Pentland Jacqueline, Maciver Donald, Owen Christine, Forsyth Kirsty, Irvine Linda, Walsh Mike, Crowe Miriam
a Occupational Therapy Research Area, School of Health Sciences, Queen Margaret University , Edinburgh , UK .
b NHS Lothian , Scotland , UK , and.
Disabil Rehabil. 2016;38(3):299-306. doi: 10.3109/09638288.2015.1037464. Epub 2015 Apr 22.
The National Health Service in Scotland published a best practice framework to support occupational therapists and physiotherapists to deliver effective services for children with developmental co-ordination disorder (DCD); however, adherence is variable. To highlight areas for development, this study compared the care pathway within a paediatric DCD service against the NHS Scotland framework.
A partnership of researchers and clinicians based in the United Kingdom conducted a qualitative study with 37 participants (N = 13 interview participants, N = 24 workshop participants). In-depth interviews and/or workshops were used to map the DCD service against the NHS framework. Identified gaps were aligned with four key stages of the care pathway. Qualitative analysis software was used to analyse the data.
Core principles to guide future development were identified for each phase of the pathway. These core principles related to the NHS framework and focused on issues such as involving the family, defining clear pathways and enhancing children's participation. Participants identified potential strategies for service improvement such as developing community-based interventions and information provision.
Challenges when providing services for children with DCD include confusing service pathways and poor partnership working. It is, therefore, important that clinicians utilise collaborative working strategies that support children's participation.
There are numerous challenges related to the implementation of best practice principles into the provision of therapy services for children with developmental coordination disorder (DCD). It is important that AHPs seek ways of engaging parents and educational professionals at all stages of the care pathway in order to ensure optimum service provision for the child. Addressing participation is an important aspect and community-based strategies may be particularly beneficial, both as a preventative activity and as an intervention approach.
苏格兰国民医疗服务体系发布了一个最佳实践框架，以支持职业治疗师和物理治疗师为患有发育协调障碍（DCD）的儿童提供有效的服务；然而，其遵循情况参差不齐。为了突出需要改进的领域，本研究将儿科DCD服务中的护理路径与苏格兰国民医疗服务体系框架进行了比较。
英国的一组研究人员和临床医生开展了一项定性研究，有37名参与者（N = 13名访谈参与者，N = 24名工作坊参与者）。通过深入访谈和/或工作坊，对照国民医疗服务体系框架梳理DCD服务。找出的差距与护理路径的四个关键阶段相对应。使用定性分析软件对数据进行分析。
确定了护理路径各阶段指导未来发展的核心原则。这些核心原则与国民医疗服务体系框架相关，重点关注诸如让家庭参与、明确路径以及增强儿童参与度等问题。参与者确定了服务改进的潜在策略，如开展基于社区的干预措施和提供信息。
为患有DCD的儿童提供服务时面临的挑战包括服务路径混乱和合作不佳。因此，临床医生采用支持儿童参与的合作工作策略非常重要。
在为患有发育协调障碍（DCD）的儿童提供治疗服务时，将最佳实践原则付诸实施存在诸多挑战。重要的是，健康与照护专业人员要设法让家长和教育专业人员在护理路径的各个阶段参与进来，以确保为儿童提供最佳服务。解决参与问题是一个重要方面，基于社区的策略可能特别有益，既作为预防活动，也作为一种干预方法。
