[show abstract][hide abstract] ABSTRACT: We wished to determine the frequency of complementary and alternative health care (CAHC) use in preschool aged children with physical disabilities (PD) waiting for public rehabilitation services in the province of Quebec (Canada), to evaluate its effectiveness from the parents' perspective and to explore factors associated with its utilisation.
Children with PD referred to rehabilitation centres from two Montreal hospitals were recruited. We evaluated the use of CAHC and its effectiveness from the parents' perspective in a cross-sectional manner, using descriptive statistics. We explored factors associated with utilisation, using logistic regression models.
In this group of children with PD (n = 206, mean age: 2.6 years), 31 (15%) used CAHC and 15 (48.4%) of those tried more than one type. CAHC was considered at least moderately beneficial by parents in 53% of the cases. The use of CAHC was higher among children with low health-related quality of life (HRQOL) and children whose mothers were more educated and considered themselves as Canadian (p < 0.05).
Although the use of CAHC by young children with PD was low, use of CAHC was higher among children with lower HRQOL and whose mothers were highly educated and Canadian. CAHC use should be evaluated by health providers to better educate parents of children with PD, which may help them to make the best decisions regarding their child's treatment while waiting for rehabilitation services.
Disability and Rehabilitation 01/2009; 31(25):2111-7. · 1.54 Impact Factor
[show abstract][hide abstract] ABSTRACT: To determine whether longer waiting times for rehabilitation were associated with deterioration in child functional status and/or quality of life.
Parents of 124 children (mean age 45 months) with physical disabilities (e.g., cerebral palsy, global developmental delay, spina bifida) who were referred to pediatric rehabilitation centers were interviewed every three months, from referral until admission into the rehabilitation program. Information from parental interviews included socio-demographics, parental empowerment (Family Empowerment Scale), function (WeeFIM: Functional Independence Measure for Children), and quality of life (PedsQL). Data on date of referral, age, gender, and diagnosis were obtained from hospital databases.
Half of the sample waited more than 9.1 months (95% confidence interval: 6.5-16.1) for admission to a public rehabilitation program. A total of 42% paid for some private services while waiting. Over the waiting period, there was statistically significant improvement in WeeFIM cognition and total scores but not in mobility scores. PedsQL psychosocial summary score declined over the waiting period (p< .05).
Longer wait times for rehabilitation were associated with declining psychosocial quality of life. Reducing waiting times for rehabilitation services may allow rehabilitation specialists to address psychosocial problems for these children.
[show abstract][hide abstract] ABSTRACT: Early therapy intervention for children with disabilities may improve functional outcomes. Access to paediatric rehabilitation services can sometimes be difficult.
To describe waiting time to receive physical therapy (PT) and occupational therapy (OT) services at rehabilitation centres for young children with physical disabilities; to examine factors associated with these waiting times.
Two hundred and six children with physical disabilities, aged 6 to 72 months, referred in 2002-2004 from the Montreal Children's Hospital and Sainte-Justine Hospital to paediatric rehabilitation centres.
Data on date of referral, age, gender and diagnosis were obtained from the hospital databases. Data on date of first PT or OT appointments at the rehabilitation centre, family socio-demographics and disability severity (WeeFIM) were obtained during parental interviews.
Half of the sample waited more than 7 and 11 months for PT and OT services, respectively. Shorter waiting time was significantly associated with younger child's age and referral to one particular rehabilitation centre.
Children with physical disabilities experience long waiting times for PT and OT rehabilitation services. Strategies to improve timely service delivery are needed.
Healthcare policy = Politiques de sante 03/2007; 2(3):e171-87.
[show abstract][hide abstract] ABSTRACT: To determine the association between functional status, measured by the WeeFIM and health-related quality of life (HRQL), measured by the PedsQL4.0 for children with physical disabilities. To explore child, parent and service-related factors associated with each of these measures.
Parents of 115 children (2-5 years) with physical disabilities who were referred to occupational (OT) or physical therapy (PT). Mean age of the children was 3 years 7 months (+/-10 months), 79 were boys and 67 were diagnosed with global developmental delay.
Children had more difficulties with self-care tasks and cognitive abilities, as compared to mobility activities on the WeeFIM. The correlation between total WeeFIM and total PedsQL4.0 was r=0.39. WeeFIM mobility and self-care quotients were each fairly correlated with PedsQL-Physical Health Summary Score (rs=0.29 and rs=0.28 respectively). There was no significant association between WeeFIM cognition quotient and each of PedsQL scores (rs=0.03-0.05). The receipt of PT services was highly associated (p<0.001) with lower scores on the PedsQL-Physical Health Summary score, PedsQL-Total score, and WeeFIM mobility quotient.
The WeeFIM and the PedsQL4.0 appear to assess related but different constructs, supporting the need to incorporate complementary measures when measuring general health of children with disabilities.
Quality of Life Research 08/2006; 15(6):1023-31. · 2.41 Impact Factor
[show abstract][hide abstract] ABSTRACT: To describe when and by whom concern is first expressed for children referred to rehabilitation because of neuromotor problems.
We conducted a survey of parents of 92 children (aged 0-6 years) who were on the waiting list for physical or occupational therapy services at rehabilitation centers in Montréal, Québec. We compared age of child at initial concern with who first expressed concern for children who were considered at risk due to their perinatal history of prematurity and those who were not born prematurely but were later diagnosed as having neuromotor problems.
Parents were interviewed regarding their child's medical history and utilization of health care services.
Parents were concerned later than physicians were regarding their child's development (mean difference, 8.2 months; 95% confidence interval [CI], 3.7-12.6 months). There was no significant difference in time of recognition of problems between the premature (10.2 months) and full-term (11.9 months) groups. Even after controlling for risk group, parental concern occurred later than physician concern (beta coefficient, 7.3; 95% CI, 2.5-12.2). The child's age at the time of initial concern was associated with the child's age at referral to rehabilitation (beta coefficient, 0.04; 95% CI, 0.01-0.06).
Early recognition is important if a child is to benefit from early rehabilitation. It may be important to improve primary care screening of children for neuromotor problems and to increase parental awareness regarding normal motor development of their children. Prompt, simultaneous referral to medical evaluation and rehabilitation resources may decrease delays in rehabilitation.
Archives of Pediatrics and Adolescent Medicine 10/2005; 159(9):882-6. · 4.28 Impact Factor