Abstract
Despite a growing body of evidence favouring a family-centred approach to rehabilitation services for children with cerebral palsy (cp), the essential components for a quality service for children with disabilities and their families living in poorly-resourced South African (SA) settings remains unknown. The study aimed to identify key components of an appropriate rehabilitation service which would meet the needs of children with CP and their caregivers at SA public sector hospitals. This cross-sectional descriptive study used the modified Measure of processes of care (Mpoc-20) questionnaire together with two open-endedquestions with a convenience sample of caregivers attending therapy at CP Clinics in gauteng and limpopo hospitals. A total of 263 caregivers attending cerebral palsy clinics at 31 public sector hospitals in gauteng and limpopo were interviewed. Kind and caring attitudes, exercises or “training” for the child, and practical assistance (handling ideas and suggestions, assistive devices, food supplements, nappies, advice) were components of care most valued. The most frustration was caused by long queues waiting for files or at the pharmacy and being treated disrespectfully whilst providing caregivers with information and explanations regarding treatment choice were services that could be improved. Key components for an appropriate therapy service include caring and respectful attitudes, hands-on therapy, handling suggestions and practical assistance. Logistical and administrative procedures together with disrespectul and unhelpful attitudes negatively impact rehabilitation service delivery.
Highlights
Cerebral palsy (CP) is the single biggest cause of childhood disability worldwide (Stanley et al 2000, Hagberg et al 1996)
Details about specific behaviours of providers can be used to target areas where improvement is warranted and can inform service providers on how best to meet parents’ needs (King et al 2004). This process has been fol lowed in a number of countries and settings (Dyke et al 2006; Hartley et al 2005; King et al 2004; Goldbart and Mukherjee 2001; Brodin and Molosiwa 2000; Milner 1996), the views, expe riences and perceptions of caregivers of children with CP attending therapy at public sector hospitals in South African have not been described
This makes it difficult for South African service providers in public hospitals to know whether the intervention services they are offering to children with CP and their caregivers are relevant and appro priate and whether they meet the needs of the caregivers and their families
Summary
Cerebral palsy (CP) is the single biggest cause of childhood disability worldwide (Stanley et al 2000, Hagberg et al 1996). Details about specific behaviours of providers can be used to target areas where improvement is warranted and can inform service providers on how best to meet parents’ needs (King et al 2004) This process has been fol lowed in a number of countries and settings (Dyke et al 2006; Hartley et al 2005; King et al 2004; Goldbart and Mukherjee 2001; Brodin and Molosiwa 2000; Milner 1996), the views, expe riences and perceptions of caregivers of children with CP attending therapy at public sector hospitals in South African have not been described. This makes it difficult for South African service providers in public hospitals to know whether the intervention services they are offering to children with CP and their caregivers are relevant and appro priate and whether they meet the needs of the caregivers and their families
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