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Rodríguez-Vélez ME, Cantillo-Medina CP, Perdomo-Romero AY. Benefits of being part of a support group for caregivers of children with multiple disabilities: a qualitative study. Rev Peru Med Exp Salud Publica 2024; 41:54-61. [PMID: 38808845 PMCID: PMC11149755 DOI: 10.17843/rpmesp.2024.411.13218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 03/06/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVE Motivation for the study. Filling a knowledge gap regarding support groups for caregivers of children with multiple disabilities. Main findings. Support groups are valuable spaces for social support and learning for caregivers of children with multiple disabilities. They facilitate resilience and coping strategies following the birth of a child with multiple disabilities. They promote the participation and empowerment of caregivers of children with multiple disabilities to address access barriers and advocate for the fundamental rights of children. Implications. It is important to promote and support support groups for caregivers of children with multiple disabilities. To explore the perceived benefits of participating in a support group of caregivers of children with multiple disabilities. MATERIALS AND METHODS. A qualitative study with a focused ethnographic approach was conducted from October 2022 to February 2023, in which we applied convenience sampling. We included 20 caregivers of children with multiple disabilities. Information was collected through participant observation, focus groups, and semi-structured interviews. Thematic analysis was performed by applying Braun and Clark's proposals. RESULTS. The emerging themes were: social support network: integrating, informing, and helping each other; learning space: learning to take care and to take care of oneself; promoting empowerment: identifying and facing access barriers. CONCLUSIONS. We found that the support group functions as a social support network provides information, reduces uncertainty, and facilitates coping and resilience after the birth and upbringing of a child with multiple disabilities. It is a space where one learns to care for and take care of oneself and where empowerment for the defense of the rights of children with disabilities is promoted.
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Affiliation(s)
- María Elena Rodríguez-Vélez
- Universidad Surcolombiana. Facultad de Salud, Programa de Enfermería. Huila, Colombia.Universidad SurcolombianaUniversidad SurcolombianaFacultad de SaludPrograma de EnfermeríaHuilaColombia
| | - Claudia Patricia Cantillo-Medina
- Universidad Surcolombiana. Facultad de Salud, Programa de Enfermería. Huila, Colombia.Universidad SurcolombianaUniversidad SurcolombianaFacultad de SaludPrograma de EnfermeríaHuilaColombia
| | - Alix Yaneth Perdomo-Romero
- Universidad Surcolombiana. Facultad de Salud, Programa de Enfermería. Huila, Colombia.Universidad SurcolombianaUniversidad SurcolombianaFacultad de SaludPrograma de EnfermeríaHuilaColombia
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Smythe T, Chen S, Rotenberg S, Unger M, Miner E, Seghers F, Servili C, Kuper H. Do children with disabilities have the same opportunities to play as children without disabilities? Evidence from the multiple indicator cluster surveys in 38 low and middle-income countries. EClinicalMedicine 2024; 67:102361. [PMID: 38169717 PMCID: PMC10758749 DOI: 10.1016/j.eclinm.2023.102361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
Background Play is essential for the cognitive, social, and emotional development of all children. Disparities potentially exist in access to play for children with disabilities, and the extent of this inequity is unknown. Methods Data from 212,194 children aged 2-4 years in 38 Low and Middle-Income Countries were collected in the UNICEF supported Multiple Indicator Cluster Survey (2017-2020). Disability was assessed by the Washington Group-Child Functioning Module. Logistic regression models were applied to investigate the relationship between disability and play opportunities, controlling for age, sex, and wealth status. Meta-analysis was used to pool the estimates (overall, and disaggregated by sex), with heterogeneity assessed by Cochran's Q test. Findings Children with disabilities have approximately 9% fewer play opportunities than those without disabilities (adjusted RR [aRR] = 0.88, 95% CI = 0.82-0.93), and this varied across countries. Mongolia and Democratic Republic of São Tomé and Príncipe had the lowest likelihood of play opportunities for children with disabilities ((aRR = 0.26, 95% CI = 0.09-0.75; aRR = 0.46, 95% CI = 0.23-0.93, respectively). Moreover, children with disabilities are 17% less likely to be provided with opportunities to play with their mothers (aRR = 0.83, 95% CI: 0.73-0.93), which is further reduced for girls with disabilities (aRR = 0.74, 95% CI: 0.60-0.90) compared to their peers without disabilities. The associations varied by impairment type, and children with communication and learning impairments are less likely to have opportunities for play with aRR of 0.69 (95% CI: 0.60-0.79) and 0.78 (95% CI: 0.71-0.86), compared to those without disabilities, respectively. Interpretation Children with disabilities are being left behind in their access to play and this is likely to have negative impacts on their overall development and well-being. Funding HK and TS are funded by HK's NIHR Global Research Professorship (NIHR301621). SR is funded by a Rhodes Scholarship. This study was funded by the Programme for Evidence to Inform Disability Action (PENDA) grant from the UK Foreign, Commonwealth and Development Office.
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Affiliation(s)
- Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel st, WC1E 7HT, London, UK
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, 8000, South Africa
| | - Shanquan Chen
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel st, WC1E 7HT, London, UK
| | - Sara Rotenberg
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, OX2 6GG, UK
| | - Marianne Unger
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, 8000, South Africa
| | - Emily Miner
- Clinton Health Access Initiative, Boston, MA, 02127, USA
| | | | - Chiara Servili
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel st, WC1E 7HT, London, UK
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Smythe T, Reichenberger V, Pinzón EM, Hurtado IC, Rubiano L, Kuper H. The feasibility of establishing parent support groups for children with congenital Zika syndrome and their families: a mixed-methods study. Wellcome Open Res 2023; 6:158. [PMID: 37346815 PMCID: PMC10280024 DOI: 10.12688/wellcomeopenres.16839.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 11/07/2023] Open
Abstract
Background: The 2015 - 2016 Zika epidemic highlighted gaps in health and social care services for parents of children with developmental disabilities. In response, we developed the 'Juntos' intervention, a 10 week community-based early intervention support group for parents of children with congenital Zika syndrome (CZS). The intervention's components include participatory learning sessions, practical skill acquisition, peer support, and psychological support, aiming to improve caregiver's knowledge and confidence in caring for their children. This study aimed to evaluate the feasibility of implementing 'Juntos' in Colombia. Methods: Two facilitators delivered 'Juntos' to four groups of 8-10 caregivers between 2017 and 2018. One researcher observed each group. Data were collected from: observation notes from 40 sessions, focus group discussions held after each session, pre- post intervention questionnaires with 34 caregivers, and semi-structured interviews conducted with four facilitators, 12 caregivers and three stakeholders. We used the Bowen framework in data analysis. Results: The feasibility evaluation revealed that 'Juntos' was highly acceptable and in demand among the target population. The intervention was predominantly delivered with fidelity. Practicality was facilitated by providing transport costs and selecting convenient locations. Additional organisational and social media support was required for successful implementation. Community health worker training may support integration and the established groups could facilitate programme expansion. However, participants perceived lack of prioritisation as a limitation within existing health systems. Participants' knowledge and confidence to care for their child improved after programme enrolment. Conclusion: The 'Juntos' intervention demonstrated high acceptability, demand, and practicality in supporting parents of children with CZS in Colombia. However, its implementation faces challenges due to existing gaps in health system support for children with CZS.
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Affiliation(s)
- Tracey Smythe
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | | | - Hannah Kuper
- London School of Hygiene & Tropical Medicine, London, UK
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Smythe T, Reichenberger V, Pinzón EM, Hurtado IC, Rubiano L, Kuper H. The feasibility of establishing parent support groups for children with congenital Zika syndrome and their families: a mixed-methods study. Wellcome Open Res 2023; 6:158. [PMID: 37346815 PMCID: PMC10280024 DOI: 10.12688/wellcomeopenres.16839.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 06/23/2023] Open
Abstract
Background: The 2015 - 2016 Zika epidemic highlighted gaps in health and social care services for parents of children with developmental disabilities. In response, we developed the 'Juntos' intervention, a 10 week community-based early intervention support group for parents of children with congenital Zika syndrome (CZS). The intervention's components include participatory learning sessions, practical skill acquisition, peer support, and psychological support, aiming to improve caregiver's knowledge and confidence in caring for their children. This study aimed to evaluate the feasibility of implementing 'Juntos' in Colombia. Methods: Two facilitators delivered 'Juntos' to four groups of 8-10 caregivers between 2017 and 2018. One researcher observed each group. Data were collected from: observation notes from 40 sessions, focus group discussions held after each session, pre- post intervention questionnaires with 34 caregivers, and semi-structured interviews conducted with four facilitators, 12 caregivers and three stakeholders. We used the Bowen framework in data analysis. Results: The feasibility evaluation revealed that 'Juntos' was highly acceptable and in demand among the target population. The intervention was predominantly delivered with fidelity. Practicality was facilitated by providing transport costs and selecting convenient locations. Additional organisational and social media support was required for successful implementation. Community health worker training may support integration and the established groups could facilitate programme expansion. However, participants perceived lack of prioritisation as a limitation within existing health systems. Participants' knowledge and confidence to care for their child improved after programme enrolment. Conclusion: The 'Juntos' intervention demonstrated high acceptability, demand, and practicality in supporting parents of children with CZS in Colombia. However, its implementation faces challenges due to existing gaps in health system support for children with CZS.
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Affiliation(s)
- Tracey Smythe
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | | | - Hannah Kuper
- London School of Hygiene & Tropical Medicine, London, UK
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Araújo LMC, Guimarães-do-Carmo VJ, Andrade TGVS, Claudino SC, Soares DM, Melo RS. Musculoskeletal pain and quality of life in mothers of children with microcephaly, due to congenital Zika virus syndrome. Child Care Health Dev 2023; 49:268-280. [PMID: 35959527 DOI: 10.1111/cch.13039] [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: 06/13/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study is to observe the prevalence and intensity of musculoskeletal pain and the quality of life in mothers of children with microcephaly and also to compare the scores of the quality of life domains between mothers who had or did not have musculoskeletal pain. METHODS This is a cross-sectional study that evaluated mothers of children with a clinical diagnosis of microcephaly, due to congenital Zika virus syndrome, in the state of Pernambuco, northeast region, Brazil. To assess musculoskeletal pain, the Nordic Questionnaire of Musculoskeletal Symptoms was used, pain intensity was assessed by the Visual Analogue Scale and quality of life by the SF-36 Questionnaire. RESULTS Of the 63 mothers evaluated, 59 (93.7%) reported currently experiencing musculoskeletal pain. The lumbar spine was the body region with the highest prevalence of pain (77.8%), followed by the thoracic spine (57.1%) and cervical spine (50.8%). Pain intensity was higher in the lumbar spine (6.00 ± 0.47), thoracic spine (4.44 ± 0.52) and shoulders (3.81 ± 0.51). The domains that presented the lowest scores in the quality of life assessment were general health status (49.0 ± 3.19), emotional aspects (49.7 ± 5.88) and pain (49.7 ± 2.50). Mothers who had musculoskeletal pain had lower scores in all domains of quality of life assessment compared to mothers who did not have pain, demonstrating significant differences for functional capacity (P = 0.035), physical aspects (P = 0.047) and pain (P = 0.002). CONCLUSION A high prevalence of musculoskeletal pain was observed in mothers of children with microcephaly, with a higher prevalence and intensity in the lumbar spine. The domains related to physical and emotional health presented the worst scores in the quality of life of the evaluated mothers and the presence of musculoskeletal pain reduced the quality of life of the mothers of children with microcephaly in this study.
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Affiliation(s)
| | | | | | | | - Diego Moura Soares
- Department of Dentistry, Faculdade Pernambucana de Saúde (FPS), Recife, Brazil
| | - Renato S Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.,Laboratory of Pediatric Studies, (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Brazil
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Klein A, Uyehara M, Cunningham A, Olomi M, Cashin K, Kirk CM. Nutritional care for children with feeding difficulties and disabilities: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001130. [PMID: 36962945 PMCID: PMC10022789 DOI: 10.1371/journal.pgph.0001130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/11/2023] [Indexed: 03/19/2023]
Abstract
One billion people worldwide have a disability, and 80 percent of them live in low- and middle-income countries (LMICs). The prevalence of feeding difficulties globally ranges from 25-45 percent to 33-80 percent in children without and with disabilities, respectively. The U.S. Agency for International Development's (USAID) flagship multi-sectoral nutrition project, USAID Advancing Nutrition, conducted a scoping review of programs supporting nutritional care of children with disability and non-disability related feeding difficulties. The non-systematic scoping review included a desk review of peer-reviewed and non-peer-reviewed literature and key informant interviews. In all, 127 documents with publication dates ranging from 2003 to 2022 were identified through keyword searches and snowballing and met the inclusion criteria, and 42 experts in nutrition and disability were interviewed. Findings were organized using structured matrices of challenges and opportunities across the universal progressive model of care framework in the identification and management of feeding difficulties and disabilities and support for children with feeding difficulties and disabilities and their families. The review found insufficient policies, programs, and evidence to support children with feeding difficulties and disabilities and their families. While some resources and promising approaches exist, they are not standardized or universally used, staff are not trained to use them, and there is insufficient funding to implement them. The combination of challenges in identifying feeding difficulties and disabilities, a lack of understanding of the link between disabilities and feeding, and weak or nonexistent referral or specialized services puts these children at risk of malnutrition. Additionally, their families face challenges providing the care they need, including coping with high care demands, accessing support, obtaining appropriate foods, and managing stigma. Four areas of recommendations emerged to support children with feeding difficulties and disabilities: (1) Strengthen systems to improve identification and service provision; (2) Provide direct support to families to address determinants that affect nutrition outcomes; (3) Conduct advocacy to raise awareness of the needs and opportunities; and (4) Build the evidence base on effective interventions to identify and support these children and their families.
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Affiliation(s)
- Alyssa Klein
- USAID Advancing Nutrition, Arlington, Virginia, United States of America
- * E-mail:
| | - Malia Uyehara
- USAID Advancing Nutrition, Arlington, Virginia, United States of America
| | - Andrew Cunningham
- USAID Advancing Nutrition, Arlington, Virginia, United States of America
| | - Madina Olomi
- USAID Advancing Nutrition, Arlington, Virginia, United States of America
| | - Kristen Cashin
- USAID Advancing Nutrition, Arlington, Virginia, United States of America
| | - Catherine M. Kirk
- USAID Advancing Nutrition, Arlington, Virginia, United States of America
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Barker Ladd S, Williams NA, Villachan-Lyra P, Chaves E, Hollist C, Trefiglio Mendes Gomes R, Barbosa LNF. Translation and preliminary validation of the Brazilian family resources scale in a sample of parents of children with congenital Zika virus syndrome. J Pediatr Rehabil Med 2023; 16:337-350. [PMID: 36847025 DOI: 10.3233/prm-220025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
PURPOSE Family-centered rehabilitative care optimizes outcomes for children with significant developmental disabilities. Family-centered services involve assessing family resources that promote positive developmental outcomes for children. Little is known regarding family resources in the context of caring for a child with developmental disabilities in Brazil due to an absence of validated measures. This study describes the translation and cultural adaptation of the Family Resource Scale and explored the measurement quality of the resulting measure (the Brazilian-Family Resource Scale, or B-FRS). METHODS A rigorous serial translation process that emphasized linguistic accuracy as well as cultural adaptation was utilized. The resulting 27-item B-FRS was theoretically related and reflected the contextual intent of the original measure. RESULTS A four-factor scoring approach yielded acceptable internal consistency estimates for the subscales and total scale score. Overall, low levels of family resources were reported by caregivers of children with Congenital Zika Syndrome. Low family resources were associated with parental depressive and stress-related symptoms. CONCLUSION Confirmatory factor analysis of the B-FRS in a larger sample is recommended. Practitioners in Brazil should broadly consider family needs and resources to provide family-centered care that is effective for the child and engages the family in a way that highlights their strengths and promotes positive developmental trajectories.
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Affiliation(s)
- Sarah Barker Ladd
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Natalie A Williams
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospital, Lincoln, NE, USA
| | | | - Emmanuelle Chaves
- Department of Education, Universidade Federal Rural de Pernambuco, Recife, PE, Brazil
| | - Cody Hollist
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, NE, USA
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Greiner R. Towards Critical Studies of Disabilities: engaging Latin American theoretical perspectives on Congenital Zika Syndrome. HORIZONTES ANTROPOLÓGICOS 2022. [DOI: 10.1590/s0104-71832022000300006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract Infection with the Zika virus during pregnancy can cause disability, yet disability remains under theorised in studies on Congenital Zika Syndrome (CZS). Existing studies are largely exploratory and descriptive in nature, and thus a deeper analysis is needed. Where theory has been applied, there is limited engagement with Latin American theoretical perspectives. The social construction of disability, and of caregiver identity in particular warrant further analysis. Understanding that disability is constructed through an ‘ideology of normality’ can help make sense of parents’ reactions to a diagnosis of CZS. Caregivers resistance to biomedical narratives about disability is apparent in the case of CZS and deserves further attention. Consideration has been given to the ways that social location and shared temporality in relationships of care shape caregiver identity. Here I read these together to reach a fuller understanding of how caregivers and the people they care for develop a shared embodiment. An analysis bringing together Latin American Critical Disability Studies with other critical theoretical perspectives can advance theorisations of disability and the experiences of caregivers in their social, political, economic and historical contexts.
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