Podium 2
Tracks
Breakout 3
| Friday, September 6, 2024 |
| 3:45 PM - 4:15 PM |
| Dobson 3 |
Speaker
Mrs Elizabeth Carrington
Lecturer
School of Physiotherapy, University of Otago
Young people with disabilities and their whānau's experiences of family/whānau-centred care and play in therapy.
Presentation Abstract
Background
Young people living with a disability can experience barriers to societal participation and limited opportunities for play. Every child has the right to play, and play influences children’s cognition, physical, mental, and social growth. To develop engaging interventions for young people with disabilities, physiotherapists require an understanding of what is meaningful and important to the young people and their families/whānau.
Purpose
To explore the experiences and perceptions of young people with disabilities and their families/whānau on family/whānau-centred care and play as a therapeutic intervention.
Methods
Qualitative semi-structured interviews with 23 caregivers and three children/adolescents with a disability aged ≤21 years, living across New Zealand. Data were interpreted using latent reflexive themes.
Results
Concepts of whānau identity, valued service/therapist attributes and participatory outcomes were identified. Both challenges and positive experiences to family/whānau-centred care were dependent on family/whānau capacity and collaborative relationships. Experiences of play in therapy were connected to positive family/whānau perceptions of family/whānau-centred care and relationships.
Conclusions
The lives of young people with disabilities and their family/whānau are complex. To understand the family/whānau’s capacity, therapists must form trusting relationships, share knowledge, and hold space to hear the families’ voice. Capacity of both the family/whānau and the service influence the delivery and engagement with family/whānau-centred care. Families/whānau value the expertise of therapists to guide and scaffold fun interventions towards long term participatory focused outcomes.
Implications
Physiotherapists can support young people with disabilities and their families/whānau through provision of scaffolded, play-focused therapies alongside delivery of timely information with consideration of family/whānau capacity. Incorporating optional play-based activities into everyday routines may provide an opportunity support young people with disabilities in their home environment. Awareness of challenges to family/whānau-centred care may aid discussion between physiotherapists and families/whānau of young people with disabilities to facilitate the co-creation of meaningful play-based interventions.
Young people living with a disability can experience barriers to societal participation and limited opportunities for play. Every child has the right to play, and play influences children’s cognition, physical, mental, and social growth. To develop engaging interventions for young people with disabilities, physiotherapists require an understanding of what is meaningful and important to the young people and their families/whānau.
Purpose
To explore the experiences and perceptions of young people with disabilities and their families/whānau on family/whānau-centred care and play as a therapeutic intervention.
Methods
Qualitative semi-structured interviews with 23 caregivers and three children/adolescents with a disability aged ≤21 years, living across New Zealand. Data were interpreted using latent reflexive themes.
Results
Concepts of whānau identity, valued service/therapist attributes and participatory outcomes were identified. Both challenges and positive experiences to family/whānau-centred care were dependent on family/whānau capacity and collaborative relationships. Experiences of play in therapy were connected to positive family/whānau perceptions of family/whānau-centred care and relationships.
Conclusions
The lives of young people with disabilities and their family/whānau are complex. To understand the family/whānau’s capacity, therapists must form trusting relationships, share knowledge, and hold space to hear the families’ voice. Capacity of both the family/whānau and the service influence the delivery and engagement with family/whānau-centred care. Families/whānau value the expertise of therapists to guide and scaffold fun interventions towards long term participatory focused outcomes.
Implications
Physiotherapists can support young people with disabilities and their families/whānau through provision of scaffolded, play-focused therapies alongside delivery of timely information with consideration of family/whānau capacity. Incorporating optional play-based activities into everyday routines may provide an opportunity support young people with disabilities in their home environment. Awareness of challenges to family/whānau-centred care may aid discussion between physiotherapists and families/whānau of young people with disabilities to facilitate the co-creation of meaningful play-based interventions.
Biography
Lizz Carrington is a lecturer at the School of Physiotherapy at the University of Otago. Her research interests are focused on family centred care, supported self (whanau)-management and novel paediatric service delivery to support children with disabilities and empower their families. Lizz is interested in the use of innovative paediatric physiotherapy service delivery and play-based therapy as a method of engagement. Her research seeks to better understand how to strengthen collaborative care in physiotherapy, particularly in paediatrics through meaningful relationships between health professionals and children with disabilities and their families.
Mrs Karen Adams
Physiotherapist
AUT
The physiotherapy conundrum for non-ambulant children with cerebral palsy and intellectual disability: An integrative review
Presentation Abstract
Background:
Physiotherapists in Aotearoa have a responsibility to base interventions on best available evidence. Despite many systematic reviews on cerebral palsy (CP) reporting “best evidence” for physiotherapy interventions, there is a paucity of evidence focused on non-ambulant children with CP combined with intellectual disability (NACCP-ID). This is mainly due to the heterogeneity of the population, making research challenging, and the hierarchy of evidence favours research suitable for ambulant children with the intellectual capacity to participate in tasks.
Purpose:
To identify and provide a comprehensive synthesis of physiotherapy interventions for NACCP-ID using an integrative review of the literature.
Methods:
An integrative review was conducted between March and April 2023 using CINAHL, Medline, Scopus, PEDRO, Google Scholar and Tu Whera databases. Articles were appraised using the Mixed Methods Appraisal Tool. Conventional content analysis ensured results were acceptable for both the primarily positivist physiotherapy profession and the interpretive nature of disability in which these children are situated.
Results:
Twenty-four studies on physiotherapy interventions for school-aged NACCP-ID were reviewed. Six intervention types were identified: functional exercise, gaming, power wheelchair training, sleep systems, static standing frames and dynamic standing frames. The outcomes and considerations of interventions were discussed within the Te Whare Tapa Whā model.
Conclusion
The complexity of NACCP-ID is the dominant finding that affects researchers’ ability to conduct studies with this population. This, in turn, limits the value placed on the available research and provides a limited scope of interventions for physiotherapists to evaluate within evidence-based practice (EBP).
Impact
For children with complex needs, such as NACCP-ID, the outcome of interventions is the sum of all the parts, not a series of predictable reactions with reliable outcomes, making EBP challenging for physiotherapists. Research must pivot to embrace the population's heterogeneity and practice requires a more holistic framework of EBP to encompass the complexity.
Physiotherapists in Aotearoa have a responsibility to base interventions on best available evidence. Despite many systematic reviews on cerebral palsy (CP) reporting “best evidence” for physiotherapy interventions, there is a paucity of evidence focused on non-ambulant children with CP combined with intellectual disability (NACCP-ID). This is mainly due to the heterogeneity of the population, making research challenging, and the hierarchy of evidence favours research suitable for ambulant children with the intellectual capacity to participate in tasks.
Purpose:
To identify and provide a comprehensive synthesis of physiotherapy interventions for NACCP-ID using an integrative review of the literature.
Methods:
An integrative review was conducted between March and April 2023 using CINAHL, Medline, Scopus, PEDRO, Google Scholar and Tu Whera databases. Articles were appraised using the Mixed Methods Appraisal Tool. Conventional content analysis ensured results were acceptable for both the primarily positivist physiotherapy profession and the interpretive nature of disability in which these children are situated.
Results:
Twenty-four studies on physiotherapy interventions for school-aged NACCP-ID were reviewed. Six intervention types were identified: functional exercise, gaming, power wheelchair training, sleep systems, static standing frames and dynamic standing frames. The outcomes and considerations of interventions were discussed within the Te Whare Tapa Whā model.
Conclusion
The complexity of NACCP-ID is the dominant finding that affects researchers’ ability to conduct studies with this population. This, in turn, limits the value placed on the available research and provides a limited scope of interventions for physiotherapists to evaluate within evidence-based practice (EBP).
Impact
For children with complex needs, such as NACCP-ID, the outcome of interventions is the sum of all the parts, not a series of predictable reactions with reliable outcomes, making EBP challenging for physiotherapists. Research must pivot to embrace the population's heterogeneity and practice requires a more holistic framework of EBP to encompass the complexity.
Biography
Karen Adams is a paediatric Physiotherapist working in the 3D Motion Analysis Gait Clinic at AUT and in the community with children with Cerebral Palsy. She has a background of working in Special Education Schools in Auckland which gave her the privilege of working with, amongst others, non-ambulatory children with CP and intellectual disability and their families. These amazing humans ignited her passion to make these potentially invisible children and whānau included in their communities and in CP research.
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