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Phys Occup Ther Pediatr. 2014 Jun 12. [Epub ahead of print]

Balancing Hope and Realism in Family-Centered Care: Physical Therapists' Dilemmas in Negotiating Walking Goals with Parents of Children with Cerebral Palsy.

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1Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.


The aims of this study were to explore physical therapists' beliefs about the value of walking for children with cerebral palsy (CP), how these beliefs inform therapy choices, and to describe how physical therapists engage families in decision-making regarding walking goals. Eight physical therapists who had experience working with children with CP each participated in a qualitative, one-to-one interview exploring their walking-related values, beliefs, and decision-making practices. The physical therapists' accounts demonstrated that they balanced their beliefs and professional expertise with families' goals in order to preserve families' hopes and maintain rapport, while also ensuring evidence-based and efficacious treatment plans were implemented. Participants experienced internal conflict when attempting to balance the principles of family-centered care with their personal beliefs and expertise. Further research will augment these findings and contribute to ongoing debates regarding rehabilitation best practices and family-centered care.


Cerebral palsy; children's rehabilitation; family-centered care; hope; physical therapists; walking

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