Home-based therapy and its determinants for children with cerebral palsy, exploration of parents' and physiotherapists' perspective, a qualitative study, Ethiopia.

Abstract

This study aimed to explore the perceptions of parents and physiotherapists regarding home-based therapy programs for children with cerebral palsy and to understand the factors affecting adherence to home-based therapy programs. Thematic analysis method was used to identify, analyse and report findings. Twelve physiotherapists and five caregivers were purposively sampled and interviewed. All transcripts were coded line by line, and the codes were then organized into categories for the development of descriptive themes and the generation of analytical themes. The data analysis followed the steps of the thematic analysis process. Seven themes emerged during the analysis: Why Home-Based Therapy? Ways of Teaching, Types of the therapy, Strategies of assessing adherence, Environmental factors, Attitude and knowledge; and Family participation. Physiotherapists use home-based therapy to prevent complications and improve functioning. They use various ways of teaching, such as explaining, demonstrating, and using pictures and videos. Physiotherapists consider several factors such as severity, age, and availability of resources before they decide the type of home therapy programs. However, parent's participation was low; and strategies to monitor and evaluate adherence were also low. Low family support, limited recourse, lack of knowledge and poor attitude negatively affected adherence to home-based therapy. Our finding revealed that physiotherapists use quite limited methods of teaching, and do not properly monitor adherence of the home-based therapy. Additionally, family participation to select type of therapy and to set goal were low.