Experience of Caregivers Caring for Children with Cerebral Palsy in Accessing Oral Health Care Services: A Qualitative Study

Abstract

Maintaining oral health (OH) is a serious issue in children with cerebral palsy (CP) for their inability to perform effective OH care as well as for lack of accessibility to dental services. This study explored the experience of the caregivers on accessibility towards OH facilities for their children with CP in Kota Bharu, Kelantan. A purposive sampling technique was utilised. In-depth interviews using guided questions captured with audio-recorder were conducted on caregivers of children with CP. Verbatim transcription of the interviews were reviewed with field notes, and themes were developed using NVivo software. Ten caregivers of children with CP aged 32-64 years old participated, which were mostly from low socio-economic status and low level of education. The age of children with CP in this study were between nine to 18 years old. From the ten verbatim transcripts, five themes emerged which were dental experience, family support, mobility, ability to pay and social value. The caregivers experienced both demanding and unique challenges in acquiring OH care services for their children with CP according to their experiences in obtaining OH services in Kota Bharu, Kelantan. Therefore, attentions are needed to address these problems that are hindering the access to OH facilities for children with CP.

Assessing healthcare access using the Levesque’s conceptual framework– a scoping review

“…Fifteen or almost half of the studies were qualitative types [ 17 – 31 ]. These qualitative studies explored access to various maternal and child healthcare services [ 17 , 19 , 22 – 24 , 28 , 31 ] or access to health services of different groups of people such as refugees [ 17 , 23 , 26 , 32 ], elderly [ 21 ], differently-abled people [ 25 ], LGBTQ [ 27 ], and migrant minorities [ 30 , 33 ]. On the other hand, there were eight quantitative descriptive studies [ 13 , 34 – 40 ].…”

“…The number of respondents in qualitative studies, which range from six to 105, is understandably smaller compared to the respondents count for the quantitative and mixed-method studies. The qualitative interviews with a lower number of respondents are those which aimed to explore access or perceptions to access of a particular group of people, such as pregnant refugees [ 23 ], transgender persons with HIV [ 27 ], and caregivers of children with cerebral palsy [ 25 ]; Qualitative studies that had comparatively more respondents were those which also conducted focused group discussion in addition to one-on-one interviews [ 18 , 24 , 26 , 28 , 30 , 45 ]. With regard to quantitative studies, the number of respondents ranged from 372 to 27,580.…”

“…With regard to country settings, 22 (71%) of the studies were conducted in high-income countries (HIC) [ 13 , 21 , 23 , 26 , 30 , 31 , 33 , 35 – 48 ], and only nine (29%) were conducted in low-and middle-income countries (LMIC) [ 18 , 19 , 22 , 24 , 25 , 27 , 28 , 32 , 34 ]. Figure 3 shows the geographic distribution of identified studies most of which were conducted in HICs.…”

“…The use of Levesque access to healthcare framework among the 31 identified studies in the scoping review can be classified into either a priori or a posteriori . There were 11 studies that used the framework a priori to develop its data collection tools such as interview guides, focus group discussion guides, and questionnaires [ 25 – 28 , 30 , 33 , 35 , 37 , 44 , 47 – 49 ]. The other 20 studies applied the framework in organizing and analyzing collected data [ 13 , 17 – 19 , 21 – 24 , 31 , 32 , 34 , 36 , 38 – 43 , 45 , 46 ].…”

“…However, instead of looking at both, several studies chose to only focus on the dimensions of access or on the abilities of access. Out of the 31 studies,13 focused solely on the health systems dimensions of healthcare access [ 13 , 21 , 28 , 33 , 35 , 38 – 40 , 42 – 44 , 47 – 49 ] while seven focused only on population abilities aspect of access [ 18 , 22 , 23 , 25 , 30 , 34 , 36 ]. Table 1 provides summarized details on the use of the Levesque framework and the dimensions/abilities explored or measured in each of the 31 studies.…”