PDF(Pubmed)
Abstract：
BACKGROUND: Involving parents of children with cerebral palsy (C-CP) in home exercise programmes (HEP) is globally practiced strategy closely linked to improved physical performance and functional outcomes for the child. Nevertheless, non-adherence to HEP is increasing at an alarming rate, and little is known about the factors influencing adherence to HEP (AHEP) especially in parents of C-CP. This systematic review aimed to identify the factors enhancing AHEP among parents of C-CP to reinforce the efficacy of rehabilitation practices proposed by health professionals, researchers, and educators.
METHODS: We conducted searches in PubMed, Scopus, CINHAL, PsycINFO, and Embase for articles published up to March 2023, that investigated the factors influencing AHEP among parents of C-CP. A narrative synthesis was conducted using the search results and pertinent material from other sources.
RESULTS: Overall, non-adherence rates to HEP were moderate to high, ranging from 34% to 79.2%. Strong evidence suggests that factors enhancing AHEP fall into three categories: child-related (such as younger age and better gross motor function [GMF]), the caregiver-related (including high self-efficacy and knowledge, strong social support, low levels of depression, anxiety and stress symptoms, and a low perception of barriers), and the physiotherapist-related. For the latter category, the parent\'s perception of a supportive and collaborative relationship with the therapist is one of the conditions most favourably influences AHEP.
CONCLUSIONS: Our findings highlight that factors influencing AHEP are multifactorial. Some, such as GMF or the economic and social conditions of the family, are challenging to change. However, the relationship between therapist and parent is an aspect that can be strengthened. These results underscore the importance of substantial training and psychosocial support for therapists to enhance their awareness and competence in building supportive relationship with parents.
METHODS: We conducted searches in PubMed, Scopus, CINHAL, PsycINFO, and Embase for articles published up to March 2023, that investigated the factors influencing AHEP among parents of C-CP. A narrative synthesis was conducted using the search results and pertinent material from other sources.
RESULTS: Overall, non-adherence rates to HEP were moderate to high, ranging from 34% to 79.2%. Strong evidence suggests that factors enhancing AHEP fall into three categories: child-related (such as younger age and better gross motor function [GMF]), the caregiver-related (including high self-efficacy and knowledge, strong social support, low levels of depression, anxiety and stress symptoms, and a low perception of barriers), and the physiotherapist-related. For the latter category, the parent\'s perception of a supportive and collaborative relationship with the therapist is one of the conditions most favourably influences AHEP.
CONCLUSIONS: Our findings highlight that factors influencing AHEP are multifactorial. Some, such as GMF or the economic and social conditions of the family, are challenging to change. However, the relationship between therapist and parent is an aspect that can be strengthened. These results underscore the importance of substantial training and psychosocial support for therapists to enhance their awareness and competence in building supportive relationship with parents.
摘要：
背景：让脑瘫（C-CP）儿童的父母参与家庭锻炼计划（HEP）是全球实践的策略，与改善儿童的身体表现和功能结果密切相关。然而，不遵守HEP的人数正以惊人的速度增加，对于影响对HEP（AHEP）的依从性的因素知之甚少，尤其是在C-CP的父母中。本系统评价旨在确定增强C-CP父母AHEP的因素，以加强卫生专业人员提出的康复实践的功效。研究人员,和教育工作者。
方法：我们在PubMed中进行了搜索，Scopus,CINHAL,PsycINFO,和Embase发表了截至2023年3月的文章，调查了C-CP父母中影响AHEP的因素。使用搜索结果和其他来源的相关材料进行了叙事综合。
结果：总体而言，对HEP的不依从率是中等到高，从34%到79.2%不等。有力的证据表明，增强AHEP的因素分为三类：与儿童有关的（例如年龄较小和运动功能较好[GMF]）。照顾者相关(包括高自我效能感和知识，强大的社会支持,低水平的抑郁症，焦虑和压力症状，和对障碍的低感知)，和物理治疗师有关。对于后一类，父母对治疗师的支持和合作关系的看法是最有利的影响AHEP的条件之一。
结论：我们的发现强调了影响AHEP的因素是多因素的。一些，如GMF或家庭的经济和社会条件，改变是具有挑战性的。然而,治疗师和父母之间的关系是可以加强的一个方面。这些结果强调了对治疗师进行大量培训和社会心理支持的重要性，以增强他们与父母建立支持关系的意识和能力。
方法：我们在PubMed中进行了搜索，Scopus,CINHAL,PsycINFO,和Embase发表了截至2023年3月的文章，调查了C-CP父母中影响AHEP的因素。使用搜索结果和其他来源的相关材料进行了叙事综合。
结果：总体而言，对HEP的不依从率是中等到高，从34%到79.2%不等。有力的证据表明，增强AHEP的因素分为三类：与儿童有关的（例如年龄较小和运动功能较好[GMF]）。照顾者相关(包括高自我效能感和知识，强大的社会支持,低水平的抑郁症，焦虑和压力症状，和对障碍的低感知)，和物理治疗师有关。对于后一类，父母对治疗师的支持和合作关系的看法是最有利的影响AHEP的条件之一。
结论：我们的发现强调了影响AHEP的因素是多因素的。一些，如GMF或家庭的经济和社会条件，改变是具有挑战性的。然而,治疗师和父母之间的关系是可以加强的一个方面。这些结果强调了对治疗师进行大量培训和社会心理支持的重要性，以增强他们与父母建立支持关系的意识和能力。
