model regarding these unsettling behaviours in youths that may help to guide future directions for research and interventions. We argue that the interdependent development of biologic factors, attachment, moral reasoning and emotion regulation in an overprotective environment may lead to social anxiety and later during development to emotion dysregulation and severe internalizing behaviour disorders. To optimize treatment efficacy for both internalizing and externalizing behaviour, we emphasize the importance transdiagnostic interventions, such as addressing non-compliance, restoration of trust between parents and their child, and limitation of avoidance behaviour. These may be seen as higher order interventions within the HiTOP framework.
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Sustaining Changes to Clinical Practice at Person, Team, and Organizational Levels. Phys Occup Ther Pediatr 2021; 41:355-357. [PMID: 34229546 DOI: 10.1080/01942638.2021.1936820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Aim: The purpose of this evidence-to-practice commentary is to provide strategies for sustaining solution-focused coaching (SFC) training outcomes and changes to clinical practice at person, team, and organizational levels.Methods: In the original study of focus, the research team conducted qualitative interviews with 13 clinical service providers 6 months after completing 2 days of SFC training and used a thematic analysis to explore the benefits and challenges of implementing a SFC approach.Results: The findings indicated that clinicians found the SFC training to be effective and valuable to practice. Additionally, challenges and barriers to clinical adaptation were reported.Conclusion: Knowledge mobilization can be supported by providing ongoing, follow-up opportunities to learn and practice solution-focused coaching across a variety of contexts. Cross-discipline professional learning opportunities that include leadership and non-clinical staff result in shared awareness, common language, and value of solution-focused coaching as a communication framework that can be implemented across an organization.
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Program factors influencing parents' engagement in a friendship-making intervention for youth with disabilities. Disabil Rehabil 2020; 44:1620-1630. [PMID: 33351666 DOI: 10.1080/09638288.2020.1861115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim was to examine parents' experiences of engagement in a friendship-making intervention for youth with physical and developmental disabilities. METHOD This mixed methods study used a convergent parallel design where quantitative and qualitative data were collected concurrently, analyzed independently, and then merged into an overall interpretation. Four parents completed the Pediatric Rehabilitation Intervention Measure of Engagement-Parent version at four points during the 8-week program. They also took part in post-intervention interviews about their engagement-related experiences, including their involvement, interest, and confidence in the parent sessions. RESULTS Parents' engagement experiences were captured in four themes involving the person-intervention fit: the relevance of program content, the usefulness of the content, their behavioral involvement in planning and group discussions, and seeing youth experience success. The themes corroborated the quantitative measurement of engagement and illustrated and elaborated on how program factors influenced engagement. CONCLUSIONS This study indicates the value of including a parent component in a youth friendship-making intervention, and points to the importance of considering relevance, usefulness, behavioral involvement, and success in designing these sessions. The four themes reflect important program factors that may be broadly relevant to the design of group-based interventions for parents of youth with disabilities.IMPLICATIONS FOR REHABILITATIONThe findings indicate the value of including a parent component in youth interventions.Parents are engaged when they feel programs are relevant and useful, are behaviorally involved, and see youth experience success-these factors should be considered in optimal program design.It is important to optimize parent engagement by personalizing content, such as by providing choices and options to increase relevance and decrease burden.Transparent communication about program content and the benefits experienced by other parents will help new parents be more fully informed about what to expect.
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Occupational Performance Coaching with Parents to Promote Community Participation and Quality of Life of Young Children with Developmental Disabilities: A Feasibility Evaluation in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217993. [PMID: 33143189 PMCID: PMC7662925 DOI: 10.3390/ijerph17217993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/17/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022]
Abstract
Participation in community activities contributes to child development and health-related quality of life (HRQOL), but restricted participation has been reported in children with disabilities. Occupational performance coaching (OPC) is an intervention that targets participatory goals in child performance through coaching parents, with evidence of effectiveness for pediatric populations. Little is known about the feasibility of OPC in Hong Kong, or its effect on children's community participation and HRQOL. A mixed-methods case study design was applied to explore Hong Kong parents' experience of OPC in relation to goal achievement, community participation, and HRQOL change in children. Four parents of young children with developmental disabilities (aged five to six years) received OPC for three to eight sessions within one to three months. Quantitative pre- and post-intervention data were analyzed descriptively. Semi-structured interviews with parents were conducted at post-intervention, and analyzed using content analysis. Results showed a trend of improvement in goal performance, child involvement in community activities, and specific aspects of HRQOL among most participants. Parents perceived undertaking OPC positively, described gaining insights and skills, and felt supported. The findings suggest that OPC warrants further investigation for use in Hong Kong, to promote children's community participation and quality of life.
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Exploring Relational Dialogue in Solution-Focused Coaching Sessions: An Analysis of Co-Construction and Reflection. Dev Neurorehabil 2020; 23:390-401. [PMID: 31902270 DOI: 10.1080/17518423.2020.1711542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: To examine solution-focused coaching (SFC) as a means to enhance clinicians' professional development. Methods: Six pediatric rehabilitation clinicians (three physical, two occupational, and one behavior therapist) each received two SFC sessions targeting clinical listening goals. Conversational intervals were noted in session transcriptions. Frequencies of relational strategies and conversational intervals were calculated. The meaning of intervals > 10 s was examined. Results: The most frequent relational strategies indicated that SFC facilitates reflection and critical thinking, and encourages action. An appreciable number of long intervals (>10 s) occurred, indicating substantial reflection by participants. These were embedded in relational dialogue sequences involving coach questions and formulations, and participant pauses. Conclusions: The findings support the use of SFC as a professional development tool and substantiate the view that SFC 'works' through the coach's use of relational strategies designed to facilitate collaborative conversations that build solutions through an emphasis on reflection and action.
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Abstract
Currently, coaching is increasingly applied to foster the involvement of families with an infant or young child with special needs in early intervention and paediatric rehabilitation. Coaching practices are included in many forms of intervention and are regarded as essential to reach beneficial outcomes for the child and family. There are, however, many ambiguities that blur the concept of coaching and hamper its understanding and integration as an evidence-based approach in early intervention and paediatric rehabilitation: lack of differentiation between coaching and training of families, for example. Challenges to incorporate coaching into professional practice relate to adult learning processes and knowledge acquisition, and transformation of attitudes, beliefs, and treatment habits. In this paper, we review the barriers encountered and the possibilities available to promote successful implementation of coaching in early childhood interventions. WHAT THIS PAPER ADDS: Literature defines coaching ambiguously, which hampers its implementation in early intervention. The term 'coaching' should be reserved for relationship-directed, family-centred intervention.
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Abstract
Aims: This qualitative descriptive study explored perceived impacts of solution-focused coaching in pediatric rehabilitation (SFC-peds) from the viewpoint of experienced therapists.Methods: Semi-structured in-depth interviews were conducted with six participants (four occupational therapists and two physical therapists) who had incorporated SFC-peds into their practice for three years or longer. Participants were asked to describe perceived differences SFC-peds has made to their clinical practice, service provision, and relationships with clients and families. Interview transcripts were analyzed using the method of thematic analysis.Results: Three major themes, each with subthemes, were identified: 1) changes in therapists' perception of their roles; 2) increased service effectiveness; and 3) enhanced client capacity. Through long-term engagement with SFC-peds, participants have experienced a role shift from an expert adviser to a collaborative facilitator who assists clients and families with capacity building and self-discovery of solutions for their everyday environments.Conclusions: The findings suggest that SFC-peds can help participants reframe professional expertise and integrate principles of family-centred care into their day-to-day practice. Individual- and system-level support, along with flexibility in service structures and processes, may be needed to further the implementation of SFC-peds in service delivery.
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The Nature, Value, and Experience of Engagement in Pediatric Rehabilitation: Perspectives of Youth, Caregivers, and Service Providers. Dev Neurorehabil 2020; 23:18-30. [PMID: 31042403 DOI: 10.1080/17518423.2019.1604580] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose: To conduct a qualitative investigation of engagement in pediatric rehabilitation therapy.Methods: Interviews were conducted with 10 youth, 10 caregivers, and 10 service providers. Transcripts were analyzed thematically using an inductive approach.Results: Themes illustrated three perspectives: engagement as a connection with components of the therapy process, engagement as working together, and engagement as an affective and motivational process. Engagement created valued connections with therapy components and forward momentum for therapy.Conclusions: The themes supported a view of engagement as complex, transactional, and multidimensional. Participants focused on different, yet not discrepant, aspects of engagement. Youth focused on having fun and personal connection with service providers. Caregivers provided a more complex perspective encompassing both their own and their child's engagement, with an emphasis on relationship, understanding what is taking place, and feeling valued in the process. Service providers highlighted goal attainment and the value of engagement in bringing about outcomes.
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A Solution-Focused Coaching Intervention with Children and Youth with Cerebral Palsy to Achieve Participation-Oriented Goals. Phys Occup Ther Pediatr 2020; 40:423-440. [PMID: 31939337 DOI: 10.1080/01942638.2020.1711841] [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] [Indexed: 10/25/2022]
Abstract
Background: The ultimate goal of therapeutic intervention is meaningful participation in one's world. For people with Cerebral Palsy (CP), limitations can often become a focus of care.Aim: Our purpose was to investigate the impact of a Solution-Focused Coaching intervention designed for pediatric rehabilitation (SFC-peds) on the attainment of participation goals for children/youth with CP.Method: Twelve participants participated in a repeated measures quantitative study and in qualitative interviews. Children and youth (ages 6-19) and their families participated in three to five coaching sessions, including an initial baseline goal setting session, with one additional follow-up session as well as the qualitative interviews. The Canadian Occupational Performance Measure and Goal Attainment Scaling were incorporated into initial coaching sessions and then re-administered by a blind assessor within one month post-intervention. Qualitative interviews were conducted at this time.Results: Statistically significant improvements were found in goal performance, satisfaction, and attainment. Interview data included consideration of both the content of the intervention (what the practitioner is doing) and the unique SFC-peds process (how the client feels about the intervention).Conclusions: SFC-peds may present an effective approach for working with children/youth with CP to achieve self-selected participation-oriented goals in a relatively short time-period.
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Adults with cerebral palsy rank factors associated with quality of life and perceived impact of childhood surgery on adult outcomes. Disabil Rehabil 2019; 43:2431-2438. [PMID: 31881158 DOI: 10.1080/09638288.2019.1701718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Impact of Solution-Focused Coaching Training on Pediatric Rehabilitation Specialists: A longitudinal evaluation study. J Interprof Care 2019; 34:481-492. [DOI: 10.1080/13561820.2019.1685477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Parent engagement and disengagement in paediatric settings: an occupational therapy perspective. Disabil Rehabil 2019; 42:2882-2893. [DOI: 10.1080/09638288.2019.1574913] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Parent Empowerment in Pediatric Healthcare Settings: A Systematic Review of Observational Studies. THE PATIENT 2019; 12:199-212. [PMID: 30328069 PMCID: PMC6397702 DOI: 10.1007/s40271-018-0336-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Parent empowerment is often an expressed goal in clinical pediatrics and in pediatric research, but the antecedents and consequences of parent empowerment are not well established. OBJECTIVE The objective of this systematic review was to synthesize potential antecedents and consequences of parent empowerment in healthcare settings. ELIGIBILITY CRITERIA The inclusion criteria were (1) studies with results about parent empowerment in the context of children's healthcare or healthcare providers; and (2) qualitative studies, observational studies, and systematic reviews of such studies. INFORMATION SOURCES We searched the databases of PubMed, Web of Science, and Google Scholar (2006-2017) and reference lists. INCLUDED STUDIES Forty-four articles met the inclusion criteria. SYNTHESIS OF RESULTS We identified six themes within consequences of empowerment: increased parent involvement in daily care, improved symptom management, enhanced informational needs and tools, increased involvement in care decisions, increased advocacy for child, and engagement in empowering others. Six themes summarizing antecedents of empowerment also emerged: parent-provider relationships, processes of care, experiences with medical care, experiences with community services, receiving informational/emotional support, and building personal capacity and narrative. We synthesized these findings into a conceptual model to guide future intervention development and evaluation. STRENGTHS AND LIMITATIONS OF EVIDENCE Non-English articles were excluded. INTERPRETATION Parent empowerment may enhance parent involvement in daily care and care decisions, improve child symptoms, enhance informational needs and skills, and increase advocacy and altruistic behaviors. Parent empowerment may be promoted by the parent-provider relationship and care processes, finding the right fit of medical and community services, and attention to the cognitive and emotional needs of parents. CLINICAL REGISTRATION NO PROSPERO 2017:CRD42017059478.
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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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