The paradox of normalization through rehabilitation: growing up and growing older with cerebral palsy
Notice bibliographique
Résumé
PURPOSE: To examine the experience of normalization through rehabilitation for persons growing up & growing older with lifelong physical impairment (cerebral palsy [CP]). METHOD: A qualitative methodology consisting of narrative inquiry informed by the Life Course Perspective. Multiple (3-4), in-depth interviews were completed with each participant in order to co-construct their life stories. Data were systematically compared for themes and categories, as well as the central plot that weaves the participants' experiences together. RESULTS: Nine community-dwelling individuals (three men; six women), aged 26-70, with mild to severe CP participated. Their common narrative involved intensive rehabilitation in childhood that focused on "normalizing" movement, particularly walking. In adolescence they were deemed to have achieved their functional potentials and "nothing further could be done". After transitioning out of pediatric health services many start to lose the gains they achieved in rehabilitation (particularly around walking). In their 30's and 40's they begin to slow down and lose functional abilities but no longer have access to rehabilitation to help them manage their aging bodies. CONCLUSIONS: Many of the assumptions that underlie the organization and delivery of rehabilitation services for people with long term impairments may contribute to difficulties encountered in adulthood and old age by focusing on normalizing physical function at the expense of learning to manage their bodies across the life course. IMPLICATIONS FOR REHABILITATION: • The way that rehabilitation services are organized and delivered for people with lifelong impairments needs to be re-considered. • Frontloading rehabilitation in childhood does not meet the long term needs of children growing up and growing older with physical impairments. As they grow up and grow older, they lose many of the gains they achieved in rehabilitation yet they have nowhere to turn to receive rehabilitation for their aging bodies. • The focus on normalizing function in childhood may only serve to emphasize the child’s lack of ablebodiedness to the detriment of their sense of self and wellbeing.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».