Relationship of Therapists’ Attitudes, Children’s Motor Ability, and Parenting Stress to Mothers’ Perceptions of Therapists’ Behaviors During Early Intervention-Article Summary
Title:
Relationship of Therapists’ Attitudes, Children’s Motor Ability, and Parenting Stress to Mothers’ Perceptions of Therapists’ Behaviors During Early Intervention
Journal:
Physical Therapy & Rehabilitation Journal
Authors:
Margaret E O’Neil, Robert J Palisano, Sarah L Westcott
Purpose:
The Purpose of this article was to assess the effectiveness of the expanding role of Physical Therapists into Family-Centered Care. Considering the psychosocial and interpersonal aspects associated with this shift, there was a desire to make sure that the families, as well as the therapists are comfortable with this shift in health care.
Population:
Pediatric Physical Therapists, Families and Children receiving Early Intervention Physical Therapy as mandated in Federal Law IDEA Part C.
Methods:
25 Pediatric Physical Therapists worked with 75 Mother/Child dyads that qualified for Early Intervention PT as a part of IDEA Part C. The mean age for the children was 21.2 months old. The mothers participated in an interview which consisted of the Measures of Processes of Care (MPOC-56) and the short form Parenting Stress Index (PSI-SF), as well as a satisfaction questionnaire about the quality of care provided. The children were tested using the Bayley-II Motor Scale. The Physical Therapists completed the Measures of Processes of Care for Service Providers (MPOC-SP), as well as a descriptive questionnaire asking about the Therapist’s level of education, and experience with Early Intervention healthcare.
Tests and Measures:
The perceptions of the mothers were measured using the MPOC-56 is a 56-item questionnaire. Each question is graded on a 0-8 scale (higher score indicating increased frequency). The MPOC-56 is graded across 5 domains. This study only focused on 3 (“Respectful and Supportive Care”) (“Providing Specific Information”) and (“Enabling and Partnership”).
The short from of the Parenting Stress Index was also administered to the mothers. The PSI-SF contains 36 questions that are rated on a 5-point scale (higher score indicating higher stress). The domains this OCM focuses on include: (“Parent-Child Dysfunctional Interaction”) (“Difficult Child”) (“Parental Distress”)
The motor abilities for the children were assessed using the Bayley-II Motor Scale. This scale is based on typical motor development, graded on a binary scale (Credit/NC). The raw scores obtained were then calculated based on the child’s developmental age.
The perceptions of the Physical Therapists were measured using a similar questionnaire, the MPOC-SP. The grading scale for this questionnaire is the same as that of the MPOC-56, but the domains are different. The research focused on the same 3 domains that corresponded to that of the mothers.
Descriptive Questionnaires were administered to the Physical Therapists and the mothers. The questionnaire for the Physical Therapists covered 3 domains: (“Education background and preparation to work in Early Intervention”) (“General Background and practice as PT in Early Intervention”) (The influence of changes in healthcare on your physical therapy practice”)
Intervention:
Once the mother/child dyad consented to participating in the study, a 90 min home visit was scheduled. To limit the inter-rater bias of the parents, the MPOC-56 was administered first, followed by the PSI-SF. After the interview with the parent, the PT administered the Bayley-II Motor Scale to the child.
The Physical Therapists were sent 2 survey packets in the mail. The packets contained the descriptive questionnaire as well as the MPOC-SP. The therapists were given instructions to complete the MPOC-SP first, to reduce their bias as well. The therapists were encouraged to return the surveys within a 2-week time frame.
Results:
The results from the PSI-SF showed an inverse relationship to the MPOC-56 domains relating to “Enabling and Partnership” and “Providing Specific Information”. There was also an inverse association of the PSI-SF with the Bayley-II scores. The only domain that showed correlation for the MPOC-56 and MPOC-SP was the domain “Respectful and Supportive Care”. The mother’s perception of the PT family-centered care showed correlation to the Therapists’ attitudes toward Family-Centered care as well.
Strengths & Limitations:
A potential area of growth for this study could potentially be found by using all 5 domains of the MPOC forms, as well as the full form Parenting Stress Index. The potential information might be insightful. The sample size for this study, and the relative proximity of geographic location for the participants might play into the cultural perceptions. Maybe doing a telehealth option or expanding further might offer broader representation across cultural differences. A strength for this study was the deliberate methodical administration to reduce any potential for bias. Given the smaller sample size, there is great demographic diversity among the group of therapists and mother/child dyads.
Overall Conclusion:
The conclusion from this article was that majority of parents and therapists were satisfied with their experience of Family-Centered Physical Therapy. Parents reported increased stress when their child had a lower motor ability. The majority of Pediatric Physical Therapists reported satisfaction with Family-Centered Care. Therapists also indicated that family centered care were not always individualized to the needs of the family and children Therapists and Parents agree that administrative issues are barriers to the best patient care.
Article Citation:
O’Neil ME, Palisano RJ, Westcott SL. Relationship of Therapists’ Attitudes, Children’s Motor Ability, and Parenting Stress to Mothers’ Perceptions of Therapists’ Behaviors During Early Intervention. Physical Therapy. 2001;81(8):1412-1424. doi:10.1093/ptj/81.8.1412
2 responses to “Relationship of Therapists’ Attitudes, Children’s Motor Ability, and Parenting Stress to Mothers’ Perceptions of Therapists’ Behaviors During Early Intervention-Article Summary”
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I think you did a great job summarizing this article. I think family-centered care is important, especially working with the pediatric population. I find it interesting that the care was not always individualized to the needs of the family and the the child and wonder if the article mentioned any approaches to better individualize the care to to better address the needs of the family and child.
Your point about looking into the impact of Telehealth therapy in this population is interesting. It seems as though administrative issues would continue to be a barrier if this study were repeated using Telehealth, but I would be curious if the attitudes of the parents would change. As clinicians, we strive to deliver a family-centered care approach, and it is wonderful to see that a small patient population feels as though we have succeeded. I think there are a variety of directions for studies related to this one to progress to, especially the influence of Telehealth, and a heavier focus on Parent stress.