Determinants of parent-delivered therapy interventions in children with cerebral palsy: A qualitative synthesis and checklist

Child Care Health Dev. 2018 Sep;44(5):659-669. doi: 10.1111/cch.12592. Epub 2018 Jul 23.

Abstract

Introduction: Parent-delivered therapy interventions for children with cerebral palsy can help achieve a sufficient therapy dose, improve parental mental well-being, and facilitate parent-child relationships creating a more relaxed familial environment. However, parent-delivered interventions may also lead to increased parental stress, guilt if the therapy is not delivered, and time constraints. The primary aim of this review was to gain a deeper understanding of the determinants of effective parent-delivered therapy interventions.

Method: Searches were conducted in the following databases: Medline, PubMed, Scopus, Embase, CINAHL, and Cochrane. Studies had to meet the following inclusion criteria: descriptions of parent/health care professional/child experiences of parent-delivered therapy interventions for children and young people age 0-18 years with cerebral palsy, published in the English language between January 1989 and May 2017, with qualitative or mixed methods research design. The articles were critically appraised, then synthesized using a meta-ethnographic approach.

Results: A literature search identified 17 articles, which met the inclusion criteria. Three main themes were identified: (a) building trusting relationships, (b) enabling the parents to cope, and (c) for parents and health care professionals to see the intervention as a priority. Further synthesis presented three concepts identifying the important aspects of the interventions: empowerment, motivation, and relationships.

Conclusions: The themes and concepts emerging from this qualitative synthesis can be addressed by specific points of action to support parent-delivered therapy interventions. We have summarized these in a checklist for use by intervention developers, health care professionals, and parents.

Keywords: cerebral palsy; child; intervention; meta-ethnography; parent-delivered; qualitative synthesis; therapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Allied Health Personnel*
  • Cerebral Palsy / therapy*
  • Checklist*
  • Child
  • Education, Nonprofessional*
  • Humans
  • Parent-Child Relations
  • Parenting / psychology
  • Parents* / education
  • Parents* / psychology
  • Professional-Family Relations
  • Qualitative Research
  • Self Report