Perceived strengths and weaknesses of paediatric physiotherapy services: Results from an international survey.

BACKGROUND AND PURPOSE: Ensuring access to high quality services in paediatric physiotherapy (PT) is important to respond to the diverse needs of children. The accessibility and quality of paediatric PT services has however never been explored internationally. The purpose of this study is to explore the perceived strengths, weaknesses, opportunities, and threats (SWOT) of paediatric PT services offered around the world. METHOD: A cross-sectional survey design method was used with a subsample of physiotherapists (PTs) who had previously participated in an online survey. The survey used for this study included close- and open-ended questions about access to services and the SWOT of PT services within participants' country. Descriptive statistics were used to summarize quantitative data and a content analysis was performed on open-ended questions. RESULTS: Overall, 47 PTs from 47 countries completed the survey; 36% of participants reported that free access was available to all children in their country while 34% stated that a referral was always required when accessing services. Lack of direct access, insufficient specialized PT, financial and geographical issues were the main perceived barriers to access services. Access also emerged as one of the nine themes following the SWOT analysis. Other themes included education, quality of PT approaches, PT practices, communication and cooperation, teamwork, government, resources, and attitudes of PTs. DISCUSSION: Despite variations in accessing services and how services are delivered across countries, some similar themes influencing PTs practices were found. Future opportunities for PTs working with children should aim at optimizing the initial training and professional development of PTs in paediatrics, increasing access to services for all children and advocating for sustainable and well-coordinated models of care building on best practices.

Scope and Practices of Physical Therapists Working With Children: Results From an International Online Survey.

PURPOSE: To describe the scope of practice of physical therapists (PTs) working with children worldwide. METHODS: PTs working with children in any context and country were invited via social media and email campaigns to complete an online survey containing 42 questions about work context and service delivery. Descriptive statistics were computed. RESULTS: Of the 1133 participants from 77 countries, most worked with children full-time (51.8%), and in government-funded work settings (57.5%). Modalities of access to services varied across countries, work settings, and children's conditions, yet 46.7% of PTs reported that most children had direct access to services. PTs provided services to children with a variety of conditions, with cerebral palsy being most reported (83.3%). Interventions focused primarily on improving body function (42.0%) and on providing face-to-face individual treatment (96.6%). CONCLUSIONS: This study provides an international portrait of pediatric PT practice and illustrates the diversity of services in pediatric PT.

Implementing Partnering for Change in Québec: Occupational Therapy Activities and Stakeholders' Perceptions.

BACKGROUND.: The occupational therapy school-based Partnering for Change (P4C) model has mostly been documented in Ontario. PURPOSE.: This implementation study describes the implementation of P4C in two Québec elementary schools (P4C-Q), as well as therapy practices, their impacts, factors perceived to influence implementation, and recommendations. METHOD.: A sequential mixed-methods design was applied. Therapists (n=2) completed daily journals, describing activities by P4C-Q level. Therapists and other school-stakeholders (n=11) participated in semi-structured interviews, analyzed through a content analysis framework. FINDINGS.: Daily journals illustrated that the majority of therapy time was spent on activities targeting the entire classroom, and on collaboration with educators. Interviews illustrated how coaching was used across different practices and the impact of these practices for schools (e.g., capacity-building) and children (e.g., increased functioning), and highlighted how relationship-building is key to facilitating the implementation of this model. IMPLICATIONS.: Lessons learned may be helpful for others implementing P4C in their own contexts.

Canadian French translation and linguistic validation of the health-related quality of life utility measure for pre-school children.

BACKGROUND: There is a need to perform a Canadian French translation and linguistic validation of the health-related quality of life utility measure for pre-school children (HuPS) conceptually equivalent to the original Canadian English version. RESEARCH DESIGN AND METHODS: The translation process consisted of forward and back translations. The linguistic validation was performed with the parents of preschool children during face-to-face cognitive debriefing interviews. The whole process was done in accordance with academic standards and the guidance of the Food and Drug Administration (FDA) for patient-reported outcome instruments. RESULTS: The results of back translations indicated that 89% of the sentences were identical or almost identical to the original English-language wording. The review of the back translations led to a change in 13 sentences out of 91 from the reconciled forward translation, while the linguistic validation process with 13 parents led to 14 additional changes. Preliminary reliability validation results indicate a Cronbach's alpha of 0.73. CONCLUSION: The translation and linguistic testing processes were successful in creating a valid HuPS in Canadian French (HuPS-CF). This translation should be the subject of reliability and validity studies in a wide variety of clinical and general populations before to use in research projects.

Understanding parental concerns related to their child's development and factors influencing their decisions to seek help from health care professionals: Results of a qualitative study.

BACKGROUND: Early identification of children at risk of developmental delay is crucial to promote healthy development. Assessing parental concerns about development is often part of identification processes. However, we currently do not understand well how and why parents become concerned and how and why they access early identification and intervention services. The purpose of this study was to explore parental perceptions about their child's development and the factors influencing their reported professional help-seeking behaviours. METHODS: This exploratory study was part of a larger study describing child development in children aged 2-5 in a small Canadian city. We conducted semistructured interviews with 16 parents whose children were at risk of developmental delay to examine their perceptions of their child's development, their use of community services promoting development, and their recommendations to optimize those services. RESULTS: Four themes were identified: (a) Vision of child development influencing help-seeking behaviours: Natural or Supported?, (b) Internal and external sources contributing to parents' level of developmental concern, (c) Using internal resources and struggling to access external resources, and (d) Satisfaction with services accessed and recommendations to access more support. Parents' vision of child development along with sources of parental concern appeared to influence the level of concern, enhancing our understanding of how parents become concerned. The level of concern and parents' knowledge and perceived access to resources seemed to influence their decision whether or not to consult health care professionals. Parents provided many suggestions to improve services to promote child development and support families. DISCUSSION: Results highlight the importance of supporting parents in recognizing if their child is at risk of delay and increasing awareness of available resources. It appears particularly important to ensure that health care professionals and community-based support services are accessible to provide parents with the support they need, especially when they have concerns.