Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Department of Physical Therapy, College of Applied Medical Science, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Disabil Rehabil. 2023 Jan;45(1):57-64. doi: 10.1080/09638288.2021.2025272. Epub 2022 Jan 12.
To explore the perspectives of children with CP, their parents or carers, and health professionals on factors affecting expectations and perceptions of surgical outcomes for lower limb orthopaedic surgery.
Semi-structured interviews were conducted with 10 healthcare professionals, 10 children and young people with CP, and 8 parents. Interview data were analysed by content analysis supported by the Framework Approach using the International Classification of Functioning, Disability, and Health (ICF-CY).
A comprehensive list of 10 factors including facilitators, barriers, motivational and demotivational factors were identified and categorized into two overreaching themes (Environmental and Personal factors): interdisciplinary collaboration, communication and information resources, holistic care, and shared goal setting are reported as environment facilitators of outcomes expectations. In contrast, reported barriers include lack of time and resources and divergent expectations. Personal motivators include family encouragement, patient's self-determination, and previous experiences, whereas personal demotivators include fear of a new environment.
The recognition of potential factors influencing expectations and perceptions of surgical outcomes could assist clinical reasoning when planning surgical interventions for ambulant children with CP. If these factors are integrated into the healthcare practice, it will most likely enhance the positive stakeholders' experiences postoperatively.IMPLICATION FOR REHABILITATIONUnderstanding relevant stakeholders' experiences offer a positive contribution to holistic and person-centred approaches in healthcare.People with cerebral palsy and their caregivers require adequate information on surgery and post-surgical rehabilitation regime in order to reach informed decisions.Previous experiences can influence surgical expectations and subsequent perceptions of the outcome.
探讨脑瘫儿童、其父母或照顾者以及卫生专业人员对影响下肢矫形外科手术结果期望和认知的因素的看法。
对 10 名卫生保健专业人员、10 名脑瘫儿童和青少年以及 8 名家长进行了半结构化访谈。采用国际功能、残疾和健康分类（ICF-CY）框架方法支持的内容分析法对访谈数据进行分析。
确定并分类为两个主题（环境和个人因素）的 10 个因素的综合清单，包括促进因素、障碍因素、激励因素和抑制因素：跨学科协作、沟通和信息资源、整体护理和共同目标设定被报告为结果期望的环境促进因素。相比之下，报告的障碍因素包括缺乏时间和资源以及不同的期望。个人激励因素包括家庭鼓励、患者的自我决定和以前的经验，而个人抑制因素包括对新环境的恐惧。
认识到影响手术结果期望和认知的潜在因素可以在为有步行能力的脑瘫儿童规划手术干预时协助临床推理。如果将这些因素纳入医疗保健实践中，很可能会增强利益相关者术后的积极体验。
理解相关利益相关者的经验为医疗保健中的整体和以人为中心的方法提供了积极的贡献。脑瘫患者及其照顾者需要充分了解手术和术后康复方案，以便做出知情决策。以前的经验可以影响手术期望和随后对结果的认知。
