Massey Jill, Tsianakas Vicki, Gordon Anne, Robert Glenn
Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Florence Nightingale School of Nursing Midwifery and Palliative Care, London, UK.
Child Care Health Dev. 2025 Mar;51(2):e70040. doi: 10.1111/cch.70040.
Partnership working between parents and therapists is a key component of family-centred care (FCC). Such partnerships in paediatric intervention delivery can help achieve required levels of dosage, intensity and embed interventions in the child's everyday activities. This study explores the experience and views of parents and therapists codelivering an intensive upper limb intervention programme for children with hemiplegia, to find ways to enhance successful partnership working.
Semistructured interviews were conducted with 12 parents and 8 therapists (3 hospital-based and 5 community-based). To help make evidence-based recommendations, data were analysed using inductive reflexive analysis and mapped to the Theoretical Domains Framework (TDF) of constructs that are common determinants of clinical behaviours or practices.
Five major themes were identified as follows: (1) realities of accessing intensive intervention, (2) key components of intervention delivery, (3) role of goal setting, (4) importance of partnership and (5) impact of intervention delivery on parents. Our findings showed that overall parents valued involvement in the programme, acknowledging benefits and challenges, as well as aspects in which they needed further support. Hospital therapists identified various education and training needs to improve their capabilities to coach parents and to collaboratively set meaningful goals. Community therapists valued the opportunity to develop their skills in intensive intervention and were keen to see evidence-based interventions offered in the community.
It is possible for parents, hospital therapists and community therapists to codeliver intensive upper limb intervention programmes to children with hemiplegia. However, it is important to create a flexible programme which clearly acknowledges the roles, skills and unique contributions of parents and therapists which is conducive to truly equal partnership working in appropriate settings.
家长与治疗师之间的合作是家庭中心护理（FCC）的关键组成部分。在儿科干预实施中，这种合作有助于达到所需的剂量、强度水平，并将干预措施融入儿童的日常活动中。本研究探讨了共同为偏瘫儿童实施强化上肢干预计划的家长和治疗师的经验与观点，以寻找加强成功合作的方法。
对12名家长和8名治疗师（3名医院治疗师和5名社区治疗师）进行了半结构化访谈。为了提出基于证据的建议，采用归纳反思分析法对数据进行分析，并将其映射到临床行为或实践的常见决定因素的理论领域框架（TDF）。
确定了五个主要主题如下：（1）获得强化干预的现实情况，（2）干预实施的关键组成部分，（3）目标设定的作用，（4）合作的重要性，（5）干预实施对家长的影响。我们的研究结果表明，总体而言，家长重视参与该计划，认识到其中的益处和挑战，以及他们需要进一步支持的方面。医院治疗师确定了各种教育和培训需求，以提高他们指导家长和共同设定有意义目标的能力。社区治疗师重视有机会在强化干预方面提升技能，并渴望看到在社区中提供基于证据的干预措施。
家长、医院治疗师和社区治疗师共同为偏瘫儿童实施强化上肢干预计划是可行的。然而，重要的是创建一个灵活的计划，明确承认家长和治疗师的角色、技能和独特贡献，这有利于在适当的环境中真正实现平等的合作。
