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Is waiting for rehabilitation services associated with changes in function and quality of life in children with
Debbie Ehrmann Feldman1, Bonnie Swaine, Julie Gosselin
1Faculté de médecine, Ecole de réadaptation, Université de Montréal C.P. 6128, Succ. Centre-ville Montréal, Quebec H3C 3J7, Canada. Debbie.feldman@umontreal.ca
Insights
Longer waits for pediatric rehabilitation led to a decline in children's psychosocial quality of life, though cognitive function improved. Reducing wait times is crucial for addressing these psychosocial issues.
Area of Science:
- Pediatric Rehabilitation
- Child Development
- Quality of Life Research
Background:
- Pediatric rehabilitation is vital for children with physical disabilities.
- Long waiting times for these services are common.
- The impact of waiting on functional status and quality of life requires investigation.
Purpose of the Study:
- To assess the association between extended waiting periods for pediatric rehabilitation and changes in child functional status.
- To determine if longer rehabilitation wait times affect a child's quality of life.
Main Methods:
- Interviews with parents of 124 children with physical disabilities (e.g., cerebral palsy) every three months from referral to admission.
- Utilized the WeeFIM (Functional Independence Measure for Children) for functional assessment and PedsQL for quality of life.
- Collected socio-demographic, parental empowerment, and clinical data.
Main Results:
- Half of the children waited over 9.1 months for public rehabilitation.
- While cognitive scores improved, mobility scores did not change significantly during the wait.
- A significant decline in the PedsQL psychosocial summary score was observed.
Conclusions:
- Extended waiting times for pediatric rehabilitation are linked to a worsening psychosocial quality of life in children.
- Shorter wait times could enable earlier intervention for psychosocial challenges in pediatric rehabilitation.
- Addressing psychosocial well-being is a critical component of effective pediatric rehabilitation.
Objectives:
To determine whether longer waiting times for rehabilitation were associated with deterioration in child functional status and/or quality of life.
Methods:
Parents of 124 children (mean age 45 months) with physical disabilities (e.g., cerebral palsy, global developmental delay, spina bifida) who were referred to pediatric rehabilitation centers were interviewed every three months, from referral until admission into the rehabilitation program. Information from parental interviews included socio-demographics, parental empowerment (Family Empowerment Scale), function (WeeFIM: Functional Independence Measure for Children), and quality of life (PedsQL). Data on date of referral, age, gender, and diagnosis were obtained from hospital databases.
Results:
Half of the sample waited more than 9.1 months (95% confidence interval: 6.5-16.1) for admission to a public rehabilitation program. A total of 42% paid for some private services while waiting. Over the waiting period, there was statistically significant improvement in WeeFIM cognition and total scores but not in mobility scores. PedsQL psychosocial summary score declined over the waiting period (p< .05).
Conclusion:
Longer wait times for rehabilitation were associated with declining psychosocial quality of life. Reducing waiting times for rehabilitation services may allow rehabilitation specialists to address psychosocial problems for these children.
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