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Challenges in Toileting Evaluation and Interventions for Children With Cerebral Palsy: A Delphi Study
Azade Riyahi1, Afsoon Hassani Mehraban2, Mehdi Rassafiani3
1Azade Riyahi, PhD, is PhD Candidate, Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Insights
Health professionals face significant challenges in toileting support for children with cerebral palsy (CP). Enhanced training and resources are crucial for improving care and independence in children with CP.
Area of Science:
- Pediatric Rehabilitation
- Child Health
- Disability Studies
Background:
- Toileting difficulties significantly impact children with cerebral palsy (CP) and their daily lives.
- Research and professional training in addressing these challenges are currently inadequate.
- Understanding healthcare professionals' challenges is vital for improving interventions.
Purpose of the Study:
- To explore the challenges faced by healthcare professionals in the evaluation and intervention of toileting issues in children with CP (ages 6-18).
Main Methods:
- A mixed-methods study employing a two-phase exploratory sequential design.
- A global Delphi consensus technique was utilized, involving 162 professionals and 16 mothers of children with CP.
- Challenges were identified and refined iteratively through Delphi questionnaires, with consensus measured using Likert scales.
Main Results:
- Strong consensus (94.4%) highlighted the need for comprehensive training in pediatric toileting.
- Professionals reported concerns regarding limited research and training (88.9%) and inadequate assessment environments (96.9%).
- Diverse commitment levels among professionals regarding toileting issues were also noted.
Conclusions:
- Critical challenges in toileting management for children with CP were identified.
- There is an urgent need for holistic strategies, comprehensive education, and interdisciplinary collaboration.
- Improving care quality and independence for children with CP requires addressing these identified professional challenges.
Importance:
Toileting difficulties have a significant impact on the daily lives of children with cerebral palsy (CP), yet research on this issue remains inadequate. There is a critical need to better understand the challenges health care professionals face in addressing toileting difficulties.
Objective:
To explore challenges faced by health care professionals in toileting evaluation and interventions for children with CP ages 6-18 yr.
Design:
A mixed-methods study with a two-phase exploratory sequential design and using a global Delphi consensus technique.
Setting:
Email communication.
Participants:
Fifty-two national and international allied health professionals and 16 mothers of children with CP were involved in the preparation of the Delphi questionnaire. Additionally, 162 professionals participated in the Delphi study.
Outcomes And Measures:
Challenges were identified and refined iteratively through the Delphi questionnaire. Consensus was measured using a Likert scale, considering agreement percentages and median scores.
Results:
The study revealed strong consensus (94.4%), emphasizing the need for comprehensive training, particularly in working with pediatric populations. Concerns about limited research on and training in toileting function (88.9%) and challenges such as inadequate assessment environments and sanitation facilities (96.9%) underscore the need for practical and innovative educational methods to illustrate toileting procedures. Additionally, the findings highlight concerns about toileting issues and diverse commitment levels among professionals.
Conclusions And Relevance:
This study pinpointed critical challenges in toileting management for children with CP. These high-consensus findings stress the urgent need for holistic strategies, comprehensive education, and interdisciplinary collaboration to improve the quality of life and independence of these children. Plain-Language Summary: Toileting difficulties have a significant impact on the daily lives of children with cerebral palsy (CP), yet research on this issue remains inadequate. This study highlights significant gaps faced by health care professionals in understanding and addressing challenges in toileting evaluation and intervention for children with CP. Insights from professionals stress the critical need for global collaboration, standardized assessments, and improved education to effectively tackle CP-related toileting issues for children.
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