Eleonore Dietrich, MA, is Occupational Therapist, Rehabilitation Department for Children With Acquired Neurological Injury, Paris-Est Val-de-Marne Hospitals, Saint Maurice, France.
Helene Lebrault, PhD, is Occupational Therapist, Rehabilitation Department for Children With Congenital Neurological Injury, Paris-Est Val-de-Marne Hospitals, Saint Maurice, France; Postdoctoral Researcher, Laboratoire d'Imagerie Biomédicale, Sorbonne Université, Paris, France; and Postdoctoral Researcher, GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France;
Am J Occup Ther. 2024 Sep 1;78(5). doi: 10.5014/ajot.2024.050586.
Care partners' involvement is a key feature of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach that can enhance rehabilitation outcomes and promote the generalization and transfer of strategies and skills to everyday life. Gaining insight into care partners' experience with their child's CO-OP intervention is critical to understanding how to enhance care partners' involvement.
To gain insight into the experience of care partners whose child with acquired brain injury (ABI) participated in CO-OP intervention.
A qualitative descriptive research design was used. Semistructured interviews were conducted at three time points (immediate postintervention and at 2 and 6 mo postintervention).
Two rehabilitation centers.
Thirteen care partners of 12 children or youth with severe ABI.
Three themes emerged from the analysis of 33 interviews: (1) The child is an active agent in their therapy, (2) the care partner is the keystone who helps solidify the elements of CO-OP, and (3) CO-OP mastery requires time and practice, and its use evolves over time.
These themes highlight the progressive nature of proficiency in CO-OP for both care partners and children. This was evident not only in the children's improvement in task performance, but also in their ability to problem solve. Care partners' role in supporting the CO-OP approach also unfolds over time as their confidence in their child's problem-solving abilities, and in their own ability to adequately provide guidance, increases. Engagement seems to be central in facilitating this progression for both children and their care partners. Plain-Language Summary: This is the first study to provide insights into the involvement of care partners in the Cognitive Orientation to daily Occupational Performance (CO-OP) approach for children and youth with executive function deficits after acquired brain injury. This is also the first study to explore the evolution of care partners' experiences over time. Involving care partners is a key feature of the CO-OP. Understanding care partners' experiences with their child's CO-OP intervention can improve a child's rehabilitation outcomes. The study found that care partners' role in supporting their child's CO-OP approach improved over time as their confidence in their child's problem-solving abilities increased. The care partners' own ability to adequately provide guidance to their child also increased over time. Engagement seems to be central in facilitating this progression for both children and their care partners. It is hoped that occupational therapists will consider the findings of this study to better support care partners in implementing the CO-OP approach with their child in their real-life context.
照护者的参与是认知导向日常生活活动（CO-OP）方法的一个关键特征，它可以增强康复效果，并促进策略和技能向日常生活的推广和转移。了解照护者对其孩子 CO-OP 干预的体验对于理解如何增强照护者的参与至关重要。
深入了解其患有获得性脑损伤（ABI）的孩子接受 CO-OP 干预的照护者的体验。
采用定性描述性研究设计。在三个时间点（干预后即刻和干预后 2 个月和 6 个月）进行半结构式访谈。
两个康复中心。
12 名患有严重 ABI 的儿童或青少年的 13 名照护者。
从 33 次访谈的分析中出现了三个主题：（1）孩子是治疗中的积极参与者，（2）照护者是帮助巩固 CO-OP 要素的关键人物，（3）CO-OP 掌握需要时间和实践，并且随着时间的推移而发展。
这些主题突出了 CO-OP 对照护者和孩子的熟练程度的渐进性质。这不仅体现在孩子在任务表现上的改善，还体现在他们解决问题的能力上。照护者在支持 CO-OP 方法方面的作用也随着时间的推移而展开，因为他们对孩子解决问题能力的信心以及他们自己提供足够指导的能力都在增加。参与似乎是促进孩子和他们的照护者取得进展的核心。
这是第一项研究，提供了关于认知导向日常生活活动（CO-OP）方法在患有执行功能缺陷的获得性脑损伤后儿童和青少年中的参与情况的见解。这也是第一项探讨照护者随着时间的推移体验演变的研究。让照护者参与是 CO-OP 的一个关键特征。了解照护者对孩子 CO-OP 干预的体验可以提高孩子的康复效果。研究发现，随着照护者对孩子解决问题能力的信心增强，他们在支持孩子 CO-OP 方法方面的作用也随着时间的推移而提高。随着时间的推移，照护者自己为孩子提供足够指导的能力也有所提高。参与似乎是促进孩子和他们的照护者取得进展的核心。希望职业治疗师考虑这项研究的结果，以便在现实生活环境中更好地支持照护者与孩子一起实施 CO-OP 方法。
