Intervenção colaborativa família-profissional na reabilitação pediátrica via telessaúde: percepção das famílias
Bibliographic record
Abstract
Introduction: The offer of services via telehealth makes it possible to know the child's natural environment and allows the physiotherapist to identify factors in the family context that can be modified to increase the performance in activities and the participation of the child. Collaborative models, which integrate the principles of family-centered practice, have been studied in the face-to-face rehabilitation of children with disabilities. However, there are no studies on the feasibility of a collaborative family-professional intervention offered via telehealth. Objectives: The primary objectives of this study were to verify the adherence rate, daily commitment time, and parents' perception regarding the feasibility and centrality in the family of a collaborative family-professional physical therapy intervention via telehealth for children with disabilities. The secondary objectives were to verify the achievement of goals and changes in the performance of the participating children, and their satisfaction with their performance based on the family's perception. Methods: This is a mixed methods feasibility study, with 15 families responsible for 17 children with disabilities who participated in a collaborative family-professional intervention, in four stages, for eight weeks. In Step 1, an interview was conducted with the adaptation of the Canadian Occupational Performance Measure (COPM) and, the Pediatric Assessment of Disability Inventory – Adaptive Computerized Testing (PEDI-CAT) was applied. Step 2 consisted of shared planning of the intervention, with the elaboration of the Goal Attainment Scaling (GAS) and the matrix of activities and family routine. In Step 3, the family-professional collaborative intervention was implemented, considering the principles of goal-oriented training. In Step 4, the entire process was evaluated, with reapplication of the COPM, PEDI-CAT and GAS. In the end, families were invited to respond to the Measure of Processes of Care - 20 (MPOC) and participated in a semi-structured interview. In-depth interviews were analyzed using thematic analysis. To compare the pre-and post-intervention scores, the paired t-test was performed, and the effect size (d) was calculated. Results: The study included 15 families, responsible for 17 children, with a mean age of 22.41 (±25.37) months, 12 of which were boys (70.6%). The adherence rate to the telehealth sessions ranged from 66.7% to 100%, and the average daily commitment time reported by the family to carry out the proposed activities was 1.32 hours (±0.58). The main facilitators, barriers, and benefits of participating in this intervention modality were explored by parents who perceived the service as “to a fair extent” family-centered, according to the MPOC-20. Through the thematic analysis method, four sub-themes for “facilitators”, three sub-themes for “barriers” and four sub-themes for “benefits” emerged from the qualitative data. More than half (58.92%) of the established goals were achieved and there was a statistically significant increase in performance (p<0.0001) and satisfaction with performance in the COPM (p=0.001), with a large effect size. A significant improvement was verified for the performance of daily activities (p=0.02) and for the mobility performance (p=0.001) in the PEDI-CAT, with a small effect size. Conclusion: The family-professional physiotherapeutic intervention via telehealth was considered feasible to be used with children with disabilities. Participating families showed satisfaction and involvement with the intervention process, with a high rate of adherence and daily commitment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".