Goal‐setting in paediatric rehabilitation: perceptions of parents and professional

Øien, Ingvil; Fallang, Bjørg; Østensjø, Sigrid

doi:10.1111/j.1365-2214.2009.01038.x

Cited by 94 publications

(103 citation statements)

References 29 publications

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“…Arguments advanced for the benefits of using a defined goal-setting process in rehabilitation include greater clarity of focus, shared understanding of issues, potential for enhanced interdisciplinary team work, increased opportunities for communication and collaboration among team members, and enhancement of parents' feelings of competency and partnership with the clinical team (Armstrong, 2008;Holliday, Ballinger, & Playford, 2007;Øien et al, 2009;Playford et al, 2009).…”

Section: Introductionmentioning

confidence: 98%

“…Collaborative goal setting between a clinician and client/family has been put forward as a fundamental component of the rehabilitation process with children (Jeglinsky, Salminen, Carlberg, & Autti-Rammo, 2012;King, Teplicky, King, & Rosenbaum, 2004;Øien, Fallang, & Østensjø, 2009) and adults (Playford, Siegert, Levack, & Freeman, 2009). Arguments advanced for the benefits of using a defined goal-setting process in rehabilitation include greater clarity of focus, shared understanding of issues, potential for enhanced interdisciplinary team work, increased opportunities for communication and collaboration among team members, and enhancement of parents' feelings of competency and partnership with the clinical team (Armstrong, 2008;Holliday, Ballinger, & Playford, 2007;Øien et al, 2009;Playford et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Addressing the Challenges of Collaborative Goal Setting with Children and Their Families

Brewer

Pollock

Wright

2013

Physical & Occupational Therapy In Pediatrics

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Collaborative goal setting between clinicians and clients/families is considered a fundamental component of the pediatric rehabilitation process. However, truly client-centered goal setting is not without its challenges. The purpose of this paper is to highlight theoretical concepts relevant to rehabilitation goal setting, review clinical studies directly evaluating relationships between goal setting and pediatric rehabilitation outcomes, and provide recommendations to facilitate collaborative goal processes. Four theoretical frameworks were identified that may lie behind and help explain the effectiveness of collaborative goal setting. The four relevant outcome studies found in the review revealed that individualized goal setting is an important component of the intervention, engages families more actively in therapy, and is associated to some extent with positive outcomes. The evidence suggests that the impact of fully collaborative goal setting is sufficiently positive to support investment of organizational and individual time, energy, and resources to make it an integral part of the rehabilitation process.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Addressing the Challenges of Collaborative Goal Setting with Children and Their Families

Brewer

Pollock

Wright

2013

Physical & Occupational Therapy In Pediatrics

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“…248 To be family centred, the family should identify needs, but also share responsibility, and health professionals should empower the family. 88,249,250 Support for shared management support might include effective training in, and printed information on, exercises that parents can perform safely and effectively with their children, as well as improved signposting to services. Key worker, partnership and skills training models of this kind reduce the stress experienced by parents of disabled children by helping them to understand the service environment, and to understand services to understand their needs.…”

Section: Focus Is On Equality and Narrowing Health Inequalitiesmentioning

confidence: 99%

Aquatic therapy for children with Duchenne muscular dystrophy: a pilot feasibility randomised controlled trial and mixed-methods process evaluation

Hind

Parkin

Whitworth

et al. 2017

Health Technol Assess

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BackgroundDuchenne muscular dystrophy (DMD) is a rare disease that causes the progressive loss of motor abilities such as walking. Standard treatment includes physiotherapy. No trial has evaluated whether or not adding aquatic therapy (AT) to land-based therapy (LBT) exercises helps to keep muscles strong and children independent.ObjectivesTo assess the feasibility of recruiting boys with DMD to a randomised trial evaluating AT (primary objective) and to collect data from them; to assess how, and how well, the intervention and trial procedures work.DesignParallel-group, single-blind, randomised pilot trial with nested qualitative research.SettingSix paediatric neuromuscular units.ParticipantsChildren with DMD aged 7–16 years, established on corticosteroids, with a North Star Ambulatory Assessment (NSAA) score of 8–34 and able to complete a 10-m walk without aids/assistance. Exclusions: > 20% variation between baseline screens 4 weeks apart and contraindications.InterventionsParticipants were allocated on a 1 : 1 ratio to (1) optimised, manualised LBT (prescribed by specialist neuromuscular physiotherapists) or (2) the same plus manualised AT (30 minutes, twice weekly for 6 months: active assisted and/or passive stretching regime; simulated or real functional activities; submaximal exercise). Semistructured interviews with participants, parents (n = 8) and professionals (n = 8) were analysed using Framework analysis. An independent rater reviewed patient records to determine the extent to which treatment was optimised. A cost-impact analysis was performed. Quantitative and qualitative data were mixed using a triangulation exercise.Main outcome measuresFeasibility of recruiting 40 participants in 6 months, participant and therapist views on the acceptability of the intervention and research protocols, clinical outcomes including NSAA, independent assessment of treatment optimisation and intervention costs.ResultsOver 6 months, 348 children were screened – most lived too far from centres or were enrolled in other trials. Twelve (30% of target) were randomised to AT (n = 8) or control (n = 4). People in the AT (n = 8) and control (n = 2: attrition because of parental report) arms contributed outcome data. The mean change in NSAA score at 6 months was –5.5 [standard deviation (SD) 7.8] for LBT and –2.8 (SD 4.1) in the AT arm. One boy suffered pain and fatigue after AT, which resolved the same day. Physiotherapists and parents valued AT and believed that it should be delivered in community settings. The independent rater considered AT optimised for three out of eight children, with other children given programmes that were too extensive and insufficiently focused. The estimated NHS costs of 6-month service were between £1970 and £2734 per patient.LimitationsThe focus on delivery in hospitals limits generalisability.ConclusionsNeither a full-scale frequentist randomised controlled trial (RCT) recruiting in the UK alone nor a twice-weekly open-ended AT course delivered at tertiary centres is feasible. Further intervention development research is needed to identify how community-based pools can be accessed, and how families can link with each other and community physiotherapists to access tailored AT programmes guided by highly specialised physiotherapists. Bayesian RCTs may be feasible; otherwise, time series designs are recommended.Trial registrationCurrent Controlled Trials ISRCTN41002956.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 27. See the NIHR Journals Library website for further project information.

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“…This is an important aspect of taxonomy, since it emphasizes the complementarity of the rehabilitation process. It is important to assess skill deficiencies 25,26 , but the effectiveness of any program depends on the implementation of adequate activities to achieve functional goals for the patient 27,28 .…”

Section: The Fama Approach -Proposal For a Practical Use Of Motor Skillsmentioning

confidence: 99%

Untitled

Monteiro

2012

J. Hum. Growth Dev.

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Goal‐setting in paediatric rehabilitation: perceptions of parents and professional

Cited by 94 publications

References 29 publications

Addressing the Challenges of Collaborative Goal Setting with Children and Their Families

Addressing the Challenges of Collaborative Goal Setting with Children and Their Families

Aquatic therapy for children with Duchenne muscular dystrophy: a pilot feasibility randomised controlled trial and mixed-methods process evaluation

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