School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Pediatr Blood Cancer. 2014 Jun;61(6):1080-7. doi: 10.1002/pbc.24940. Epub 2014 Jan 22.
As pediatric brain tumor survivors may experience cognitive decline post-treatment, a neuropsychology assessment is often conducted. The assessment evaluates the child's cognitive functioning and highlights potential challenges. Whilst neuropsychology reports provide recommendations for the home and school, how this translates in practice is under researched. This study explored parent and teacher understanding of neuropsychology reports, implementation rates for recommendations and their perceived effectiveness. Barriers to implementation were also investigated.
Twenty-five semi-structured interviews were conducted with 17 parents and 8 teachers of childhood brain tumor survivors from 15 Australian families who had received a neuropsychology report within 2 years of the interview. Twenty-four neuropsychology reports encompassing 131 recommendations were reviewed. The qualitative methodological framework of Miles and Huberman [Miles M, Huberman A. Qualitative data analysis: An expanded sourcebook. London: Sage; 1994] was used to analyze interview transcripts with QSR NVivo 9.0.
The majority of parents and teachers had a sound understanding of the report. Implementation of recommendations at home and school was 47% and 41%, respectively. Recommendations that did not require extra effort and organization appeared more likely to be implemented, however, those perceived to be more effective or helpful did not necessarily have higher implementation rates. Key reported barriers to implementation barrier were patient reluctance, and a lack of parents' willingness to adopt the recommendation.
Patient understanding and willingness play a significant role in the implementation of neuropsychology recommendations. Collaboration and clear communication between the patient, teacher, parent, and neuropsychologist is vital for effective management.
由于儿科脑肿瘤幸存者在治疗后可能会出现认知能力下降，因此通常会进行神经心理学评估。该评估评估儿童的认知功能，并突出潜在的挑战。虽然神经心理学报告提供了有关家庭和学校的建议，但其实践中的转化情况研究较少。本研究探讨了家长和教师对神经心理学报告的理解、建议的实施率及其感知效果。还调查了实施的障碍。
对来自 15 个澳大利亚家庭的 17 名儿童脑肿瘤幸存者的父母和 8 名教师进行了 25 次半结构化访谈，这些家庭的孩子在访谈前 2 年内收到了神经心理学报告。共审查了 24 份神经心理学报告，其中包含 131 项建议。采用 Miles 和 Huberman [Miles M，Huberman A.定性数据分析：扩展资源手册。伦敦：Sage；1994]的定性方法框架，使用 QSR NVivo 9.0 分析访谈记录。
大多数父母和教师对报告有很好的理解。在家中和学校实施建议的比例分别为 47%和 41%。那些不需要额外努力和组织的建议似乎更有可能得到实施，然而，那些被认为更有效或更有帮助的建议并不一定具有更高的实施率。报告的实施障碍的主要障碍是患者不愿意，以及家长不愿意采用建议。
患者的理解和意愿在神经心理学建议的实施中起着重要作用。患者、教师、家长和神经心理学家之间的协作和清晰沟通对于有效管理至关重要。
