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The Journey: Parental Expectations and Perceptions of Therapy Services for Children With Down Syndrome. Pediatr Phys Ther 2022; 34:318-326. [PMID: 35639547 DOI: 10.1097/pep.0000000000000905] [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: 11/26/2022]
Abstract
PURPOSE The researchers sought to identify and describe parents' expectations and perceptions of therapy services received by their children with Down syndrome. METHODS This study used a qualitative descriptive approach conducted in 2 phases: individual semi-structured parent interviews followed by focus groups. Analysis of interview transcripts served as the basis for development of codes, categories, and themes describing parents' beliefs, values, and opinions of their children's therapy. RESULTS Within the metaphor of The Journey, 3 major themes emerged: Where are we going? Who's driving the car? What I really need for this trip. CONCLUSIONS Parents value the principles of family-centered care and want a partnership with therapists in caring for their children. Therapists can help parents of children with Down syndrome navigate their children's therapy services by establishing a relationship of trust and by communicating with respect, understanding, and compassion.
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Manikandan M, Kerr C, Lavelle G, Walsh M, Walsh A, Ryan JM. Health service use among adults with cerebral palsy: a mixed-methods systematic review. Dev Med Child Neurol 2022; 64:429-446. [PMID: 34705276 DOI: 10.1111/dmcn.15097] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 08/26/2021] [Accepted: 09/25/2021] [Indexed: 12/15/2022]
Abstract
AIM To determine the proportion of adults with cerebral palsy (CP) using health services and frequency of use, and to explore experiences and perceptions of health services for this population. METHOD A mixed-methods systematic review was conducted using the Joanna Briggs Institute methodology. Five databases were searched to September 2020. Observational and qualitative studies were included. Two reviewers screened titles, abstracts, and full texts; extracted data; and assessed the quality of included studies. Separate meta-analyses were used to pool the proportion of adults using each service and frequency of use. A meta-aggregation approach was used to synthesize qualitative data. Quantitative and qualitative findings were integrated using the Andersen and Newman Model of health care utilization. RESULTS Fifty-seven studies (31 quantitative, 26 qualitative) of 14 300 adults with CP were included. The proportion of adults using services ranged from 7% (95% confidence interval [CI]: 2-13%) for urologists to 84% (95% CI: 78-90%) for general practitioners. Incidence of visits ranged from 67 (95% CI: 37-123) hospital admissions to 404 (95% CI: 175-934) general practitioner visits per 100 person-years. Qualitative themes highlighted issues regarding accessibility, caregivers' involvement, health workers' expertise, unmet ageing needs, transition, and health system challenges. INTERPRETATION Adults with CP used a wide range of health services but faced context-specific challenges in accessing required care. Appropriate service delivery models for adults with CP are required. This review emphasizes a need to develop an appropriate service model for adults with CP to meet their needs.
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Affiliation(s)
- Manjula Manikandan
- Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Claire Kerr
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Grace Lavelle
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael Walsh
- National Clinical Programme for People with Disability, Clinical Design and Innovation Office, Health Service Executive, Dublin, Ireland
| | - Aisling Walsh
- Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jennifer M Ryan
- Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin, Ireland.,College of Health and Life Sciences, Brunel University, London, UK
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Orthopaedic Disorders in Cerebral Palsy in International Cooperation Projects: A Descriptive Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157872. [PMID: 34360167 PMCID: PMC8345347 DOI: 10.3390/ijerph18157872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/14/2021] [Accepted: 07/21/2021] [Indexed: 12/03/2022]
Abstract
Background: In international cooperation projects that are carried out in less developed and developing countries, a large number of children with disabilities present cerebral palsy (CP). Orthopaedic disorders are frequent complications associated with this disorder. Their prevention and early intervention are essential to achieve an appropriate therapeutic approach for children with PC and to improve their quality of life. Objective: To describe the treatment approach that is currently used in international cooperation projects for the rehabilitation management of the orthopaedic disorders in children with cerebral palsy. Methods: This is an observational, descriptive, cross-sectional study, carried out by means of an online questionnaire to professionals in the field of Physiotherapy and Rehabilitation working in international cooperation projects. The inclusion criteria were professionals working in the rehabilitation field in development aid, humanitarian action or emergency projects that provided rehabilitation services, working with children with cerebral palsy from 0 to 18 years old. Results: Ninety-eight questionnaires were analysed. The average age of the participants was 33.2 years, they were mainly working in development cooperation projects (83.33%) that were implemented in rehabilitation centres and through community-based rehabilitation services (60%). The projects were located in countries all over the world but mainly on the Asian continent (71.4%). Physiotherapists and orthopaedic technicians (72.22%) were the main professionals working in these projects, followed by occupational therapists and social workers (55.56%). The results indicated that the orthopaedic disorders were very frequent in the sample (66.67%), with hip subluxation (50%), scoliosis (77.78%), kyphosis (61.1%), clubfoot (88.7%) and varus foot (61.11%) standing out. The most commonly used treatment approaches were positioning (88.89%) and the Bobath concept (83.33%). The technical aids that were used by the professionals were ankle foot orthosis (AFO) (94.44%), bracing (66.67%), standing frames (83.33%), moulded seats (100%), corner seats (93.75%) and adapted seats (92.85%). Conclusions: In international cooperation projects, the rehabilitation treatment of children with cerebral palsy is based on a holistic approach. This is reflected in the interventions that are carried out to treat their orthopaedic disorders and in locally produced devices, awareness raising and community education. However, the professionals surveyed considered that the aids or orthoses used are insufficient in the treatment and prevention of orthopaedic disorders in cerebral palsy.
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Prajakta P, John S, Bellur R. Parental Perspectives on Quality of Life in Adolescents with Cerebral Palsy. Indian J Psychol Med 2020; 42:256-261. [PMID: 32612330 PMCID: PMC7320728 DOI: 10.4103/ijpsym.ijpsym_300_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/06/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Quality of life (QoL) is an important outcome variable while evaluating intervention effectiveness during adolescence. Limited studies have addressed the issues that affect the QoL in adolescents with cerebral palsy. The present study explores the parent-reported QoL in adolescents with cerebral palsy. MATERIALS AND METHODS Using a cross-sectional study design, parental perspectives on QoL were investigated among 35 parents of adolescents with cerebral palsy, aged between 13 and 18 years. Performance on seven domains of QoL across age and gender were explored. RESULTS While the maximum QoL was seen in the domain of social well-being, the least QoL was noted for feelings about functioning. Across age, the early adolescence group (13-15 years) had a poorer quality of life in comparison to the late adolescence group (16-18 years). With respect to the gender, though females had a lower QoL scores, a statistically significant difference was observed only for the domain of general well-being and participation. CONCLUSIONS From a parental perspective, the major issues of concern in adolescents with cerebral palsy were feelings about functioning, general well-being and participation, and access to services. This information will be useful when establishing management options or assessment protocols to improve their overall QoL.
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Affiliation(s)
- Prabhu Prajakta
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sunila John
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajashekhar Bellur
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Shikako-Thomas K, Shevell M. Promoting the Human Rights of Children With Neurologic Conditions. Semin Pediatr Neurol 2018; 27:53-61. [PMID: 30293590 DOI: 10.1016/j.spen.2018.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Children with neurologic conditions benefit from international conventions, and national treaties, policies and regulations that safeguard their human rights. These regulations also exist to serve as guidance in the creation of comprehensive systems of care, inclusive environments, accessible societies and communities that allow these children to thrive and to achieve the best of their capacities. This narrative review of issues related to human rights and advocacy in pediatric neurologic disabilities will provide an overview of the human rights conventions that relate to children with disabilities, and the most current approaches implicating health care providers in rights promotion for these individuals and their families. We also suggest venues for professionals to advocate for their patients, and suggest strategies to consider rights-based approaches as a mean to provide holistic care in a social neurology framework.
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Affiliation(s)
- Keiko Shikako-Thomas
- *Participation and Knowledge Translation in Childhood Disability Lab, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada; ((†))Department of Pediatrics, Montreal Children's Hospital, Centre for Interdisciplinary Research in Rehablitation (CRIR), Montreal, QC, Canada.
| | - Meaghan Shevell
- *Participation and Knowledge Translation in Childhood Disability Lab, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
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Milićević M, Nedović G. Comparative study of home and community participation among children with and without cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 80:74-83. [PMID: 29957491 DOI: 10.1016/j.ridd.2018.06.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 03/15/2018] [Accepted: 06/19/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Children with cerebral palsy (CP) are at increased risk of reduced participation. Parental evaluation of child's participation is often the decision-making factor in the process of special education and/or rehabilitation. AIMS Examine and compare home and community participation of children with CP and typical development (TD) and the associations between their parents' desire for change and participation dimensions in both settings. METHODS AND PROCEDURES This cross-sectional study included a convenience sample of 110 children with CP (55% males; mean age 12.7 years) and 134 children with TD (49% males; mean age 12.1 years). The Participation and Environment Measure for Children and Youth (PEM-CY) was used. OUTCOMES AND RESULTS Home and community participation and environmental supportiveness of children with CP were lower compared to children with TD (p < .001, family income controlled). The effect sizes indicated that there may be no clinically important difference in participation frequency. Parents of children with CP desired change if participation was less diverse at home, less frequent in the community, or if involvement was lower in both settings (environmental supportiveness and income controlled). CONCLUSIONS AND IMPLICATIONS At home, parents expressed a desire for change more intensely through the range of activities, while parents of children with TD emphasized participation frequency. In the community, parents of children with CP equally perceived participation diversity and focused more on frequency and involvement.
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Affiliation(s)
- Milena Milićević
- Institute of Criminological and Sociological Research, Gračanička 18, 11000 Belgrade, Serbia.
| | - Goran Nedović
- Faculty of Special Education and Rehabilitation, University of Belgrade, Visokog Stevana 2, 11000 Belgrade, Serbia.
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Lee CE, Burke MM, Arnold CK, Owen A. Comparing differences in support needs as perceived by parents of adult offspring with down syndrome, autism spectrum disorder and cerebral palsy. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:194-205. [PMID: 30101573 DOI: 10.1111/jar.12521] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 07/02/2018] [Accepted: 07/25/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Parents often face many barriers when taking care of their offspring with disabilities. In childhood, support needs vary with families of children with Down syndrome often reporting less caregiving challenges. However, it is unclear whether support needs vary in adulthood. This study compared parents of adults with Down syndrome (DS), autism spectrum disorder (ASD) and cerebral palsy (CP) regarding support needs of their offspring with intellectual and developmental disabilities (IDD) and their families. METHOD Data were collected via a national survey in the United States with 189 parents of adults with IDD. RESULTS Across the quantitative and qualitative analyses, parents of adults with DS (versus CP and ASD) reported significantly greater recreational, natural supports, more formal services and less future planning barriers. CONCLUSION The results indicate that the DS advantage may persist in adulthood regarding support needs. More research is needed to understand different types of support needs.
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Affiliation(s)
- Chung Eun Lee
- University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois
| | - Meghan M Burke
- University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois
| | | | - Aleksa Owen
- University of Illinois at Chicago, Chicago, Illinois
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Allen D, Scarinci N, Hickson L. The Nature of Patient- and Family-Centred Care for Young Adults Living with Chronic Disease and their Family Members: A Systematic Review. Int J Integr Care 2018; 18:14. [PMID: 30127698 PMCID: PMC6095060 DOI: 10.5334/ijic.3110] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 05/09/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND AIM The published literature addressing the nature of patient- and family-centred care (PFCC) among young adults (16-25 years old) living with chronic disease and their family members is diverse. The aim of this systematic review was to collect and interpretatively synthesise this literature to generate a conceptual understanding of PFCC in this age group. METHOD From an initial pool of 10,615 papers, 51 were systematically identified as relevant to the research question and appraised using the Critical Appraisal Skills Programme tools. A total of 24 papers passed the quality appraisal and proceeded to a qualitative meta-synthesis. RESULTS The qualitative meta-synthesis revealed three major elements of PFCC relevant to young adults living with chronic disease and their family members: (1) patients and practitioners felt able to engage with each other on an emotional and social level; (2) patients and families felt empowered to be part of the care process; and (3) patients and families experienced care as effective at addressing their individual needs. CONCLUSION There is agreement among young adult patients and families about what constitutes PFCC in a chronic disease setting, independent of the aetiology of the pathological process. Patients and families also have strong feelings about how practitioners can achieve PFCC in practice. These findings have implications for the delivery of health services to young adults living with chronic disease and their family members.
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Affiliation(s)
- David Allen
- The HEARing CRC, The University of Queensland, AU
- The HEARing CRC, Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Carlton, Victoria, AU
- School of Health and Rehabilitation Sciences, The University of Queensland, AU
| | - Nerina Scarinci
- The HEARing CRC, The University of Queensland, AU
- The HEARing CRC, Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Carlton, Victoria, AU
- School of Health and Rehabilitation Sciences, The University of Queensland, AU
| | - Louise Hickson
- The HEARing CRC, The University of Queensland, AU
- The HEARing CRC, Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Carlton, Victoria, AU
- School of Health and Rehabilitation Sciences, The University of Queensland, AU
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Scime NV, Bartlett DJ, Brunton LK, Palisano RJ. Parents' Experiences and Perceptions when Classifying their Children with Cerebral Palsy: Recommendations for Service Providers. Phys Occup Ther Pediatr 2017; 37:252-267. [PMID: 27366828 DOI: 10.1080/01942638.2016.1185505] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS This study investigated the experiences and perceptions of parents of children with cerebral palsy (CP) when classifying their children using the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). The second aim was to collate parents' recommendations for service providers on how to interact and communicate with families. METHODS A purposive sample of seven parents participating in the On Track study was recruited. Semi-structured interviews were conducted orally and were audiotaped, transcribed, and coded openly. A descriptive interpretive approach within a pragmatic perspective was used during analysis. RESULTS Seven themes encompassing parents' experiences and perspectives reflect a process of increased understanding when classifying their children, with perceptions of utility evident throughout this process. Six recommendations for service providers emerged, including making the child a priority and being a dependable resource. CONCLUSIONS Knowledge of parents' experiences when using the GMFCS, MACS, and CFCS can provide useful insight for service providers collaborating with parents to classify function in children with CP. Using the recommendations from these parents can facilitate family-provider collaboration for goal setting and intervention planning.
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Affiliation(s)
- Natalie V Scime
- a Faculty of Health Sciences , Western University , London , Ontario , Canada
| | - Doreen J Bartlett
- a Faculty of Health Sciences , Western University , London , Ontario , Canada.,b CanChild Centre for Childhood Disability Research , McMaster University , Hamilton , Ontario , Canada
| | - Laura K Brunton
- b CanChild Centre for Childhood Disability Research , McMaster University , Hamilton , Ontario , Canada.,c Faculty of Kinesiology , University of Calgary , Calgary , Alberta , Canada
| | - Robert J Palisano
- b CanChild Centre for Childhood Disability Research , McMaster University , Hamilton , Ontario , Canada.,d Department of Physical Therapy and Rehabilitation Sciences , Drexel University , Philadelphia , Pennsylvania , USA
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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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Ravesloot C, White GW, Gonda-Kotani C, Shinnick K. A comparative analysis of Center for Independent Living staff and board of directors regarding CIL services and consumer participation. J Prev Interv Community 2017; 45:100-111. [PMID: 28287370 DOI: 10.1080/10852352.2017.1281047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Community living of people with disabilities spans independent living and community engagement. Consumer choice and control of their level of community participation requires community accessibility, resources and supports. Some people with disabilities have difficulties procuring and maintaining these resources. Centers for Independent Living (CIL) are advocacy and service agencies that have been empowering consumers to meet their needs for over 40 years. Despite this history, little is known about the value of CIL services for increasing community participation of people with disabilities. We administered the CIL Participation Service Survey to 420 CIL staff members and 107 CIL board members to examine their opinions about the relative value of different CIL services for increasing community participation of their consumers. Results indicated that both staff and board members have very high regard for the value and quality of CIL services. The Independent Living (IL) philosophy of consumer choice and control was among the most highly rated aspects of CIL service delivery for both staff and board members. Overall, staff and board member responses were very consistent in terms of the top-rated strengths and weaknesses of CIL services for increasing participation among consumers. Differences appeared to reflect the daily staff focus on specific consumer need versus board members' view of larger community issues.
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Affiliation(s)
- Craig Ravesloot
- a Research and Training Center on Disability in Rural Communities, University of Montana , Missoula , Montana , USA
| | - Glen W White
- b Research and Training Center on Independent Living, University of Kansas , Lawrence , Kansas , USA.,c Department of Applied Behavioral Science, The University of Kansas , Lawrence , Kansas , USA
| | - Chiaki Gonda-Kotani
- d Graduate School of Core Ethics and Frontier Sciences, Ritsumeikan University , Kyoto , Japan
| | - Kelsey Shinnick
- b Research and Training Center on Independent Living, University of Kansas , Lawrence , Kansas , USA
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Kumurenzi A, Goliath C, Mji G, Mlenzana N, Joseph C, Stathum S, Rhoda A. Experiences of patients and service providers with out-patient rehabilitation services in a rehabilitation centre in the Western Cape Province. Afr J Disabil 2015; 4:164. [PMID: 28730027 PMCID: PMC5433475 DOI: 10.4102/ajod.v4i1.164] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 05/20/2015] [Indexed: 11/24/2022] Open
Abstract
Background Rehabilitation is important for persons with disabilities as it contributes to their sense of autonomy, self-worth and social participation, and improves their quality of life. Improving the quality of rehabilitation services requires the dialogue of patients’ perceptions with those of service providers, in order to recommend informed reform. Objective The objective was to explore the experiences of persons with physical disabilities and service providers, regarding the multi-disciplinary rehabilitation services provided at a community-based out-patient rehabilitation centre. Methods A qualitative, exploratory study design was used to collect the data. A focus group was conducted with conveniently selected persons with physical disabilities. Three in-depth interviews were conducted with purposively selected key informants. All ethical considerations were adhered to during the implementation of the study. Results Patients and service providers had different experiences regarding accessibility to rehabilitation services, and similar experiences with patient education and intensity of rehabilitation. Although the patients experienced that the service providers had sufficient knowledge and skills to manage them, services providers expressed that they lacked certain skills. Conclusions The experiences expressed highlighted the need to improve rehabilitation services in terms of increasing the capacity of service providers and providing transport services for persons with disabilities.
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Affiliation(s)
- Anne Kumurenzi
- Department of Physiotherapy, University of Rwanda, Rwanda
| | - Charlyn Goliath
- Division of Physiotherapy, Stellenbosch University, South Africa
| | - Gubela Mji
- Division of Physiotherapy, Stellenbosch University, South Africa
| | - Nondwe Mlenzana
- Physiotherapy Department, University of the Western Cape, South Africa
| | | | - Sue Stathum
- Division of Physiotherapy, Stellenbosch University, South Africa
| | - Anthea Rhoda
- Physiotherapy Department, University of the Western Cape, South Africa
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Darbyshire P, Mischo-Kelling M, Lochner L, Messerschmidt-Grandi C. ‘Fighting for care’: parents' perspectives of children's palliative care in South Tyrol, Italy. Int J Palliat Nurs 2015; 21:542-7. [DOI: 10.12968/ijpn.2015.21.11.542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Maria Mischo-Kelling
- Professor of Nursing, University of Applied Science Ravensburg-Weingarten, Germany
| | - Lukas Lochner
- Medical Tutor, at Claudiana College of Health-Care Professions, Bolzano/Bozen, Italy
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Hayles E, Harvey D, Plummer D, Jones A. Parents' Experiences of Health Care for Their Children With Cerebral Palsy. QUALITATIVE HEALTH RESEARCH 2015; 25:1139-1154. [PMID: 25711842 DOI: 10.1177/1049732315570122] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Although current health care service delivery approaches for children with cerebral palsy recognize the importance of including parents in the health care of their child, we do not yet understand how parents experience this phenomenon. In this study, we used grounded theory methodology to explore parents' experiences of health care for their children with cerebral palsy living in a regional area of Australia. Our findings indicate that parents experience health care for their child as a cyclical process of "making the most of their body and their life." Important aspects of care include "learning as you go," "navigating the systems," "meeting needs through partnership," "being empowered or disempowered," and "finding a balance." We suggest modifications to health care service delivery practices that might contribute to improved experiences of health care for this population.
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Affiliation(s)
- Emily Hayles
- James Cook University, Townsville, Queensland, Australia
| | - Desley Harvey
- James Cook University, Townsville, Queensland, Australia
| | | | - Anne Jones
- James Cook University, Townsville, Queensland, Australia
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Wang M, Petrini MA, Guan Q. Evaluation of family-centred services from parents of Chinese children with cerebral palsy with the Measure of Processes of Care. Child Care Health Dev 2015; 41:408-15. [PMID: 25081418 DOI: 10.1111/cch.12183] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Family-centred service (FCS) has become essential to parents of children with cerebral palsy (CP) and professionals in Chinese paediatric rehabilitation services. FCS practice meets the unique needs of the child and family, through facilitation of optimal service provision delivered by professionals, and ensures service systems to be flexible, appropriate and actively responsive to the family needs. Parents used the Measure of Processes of Care 20 (MPOC-20) questionnaire to evaluate and verify the efficacy of use in China. The aims of the present study were twofold: to assess the validity and reliability of the Chinese MPOC-20, and investigate the range of parents' satisfaction with service provision in an FCS practice using the MPOC-20. METHODS The Chinese MPOC-20 was selected to assess parent satisfaction with service provision of professionals in FCS practice. Participants were parents of children under 8 years of age with CP, who had received rehabilitation services between May 2012 and May 2013, and were receiving rehabilitation services in May 2013 at a hospital outpatient department and a rehabilitation centre. RESULTS The reliability and validity of the Chinese MPOC-20 were confirmed. Parents evaluated FCS practice with the MPOC-20 survey. Respectful and supportive care was rated with the highest score and providing general information the lowest. Parents according to the data were dissatisfied with the lack of information. CONCLUSIONS Parents fairly evaluated service provision of professionals in FCS practice with the Chinese MPOC-20. Professionals received feedback reports of parents, summaries of the inadequacy of service delivery, and developed and implemented ameliorated measures in the FCS policy to strive to provide exemplary service.
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Affiliation(s)
- M Wang
- Department of Critical Care and Community Nursing, School of Nursing, Jilin Medical College, Changchun, Jilin, China
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Hayles E, Jones A, Harvey D, Plummer D, Ruston S. Delivering healthcare services to children with cerebral palsy and their families: a narrative review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2015; 23:242-251. [PMID: 25175322 DOI: 10.1111/hsc.12121] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/16/2014] [Indexed: 06/03/2023]
Abstract
Children with cerebral palsy have complex healthcare needs and often require complex multidisciplinary care. It is important for clinicians to understand which approaches to healthcare service delivery for this population are supported in the literature and how these should be applied in clinical practice. This narrative review aims to identify and review the evidence for current approaches to healthcare service delivery for children with cerebral palsy. Databases were searched using key terms to identify relevant research articles and grey literature from December 2011 to September 2013. Search results were screened and sorted according to inclusion and exclusion criteria. Thirty-two documents were included for evaluation and their content was analysed thematically. Three current approaches to healthcare service delivery for children with cerebral palsy identified in this narrative review were family-centred care, the World Health Organisation's International Classification of Functioning, Disability and Health, and collaborative community-based primary care. However, healthcare services for children with cerebral palsy and their families are inconsistently delivered according to these approaches and the identified guidelines or standards of care for children with cerebral palsy have limited incorporation of these approaches. Future research is required to investigate how these approaches to healthcare service delivery can be integrated into clinical practices to enable clinicians to improve services for this population.
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Affiliation(s)
- Emily Hayles
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia; Mackay Hospital & Health Service, Queensland Health, Mackay, Queensland, Australia
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Blanchet K, Girois S, Urseau I, Smerdon C, Drouet Y, Jama A. Physical rehabilitation in post-conflict settings: analysis of public policy and stakeholder networks. Disabil Rehabil 2013; 36:1494-501. [PMID: 23672208 DOI: 10.3109/09638288.2013.790489] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Physical rehabilitation plays a determinant role in post-conflict contexts to restore disabled citizens' mobility and independence. While the main objectives of any physical rehabilitation programme are to ensure that the services provided are accessible and of good quality to meet existing needs, it is intended that the services need to be supported over the long term by public health and social welfare authorities. This article presents the results of a study conducted in three post-conflict countries on the relationships between the level of commitment of national governments to rehabilitation services and the influence of social networks on national policy related to physical rehabilitation. From a policy and resource standpoint, the environment in Nepal is the most favourable for creating leverage at the national level to influence the commitment of ministries in the rehabilitation sector, compared with Cambodia and Somaliland. Stakeholder network analysis in Nepal, furthermore, reveals a dominant civil society and private sector supporting rehabilitation services, including intense involvement of local organisations and user groups. Implications for Rehabilitation Physical rehabilitation is not on the top of the agenda of governments in fragile states. The commitment and involvement of national authorities in the rehabilitation sector is positively influenced by civil society and international organisations. The denser the social network of the rehabilitation sector is, the more influence the actors can exert influence over national authorities.
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Affiliation(s)
- Karl Blanchet
- International Centre for Evidence on Disability, Clinical Research Department, London School of Hygiene and Tropical Medicine , London , UK
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Papavasiliou AS, Ioannou J, Gavatha M, Nikaina I, Rizou I. Assessment of families of children with cerebral palsy of the "CP-graph on treatment modalities for gross motor function". Eur J Paediatr Neurol 2012; 16:762-3. [PMID: 22483444 DOI: 10.1016/j.ejpn.2012.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Accepted: 02/24/2012] [Indexed: 11/18/2022]
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Jeglinsky I, Autti-Rämö I, Brogren Carlberg E. Two sides of the mirror: parents' and service providers' view on the family-centredness of care for children with cerebral palsy. Child Care Health Dev 2012; 38:79-86. [PMID: 21902711 DOI: 10.1111/j.1365-2214.2011.01305.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In order to best meet the needs of both families and their children with cerebral palsy, many rehabilitation service providers have adopted a family-centred service (FCS) approach. In FCS parents are seen as experts on their child's needs, and the family and professionals collaborate in the rehabilitation process. However, parents and service providers might look at FCS from different points of view, i.e. look into the mirror from two different sides. The objective of this study was to explore the degree to which parents experience the service as being family-centred and to which extent the service providers experience their service provision as family-centred. METHODS A translated version of The Measure of Processes of Care 20 (MPOC-20) questionnaire was used to evaluate parents' experience of FCS, and a Measures of Processes of Care for Service Providers (MPOC-SP) questionnaire was used to evaluate the FCS provided by professionals. Parents visiting two university hospital neuropediatric wards (n= 67) during a 2-month period and who were willing to participate received the questionnaire. Also the service providers working on the same wards (n= 49) were invited to participate. RESULTS A total of 53 families and 29 service providers completed the questionnaires. Both parents and professionals generally rated the FCS positively. General information was rated lowest and respectful treatment the highest by both parents and professionals. The results revealed that written information about the child's condition, the possibility to choose when to receive information, and contact with other families in the same situation are areas in need of improvement. CONCLUSIONS The possibility to regularly evaluate services both from the families' and the professionals' perspectives should be part of quality development. Providing general information is a challenge for all service providers. The MPOC questionnaires can be used to highlight important areas of improvement in FCS.
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Affiliation(s)
- I Jeglinsky
- Department of Health and Wellfare, Arcada, University of Applied Sciences, Helsinki, Finland.
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Kingsnorth S, Gall C, Beayni S, Rigby P. Parents as transition experts? Qualitative findings from a pilot parent-led peer support group. Child Care Health Dev 2011; 37:833-40. [PMID: 22007983 DOI: 10.1111/j.1365-2214.2011.01294.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND This paper focuses on the introduction of parents as 'transition experts' within a paediatric rehabilitation hospital. Through the personal experience of raising a young adult with special healthcare needs, Family Facilitators are knowledgeable about the processes of social and healthcare service transfer and transition to adulthood. Following a needs assessment, a pilot transition support group was established for parents of youth who were eligible for augmentative communication support. The goal was to provide informational, emotional and affirmational support during this stressful period. This study examined the impact of the Family Facilitator-led Transition Peer Support Group on parents' knowledge, skill and level of support in planning for the future. METHODS Qualitative methods were used to explore benefits, limitations and outcomes of the parent support group. In addition to a review of 10 narrative field notes maintained for each session by the Family Facilitator and four session feedback forms, a 90-min focus group was conducted with eight core members. RESULTS Qualitative examination of the data revealed three themes: (i) increased awareness related to personal challenges in planning and shifting viewpoints on future orientation; (ii) increased active planning with regard to knowledge building and actions taken; and (iii) the value of experiential knowledge. CONCLUSIONS Parents reported gaining new knowledge and became more active and future-oriented in their planning. Further, they strongly valued the facilitator role and benefited from the social support provided by the group. Findings provide a unique snapshot of parental needs. Individualized support with an emphasis on citizenship, participation and inclusion were targeted topics. Future work should continue to explore optimal mechanisms for the provision of parent-focused transition support and the inclusion of parents as experts within healthcare settings.
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Affiliation(s)
- S Kingsnorth
- Bloorview Research Institute, Toronto, Ontario, Canada.
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Knis-Matthews L, Falzarano M, Baum D, Manganiello J, Patel S, Winters L. Parents' experiences with services and treatment for their children diagnosed with cerebral palsy. Phys Occup Ther Pediatr 2011; 31:263-74. [PMID: 21521003 DOI: 10.3109/01942638.2011.566806] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
While there is a considerable body of knowledge investigating the efficacy of constraint-induced movement therapy (CIMT), there is a need for information focusing on parents' experiences when their children receive these services. This qualitative research study initially explored the experiences of four parents with children who are diagnosed with cerebral palsy (CP) and who participated in CIMT using a group format. Additionally, the richness of the information shared by parents provided insights on other important issues related to family supports when raising a child and the availability of resources for children diagnosed with CP. Response analysis from in-depth interviews with parents resulted in three themes: (a) Everything in my family changed when my child was diagnosed with CP and the support I feel from my family makes all the difference in how I cope. (b) It was so hard to get the information and support that I needed for my child. (c) The group format enhanced CIMT for my child and provided social benefits as well. Findings from this study suggest there are benefits of using CIMT in group formats.
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Affiliation(s)
- Laurie Knis-Matthews
- Department of Occupational Therapy, Kean University, Union, New Jersey 07083, USA.
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Fiamenghi GA, Vedovato AG, Meirelles MC, Shimoda ME. Mothers' interaction with their disabled infants: two case studies. J Reprod Infant Psychol 2010. [DOI: 10.1080/02646830903295042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Blacher J, Kraemer B, Howell E. Family expectations and transition experiences for young adults with severe disabilities: does syndrome matter? ACTA ACUST UNITED AC 2010. [DOI: 10.5042/amhld.2010.0052] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Mundhenke L, Hermansson L, Sjöqvist Nätterlund B. Experiences of Swedish children with disabilities: activities and social support in daily life. Scand J Occup Ther 2010. [DOI: 10.3109/11038120903114386] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Nieuwenhuijsen C, van der Laar Y, Donkervoort M, Nieuwstraten W, Roebroeck ME, Stam HJ. Unmet needs and health care utilization in young adults with cerebral palsy. Disabil Rehabil 2009; 30:1254-62. [DOI: 10.1080/09638280701622929] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ödman P, Richt B, Öberg B. Parents' conceptions of intensive group training. The case of cerebral palsy. Disabil Rehabil 2009; 31:293-301. [DOI: 10.1080/09638280801945709] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Engaging adolescents with disabilities in research. ALTER-EUROPEAN JOURNAL OF DISABILITY RESEARCH 2009. [DOI: 10.1016/j.alter.2009.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
PURPOSE The dual purpose of this study was to identify areas of need as perceived by parents of children with cerebral palsy in three domains and to evaluate internal reliability of the Family Needs Assessment Tool (FNAT). DESIGN AND METHODS The FNAT was distributed to parents and includes a demographic survey and three subscales: service, information, and obstacles to care. RESULTS Parents identified services as their greatest need, followed by information and then obstacles to care. PRACTICE IMPLICATIONS The FNAT may be utilized to evaluate parental perceptions of needs, and provide clinicians with information for program planning and assessing needs central to providing quality care.
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Affiliation(s)
- Constance F Buran
- Pediatric Ambulatory Care Services, Riley Hospital for Children, Indianapolis, IN, USA.
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Binks JA, Barden WS, Burke TA, Young NL. What Do We Really Know About the Transition to Adult-Centered Health Care? A Focus on Cerebral Palsy and Spina Bifida. Arch Phys Med Rehabil 2007; 88:1064-73. [PMID: 17678671 DOI: 10.1016/j.apmr.2007.04.018] [Citation(s) in RCA: 176] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To address the lack of synthesis regarding the factors, processes, and outcomes specific to the transition from child-centered to adult-centered health care for people with cerebral palsy (CP) and spina bifida (SB); more specifically, to identify barriers, to outline key elements, to review empirical studies, and to make clinical and research recommendations. DATA SOURCES We searched Medline and CINAHL databases from 1990 to 2006 using the key words: transition, health care transition, pediatric health care, adult health care, health care access, health care use, chronic illness, special health care needs, and physical disability. The resulting studies were reviewed with a specific focus on clinical transition for persons with CP and SB, and were supplemented with key information from other diagnostic groups. STUDY SELECTION All studies meeting the inclusion criteria were included. DATA EXTRACTION Each article classified according to 5 criteria: methodology, diagnostic group, country of study, age group, and sample size. DATA SYNTHESIS We identified 149 articles: 54 discussion, 21 case series, 28 database or register, 25 qualitative, and 34 survey articles (some included multiple methods). We identified 5 key elements that support a positive transition to adult-centered health care: preparation, flexible timing, care coordination, transition clinic visits, and interested adult-centered health care providers. There was, however, limited empirical evidence to support the impact of these elements. CONCLUSIONS This review summarizes key factors that must be considered to support this critical clinical transition and sets the foundation for future research. It is time to apply prospective study designs to evaluate transition interventions and determine long-term health outcomes.
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Young NL. The transition to adulthood for children with cerebral palsy: what do we know about their health care needs? J Pediatr Orthop 2007; 27:476-9. [PMID: 17513974 DOI: 10.1097/01.bpb.0000271311.87997.e7] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Phua V, Reid SM, Walstab JE, Reddihough DS. Inpatient care of children with cerebral palsy as perceived by their parents. J Paediatr Child Health 2005; 41:432-6. [PMID: 16101978 DOI: 10.1111/j.1440-1754.2005.00661.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Children with cerebral palsy (CP) have special health care needs. The aim of the study was to evaluate the inpatient care of children with CP, as perceived by their parents. METHODS Forty parents of children with CP and 90 parents of able-bodied children completed a questionnaire designed to evaluate their perception of their child's hospital admission, including the care provided. The parents also completed the Perceived Stress Scale. RESULTS Overall, parents of able-bodied children were more satisfied with the hospitalization than parents of children with CP (P < 0.0001). Significant differences were found in four of the five areas assessed: the admissions process (P = 0.0002); the care that their child received (P < 0.0001); their communication and confidence in doctors and nurses (P < 0.0001); and their personal experience of the hospital (P = 0.0076). Parents of disabled children displayed a much higher mean score on the Perceived Stress Scale, but no correlation was found between this scale and the satisfaction questionnaire for either group. CONCLUSION The results of this study show that parents of children with CP were, as a group, less satisfied than parents of able-bodied children with their inpatient experience. Although these children have complex needs and often require more care than able-bodied children, it is imperative that their needs are met and that parents are satisfied with all aspects of the care they receive in hospital.
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Affiliation(s)
- Vanessa Phua
- Department of Paediatrics, Royal Children's Hospital, Murdoch Children's Hospital, Victoria, Australia
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Abstract
This qualitative study focused on the experiences of six 20-to 23-year-old persons with cerebral palsy and their parents during the transition to adulthood and explored perceived changes in their relationship. Using semi-structured interviews, three interrelated themes emerged: (a) perceptions of readiness for increased autonomy, (b) opportunities for the young adults to make independent decisions and learn from life experiences, and (c) shifting parental roles. The youths' autonomy related to parental perceptions of their readiness and push for autonomy, the parents' personal beliefs and readiness to support the changing relationship, and the parents' needs for separation from the child. In some families of youths requiring ongoing support for personal care, finances were a barrier to altering relationships with their child.
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Affiliation(s)
- Joyce Magill-Evans
- a Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta
| | - Lesley Wiart
- b Edmonton Public Schools, Consulting Services.,c Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta
| | - Johanna Darrah
- c Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta
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Abstract
OBJECTIVES The needs and provisions for health service and housing adaptation of a cohort of school leavers with physical disabilities in two inner city London health districts are described in this cross-sectional study. METHODS Fourteen young people were assessed by two consultant community paediatricians during their last year at school, using a structured proforma that includes the British Association of Community Child Health standards of functional levels. RESULTS Great difficulty was encountered in identifying the subjects, partly because of inadequate information systems. Only 16 were identified out of over 12 000 school leavers. Important discrepancies were found between the needs assessed and the services provided. For the total sample, the need for 49 potential referrals to adult specialist services was identified, but 17 were not made as such services did not exist, in contrast to what had been available within paediatric services. Adult physiotherapy and occupational therapy services were particularly under-provided for young people with physical disabilities. Only a minority were eligible for housing adaptations. CONCLUSIONS Suggestions are made for improvements in information systems, the transition process, revised provision of services and closer involvement of general practitioners.
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Affiliation(s)
- B Ko
- Newham Primary Care Trust, London, UK.
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Magill-Evans J, Darrah J, Adkins R. Youths with Cerebral Palsy and Their Satisfaction with Recreational Services: Implications for Inclusion. ACTA ACUST UNITED AC 2003. [DOI: 10.1080/14927713.2003.9649940] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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