Improving Parent and Therapist Experiences of Codelivering Intensive Upper Limb Interventions for Children With Hemiplegia: A Qualitative Study Using the Theoretical Domains Framework

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development Pub Date : 2025-01-28 DOI:10.1111/cch.70040

Jill Massey, Vicki Tsianakas, Anne Gordon, Glenn Robert

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Abstract

Background

Partnership working between parents and therapists is a key component of family-centred care (FCC). Such partnerships in paediatric intervention delivery can help achieve required levels of dosage, intensity and embed interventions in the child's everyday activities. This study explores the experience and views of parents and therapists codelivering an intensive upper limb intervention programme for children with hemiplegia, to find ways to enhance successful partnership working.

Methods

Semistructured interviews were conducted with 12 parents and 8 therapists (3 hospital-based and 5 community-based). To help make evidence-based recommendations, data were analysed using inductive reflexive analysis and mapped to the Theoretical Domains Framework (TDF) of constructs that are common determinants of clinical behaviours or practices.

Results

Five major themes were identified as follows: (1) realities of accessing intensive intervention, (2) key components of intervention delivery, (3) role of goal setting, (4) importance of partnership and (5) impact of intervention delivery on parents. Our findings showed that overall parents valued involvement in the programme, acknowledging benefits and challenges, as well as aspects in which they needed further support. Hospital therapists identified various education and training needs to improve their capabilities to coach parents and to collaboratively set meaningful goals. Community therapists valued the opportunity to develop their skills in intensive intervention and were keen to see evidence-based interventions offered in the community.

Conclusions

It is possible for parents, hospital therapists and community therapists to codeliver intensive upper limb intervention programmes to children with hemiplegia. However, it is important to create a flexible programme which clearly acknowledges the roles, skills and unique contributions of parents and therapists which is conducive to truly equal partnership working in appropriate settings.

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改善家长和治疗师对偏瘫儿童共同提供强化上肢干预的经验：一项使用理论域框架的定性研究。

背景：父母和治疗师之间的合作伙伴关系是家庭中心护理（FCC）的关键组成部分。在提供儿科干预措施方面的这种伙伴关系有助于达到所需的剂量和强度水平，并将干预措施纳入儿童的日常活动。本研究探讨了家长和治疗师共同为偏瘫儿童提供强化上肢干预方案的经验和观点，以寻找增强成功合作伙伴关系的方法。方法：对12名家长和8名治疗师（3名医院，5名社区）进行半结构化访谈。为了帮助提出基于证据的建议，使用归纳反射分析对数据进行分析，并将其映射到构成临床行为或实践的共同决定因素的理论领域框架（TDF）。结果：确定了五个主要主题：(1)获得强化干预的现实；(2)干预交付的关键组成部分；(3)目标设定的作用；(4)伙伴关系的重要性；(5)干预交付对家长的影响。我们的研究结果表明，总体而言，家长重视参与该计划，承认好处和挑战，以及他们需要进一步支持的方面。医院治疗师确定了各种教育和培训需求，以提高他们指导父母和合作设定有意义目标的能力。社区治疗师重视在强化干预中发展技能的机会，并渴望看到社区提供基于证据的干预措施。结论：家长、医院治疗师和社区治疗师可以共同为偏瘫儿童提供强化上肢干预方案。然而，重要的是要制定一个灵活的方案，明确承认父母和治疗师的作用、技能和独特贡献，这有助于在适当的环境中建立真正平等的伙伴关系。

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来源期刊

Child Care Health and Development 医学-小儿科

CiteScore

3.40

自引率

5.30%

发文量

136

审稿时长

4-8 weeks

期刊介绍： Child: care, health and development is an international, peer-reviewed journal which publishes papers dealing with all aspects of the health and development of children and young people. We aim to attract quantitative and qualitative research papers relevant to people from all disciplines working in child health. We welcome studies which examine the effects of social and environmental factors on health and development as well as those dealing with clinical issues, the organization of services and health policy. We particularly encourage the submission of studies related to those who are disadvantaged by physical, developmental, emotional and social problems. The journal also aims to collate important research findings and to provide a forum for discussion of global child health issues.