HU University of Applied Sciences Utrecht, Institute of Human Movement Studies, Master Pediatric Physiotherapy, Utrecht, The Netherlands.
HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, Utrecht, The Netherlands.
BMC Pediatr. 2021 Aug 28;21(1):369. doi: 10.1186/s12887-021-02827-5.
Children with physical disabilities (PD) are less physically active than typically developing peers. The most important contributor to physical activity for primary school-aged children is outside play and therefore this should be part of every child's life. However, children with PD experience multiple barriers to participation in playgrounds. Despite recent improvements in the accessibility of Dutch playgrounds, the participation of children with PD has not increased. This study aims to explore facilitators, barriers and solutions influencing the participation of children with PD in Dutch outdoor playgrounds, from parents' and professionals' perspectives.
Twelve semi-structured interviews with parents of children with PD aged 2-12 years and five focus group meetings with professionals working with these children were conducted. To ensure data saturation, we performed three member-check meetings. Two independent researchers analyzed the data using an inductive thematic approach.
Similar barriers, facilitators and solutions were mentioned by parents and professionals. Three main themes were identified: the emotional barrier versus the physical barrier, play as a part of an inclusive society and the role of professionals in facilitating active inclusive play. The most important personal factors were physical and social problems experienced when children with PD wanted to join outdoor play. Interestingly, parents and professionals believed the social barrier was far more important than the physical one. The most important environmental factor was that the Dutch society is not sufficiently inclusive.
According to both parents and professionals, the most important barrier to active inclusive outdoor play was social, hindering the participation of children with PD in play with typically developing peers. To overcome such problems, professionals should take an active role in empowering children with PD and their parents. Furthermore, it is important to introduce outdoor active play early, so it becomes part of normal daily life. In addition, a change in the mindset of typically developing children and their parents seems essential to achieve true inclusive active play.
身体残疾儿童（PD）的身体活动量不如一般发育同龄人。对小学年龄儿童而言，最重要的身体活动贡献来自户外游戏，因此，这应该成为每个孩子生活的一部分。然而，PD 儿童在参与操场活动时会遇到多种障碍。尽管荷兰游乐场的可达性最近有所提高，但 PD 儿童的参与度并未增加。本研究旨在从家长和专业人员的角度探讨影响 PD 儿童参与荷兰户外游乐场的促进因素、障碍和解决方案。
对 2-12 岁 PD 儿童的家长进行了 12 次半结构化访谈，并与这些儿童一起进行了 5 次焦点小组会议。为了确保数据饱和，我们进行了 3 次成员核对会议。两位独立的研究人员使用归纳主题方法分析数据。
家长和专业人员提到了类似的障碍、促进因素和解决方案。确定了三个主要主题：情感障碍与身体障碍、游戏作为包容社会的一部分以及专业人员在促进积极包容游戏中的作用。最重要的个人因素是 PD 儿童在想要参与户外游戏时所经历的身体和社会问题。有趣的是，家长和专业人员认为社会障碍远比身体障碍重要。最重要的环境因素是荷兰社会不够包容。
根据家长和专业人员的说法，积极包容的户外游戏的最大障碍是社会障碍，阻碍了 PD 儿童与一般发育同龄人一起参与游戏。为了解决这些问题，专业人员应在赋予 PD 儿童及其家长权力方面发挥积极作用。此外，尽早引入户外积极游戏很重要，使其成为日常生活的一部分。此外，改变一般发育儿童及其家长的思维模式对于实现真正的包容性积极游戏似乎至关重要。
