Exploring the factors that influence stakeholders' expectations and subsequent perception of lower limb orthopaedic surgical outcomes for ambulant children with cerebral palsy - a qualitative study

Hajar Almoajil; Tim Theologis; Helen Dawes; Jo Pierce; Andrew Meaney; Aziz Baklouti; Lara Poverini; Sally Hopewell; Francine Toye

doi:10.1080/09638288.2021.2025272

Exploring the factors that influence stakeholders' expectations and subsequent perception of lower limb orthopaedic surgical outcomes for ambulant children with cerebral palsy - a qualitative study

Disabil Rehabil. 2023 Jan;45(1):57-64. doi: 10.1080/09638288.2021.2025272. Epub 2022 Jan 12.

Authors

Hajar Almoajil^{1

2}, Tim Theologis^{1

3}, Helen Dawes^{4

5}, Jo Pierce⁶, Andrew Meaney⁴, Aziz Baklouti⁴, Lara Poverini⁴, Sally Hopewell¹, Francine Toye³

Affiliations

¹ Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
² Department of Physical Therapy, College of Applied Medical Science, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
³ Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
⁴ Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK.
⁵ Oxford Health NHS Foundation Trust, Oxford, UK.
⁶ Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK.

PMID: 35019783
DOI: 10.1080/09638288.2021.2025272

Abstract

Purpose: To explore the perspectives of children with CP, their parents or carers, and health professionals on factors affecting expectations and perceptions of surgical outcomes for lower limb orthopaedic surgery.

Materials and methods: Semi-structured interviews were conducted with 10 healthcare professionals, 10 children and young people with CP, and 8 parents. Interview data were analysed by content analysis supported by the Framework Approach using the International Classification of Functioning, Disability, and Health (ICF-CY).

Results: A comprehensive list of 10 factors including facilitators, barriers, motivational and demotivational factors were identified and categorized into two overreaching themes (Environmental and Personal factors): interdisciplinary collaboration, communication and information resources, holistic care, and shared goal setting are reported as environment facilitators of outcomes expectations. In contrast, reported barriers include lack of time and resources and divergent expectations. Personal motivators include family encouragement, patient's self-determination, and previous experiences, whereas personal demotivators include fear of a new environment.

Conclusion: The recognition of potential factors influencing expectations and perceptions of surgical outcomes could assist clinical reasoning when planning surgical interventions for ambulant children with CP. If these factors are integrated into the healthcare practice, it will most likely enhance the positive stakeholders' experiences postoperatively.IMPLICATION FOR REHABILITATIONUnderstanding relevant stakeholders' experiences offer a positive contribution to holistic and person-centred approaches in healthcare.People with cerebral palsy and their caregivers require adequate information on surgery and post-surgical rehabilitation regime in order to reach informed decisions.Previous experiences can influence surgical expectations and subsequent perceptions of the outcome.

Keywords: Cerebral palsy; children; factors; interview; surgery.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Cerebral Palsy* / rehabilitation
Cerebral Palsy* / surgery
Child
Humans
Motivation
Orthopedic Procedures*
Orthopedics*
Perception
Qualitative Research
Treatment Outcome