Although the attention for functional outcomes after burn injury has grown over the past decades, little is known about functional independence in performing activities of daily living in children after burn injury. Therefore, in this prospective cohort study functional independence was measured by burn care professionals with the WeeFIM(®) instrument in 119 pediatric patients with burns (age: 6 months-16 years; 58.8% boys) in the Netherlands. In order to identify whether functional independence was affected, participants' total scores on the WeeFIM(®) instrument were compared to American norm values. Of the participants assessed at 2 weeks post burn (n = 117), 3 months post burn (n = 68) and/or 6 months post burn (n = 38), 22, 9 and 9 participants showed affected performance, respectively. Improvements in WeeFIM(®) total scores for the total study population between 2 weeks and 6 months post burn were significant (Wilcoxon T = 2.5; p<.001, effect size = -0.59). Individual improvements were found to be significant for 30.3% of the assessed participants between 2 weeks and 3 months post burn, and for 12.1% between 3 and 6 months post burn. This study is unique in providing data on functional independence for this large and special population. However, a proportion of participants were lost to follow-up and the use of the WeeFIM(®) instrument in this specific population and setting has its limitations. To conclude, burn injury impacts functional independence in children, yet the vast majority of Dutch pediatric patients with burns returns to functional independence typical for age within 6 months post burn.
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Introduction Physical activity levels of children with disabilities are low, as these children and their parents face a wide variety of both personal and environmental barriers. Behavior change techniques support pediatric physical therapists to address these barriers together with parents and children. We developed the What Moves You?! intervention Toolkit (WMY Toolkit) filled with behavioral change tools for use in pediatric physical therapy practice. Objective To evaluate the feasibility of using the WMY Toolkit in daily pediatric physical therapy practice. Methods We conducted a feasibility study with a qualitative approach using semi-structured interviews with pediatric physical therapists (n = 11). After one day of training, the pediatric physical therapists used the WMY Toolkit for a period of 9 weeks, when facilitating physical activity in children with disabilities. We analyzed the transcripts using an inductive thematic analysis followed by a deductive analysis using a feasibility framework. Results For acceptability, pediatric physical therapists found that the toolkit facilitated conversation about physical activity in a creative and playful manner. The working mechanisms identified were in line with the intended working mechanisms during development of the WMY Toolkit, such as focusing on problem solving, self-efficacy and independence. For demand, the pediatric physical therapists mentioned that they were able to use the WMY Toolkit in children with and without disabilities with a broad range of physical activity goals. For implementation, education is important as pediatric physical therapists expressed the need to have sufficient knowledge and to feel confident using the toolkit. For practicality, pediatric physical therapists were positive about the ease of which tools could be adapted for individual children. Some of the design and materials of the toolkit needed attention due to fragility and hygiene. Conclusion The WMY Toolkit is a promising and innovative way to integrate behavior change techniques into pediatric physical therapy practice.
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Crying by healthcare professionals in the medical setting is a common but understudied phenomenon. We aimed to develop a questionnaire which measures the attitudes of parent towards crying pediatricians and pediatric nurses. We assessed reliability and validity in a group of parents of children who are living with, have died from or survived a life-limiting or life-threatening-condition. The development of the PACPN was based on modification of an existing questionnaire and expert input. In a cross-sectional-design, we assessed reliability and validity for both pediatricians and pediatric nurses. Dimensionality was assessed using principal component analysis (PCA). Cronbach’s alphas were calculated for each subscale. For construct validity, participants were asked to rate an additional question regarding the goal to measure parents’ attitudes towards crying pediatricians/pediatric nurses. We hypothesized that a higher score would have a strong positive correlation with the total score of the PACPN. At the end of the questionnaire, participants were asked to rate and comment the completeness. The developed 25-item questionnaire was completed by 116 parents. The PCA revealed two dimensions: (1) family’s circumstances; (2) personal circumstances of the pediatrician/pediatric nurse. Internal consistency was good (pediatricians,.81–.93; pediatric nurses,.83–.93). The hypothesis regarding construct validity was confirmed (Spearman’s rho =.71–.75). The completeness score was 7.7 (min–max 1–10, SD = 1.51). Conclusion: The PACPN showed good internal consistency and some degree of construct validity. We assume that by adding some items with nuance to the situation and the degree of crying the completeness of the questionnaire will improve. (Table presented.)
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Het Godivapp Applied in Pediatric Primary care (GoAPP) project ontwikkelt, onderzoekt en realiseert de implementatie van een e-health applicatie voor uitwisseling van videomateriaal in zelfstandige praktijken (MKB) in de eerstelijnsgezondheidszorg. Voor een goede analyse van bewegingsproblemen bij baby?s uit risicogroepen is het van belang de motorische ontwikkeling te meten en te volgen in de tijd. Kinderfysiotherapeuten gebruiken hiervoor een observatie-instrument, de Alberta Infant Motor Scale (AIMS). In 2014 en 2015 heeft de GODIVA-onderzoeksgroep (GrOss motor Development of Infants using home Video registration with the AIMS) van Hogeschool Utrecht een methode ontworpen, waarbij de ontwikkeling gevolgd kan worden aan de hand van video?s gemaakt door ouders. De methode wordt door professionals gezien als een aanvulling op bestaande methoden, die het monitoring van kinderen doelmatiger en transparanter maakt. De methode past uitstekend in de huidige e-health ontwikkeling en zelfmanagement/empowerment van ouders. Voor research met de videomethode is een prototype applicatie ontwikkeld waarmee op veilige wijze de filmbeelden verstuurd kunnen worden en opgeslagen. Het prototype is nog niet geschikt voor gebruik binnen de beroepspraktijk. Eerstelijns Kinderfysiotherapiepraktijken zouden graag de applicatie gebruiken. Zij verwachten dat het een waardevolle uitbreiding is van hun mogelijkheden en een kans om als praktijk te innoveren. Zij zien, als zelfstandige ondernemers, echter ook belemmeringen, zoals ICT-ondersteuning en een passende tarifering van een videoconsult. Voor deze kleine bedrijven spelen ook betaalbaarheid en gebruiksgemak een essentiële rol. Binnen GoAPP zijn vijf perspectieven voor innovatie en implementatie van e-health bij elkaar gebracht: eindgebruikers, zorginhoudelijk, harde technologie, zachte technologie en bedrijfskundig perspectief. Georganiseerd rondom drie werkpakketten wordt interdisciplinair onderzoek gedaan naar (1) optimalisatie van het videoportal, (2) implementatie, en (3) bedrijfskundige haalbaarheid, via ontwerpgericht onderzoek, literatuuronderzoek, implementatieanalyse en business-case onderzoek. Een vierde werkpakket richt zich op doorgroei van het netwerk kinderfysiotherapeuten naar een Community of Practice. Doel: Een innovatieve videomethode voor het observeren van de motoriek van zuigelingen, geschikt voor eerstelijnspraktijken kinderfysiotherapie, met een passend implementatieplan en business modelling.
