Caregiver

护理人员
  • 文章类型: Journal Article
    对于自闭症青年及其家庭来说,向成年过渡是最具挑战性和最复杂的过程之一。很少有基于证据的过渡支持计划存在,那些获得支持的人需要长期承诺和资源,可能会禁止有经济和时间限制的家庭参与。当前的研究调查了一个简短的可行性和初步承诺,以照顾者为中心的自闭症青年家庭教育过渡计划在一天内在社区提供。
    在参与计划之前和之后,从12名自闭症青年的照顾者那里收集了定量信息报告和定性访谈数据。使用部分混合顺序等状态设计,整合了定量和定性数据,以评估护理人员过渡知识和赋权的变化,以及护理人员对计划可行性的看法,可接受性,和有用性。
    看护者报告说,他们对过渡相关主题的了解和对家庭生活的赋权感显著增加。照顾者对干预的看法表明他们发现这是可行的,可接受,和有用的。
    对于寻求自闭症青年过渡支持的护理人员来说,短期过渡计划可能是一个有用的选择。
    对于自闭症青少年及其照顾者来说,向成年过渡是一个充满压力和复杂的过程。许多护理人员缺乏时间,财政资源,并获得全面的过渡支持。简短的教育支持是帮助护理人员规划和协助青少年高等教育/教育的潜在替代方案,employment,社会,和生活安排。为您的亲人的未来规划(PLOF)干预在改善护理人员关于过渡和赋权感的知识方面显示出希望,被描述为可行的,可访问,并对参与试点研究的人有所帮助。
    UNASSIGNED: The transition to adulthood is one of the most challenging and complex processes for autistic youth and their families. Few evidence-based transition support programs exist, and those that have garnered support require long-term commitments and resources that may prohibit participation by families with financial and time limitations. The current study investigated the feasibility and initial promise of a brief, caregiver-focused educational transition program for families of autistic youth delivered in the community over a single day.
    UNASSIGNED: Quantitative informant-report and qualitative interview data were collected from 12 caregivers of autistic youth before and after program participation. Using a partially mixed sequential equal status design, quantitative and qualitative data were integrated to evaluate change in caregiver transition knowledge and empowerment, as well as caregivers\' perceptions of program feasibility, acceptability, and usefulness.
    UNASSIGNED: Caregivers reported significant increases in knowledge of transition-related topics and sense of empowerment regarding their family life. Caregiver perceptions of the intervention suggest they found it feasible, acceptable, and useful.
    UNASSIGNED: Short-term transition programming may be a helpful option for caregivers who seek transition supports for autistic youth.
    The transition to adulthood is a stressful and complex process for autistic adolescents and their caregivers.Many caregivers lack time, financial resources, and access to comprehensive transition supports.Brief educational support is a potential alternative for aiding caregivers in planning for and assisting with adolescents’ postsecondary training/education, employment, social, and living arrangements.The Planning for your Loved Ones Future (PLOF) intervention showed promise in improving caregiver knowledge about transition and sense of empowerment, and was described as feasible, accessible, and helpful by those who participated in a pilot study.
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  • 文章类型: Randomized Controlled Trial
    招募家庭照顾者的挑战存在,并且在混乱的医疗保健环境中必须征得同意时,这种挑战会加剧。比如从医院到家庭的过渡。在我们的随机对照试验期间,COVID-19大流行的发作为探索和检查招募护理人员的不同同意程序提供了一个自然实验的机会。本出版物的目的是描述不同的招聘过程(当面与虚拟),并在接受护理者住院的情况下比较招聘率的多样性。我们发现,当面与虚拟家庭护理人员的招聘率分别为28%和23%,分别(p=0.01)。不同群体之间存在差异,招募的家庭护理人员实际上更有可能更年轻,白色,有比高中更高的教育,并且不是被照顾者的配偶或重要的其他人,比如一个孩子。仍然需要今后的工作来确定家庭护理人员招聘的方式和时间,以最大限度地提高费率并提高人口的代表性,以实现公平影响。
    Challenges to recruitment of family caregivers exist and are amplified when consent must occur in the context of chaotic healthcare circumstances, such as the transition from hospital to home. The onset of the COVID-19 pandemic during our randomized controlled trial provided an opportunity for a natural experiment exploring and examining different consent processes for caregiver recruitment. The purpose of this publication is to describe different recruitment processes (in-person versus virtual) and compare diversity in recruitment rates in the context of a care recipient\'s hospitalization. We found rates of family caregiver recruitment for in-person versus virtual were 28% and 23%, respectively (p = 0.01). Differences existed across groups with family caregivers recruited virtually being more likely to be younger, white, have greater than high school education, and not be a spouse or significant other to the care recipient, such as a child. Future work is still needed to identify the modality and timing of family caregiver recruitment to maximize rates and enhance the representativeness of the population for equitable impact.
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  • 文章类型: Journal Article
    背景:COVID-19大流行给个人和家庭带来了额外的心理健康负担,导致广泛的服务访问问题。数字心理健康干预措施有望改善可访问性。最近的评论显示了个人使用的新证据和多用户的早期证据。然而,数字心理健康干预措施的流失率仍然很高,和额外的复杂性存在时,多个家庭成员在一起。
    目标:因此,本范围审查旨在详细介绍为家庭使用设计的数字心理健康干预措施的报告证据,重点是促进可访问性和参与度并使家庭共同完成的构建和设计特征。
    方法:MEDLINE系统文献检索,Embase,PsycINFO,WebofScience,对2002年1月至2024年3月以英语发表的文章进行了和CINAHL数据库。合格的记录包括对数字平台的实证研究,其中包含一些旨在由相关人员共同完成的元素,以及一些旨在在没有治疗师参与的情况下完成的组件。已记录临床证据的病例包括平台。
    结果:在所审查的9527篇论文中,85(0.89%)符合资格标准。总共确定了24个供相关方共同使用的独特平台。参与者之间的关系包括夫妻,父子二元组合,家庭照顾者护理接受者,和家庭。常见的平台功能包括通过结构化干预来交付内容,而无需提供最少的剪裁或个性化。一些干预措施提供了与治疗师的现场接触。用户参与度指标和调查结果各不相同,包括用户体验,满意,完成率,和可行性。我们的发现对于文献中没有的比现在的更显著。与预期相反,很少有研究报告任何设计和建造特征,使联排。没有研究报告关于实现共同完成的平台功能或确保个人隐私和安全的考虑因素。没有人检查平台构建或设计特征作为干预效果的调节者,没有人对平台本身进行形成性评估。
    结论:在数字心理健康平台设计的早期时代,这项新颖的评论表明,与多个相关用户在治疗过程的任何方面的成功参与相关的设计元素的信息明显缺失。在详细介绍和评估平台设计的文献中仍然存在很大差距,突出未来跨学科研究的重要机会。这篇综述详细介绍了开展此类研究的动机;提出了构建供家庭使用的数字心理健康平台时的设计考虑因素;并为未来的发展提供了建议,包括平台协同设计和形成性评价。
    BACKGROUND: The COVID-19 pandemic placed an additional mental health burden on individuals and families, resulting in widespread service access problems. Digital mental health interventions suggest promise for improved accessibility. Recent reviews have shown emerging evidence for individual use and early evidence for multiusers. However, attrition rates remain high for digital mental health interventions, and additional complexities exist when engaging multiple family members together.
    OBJECTIVE: As such, this scoping review aims to detail the reported evidence for digital mental health interventions designed for family use with a focus on the build and design characteristics that promote accessibility and engagement and enable cocompletion by families.
    METHODS: A systematic literature search of MEDLINE, Embase, PsycINFO, Web of Science, and CINAHL databases was conducted for articles published in the English language from January 2002 to March 2024. Eligible records included empirical studies of digital platforms containing some elements designed for cocompletion by related people as well as some components intended to be completed without therapist engagement. Platforms were included in cases in which clinical evidence had been documented.
    RESULTS: Of the 9527 papers reviewed, 85 (0.89%) met the eligibility criteria. A total of 24 unique platforms designed for co-use by related parties were identified. Relationships between participants included couples, parent-child dyads, family caregiver-care recipient dyads, and families. Common platform features included the delivery of content via structured interventions with no to minimal tailoring or personalization offered. Some interventions provided live contact with therapists. User engagement indicators and findings varied and included user experience, satisfaction, completion rates, and feasibility. Our findings are more remarkable for what was absent in the literature than what was present. Contrary to expectations, few studies reported any design and build characteristics that enabled coparticipation. No studies reported on platform features for enabling cocompletion or considerations for ensuring individual privacy and safety. None examined platform build or design characteristics as moderators of intervention effect, and none offered a formative evaluation of the platform itself.
    CONCLUSIONS: In this early era of digital mental health platform design, this novel review demonstrates a striking absence of information about design elements associated with the successful engagement of multiple related users in any aspect of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design, highlighting a significant opportunity for future cross-disciplinary research. This review details the incentive for undertaking such research; suggests design considerations when building digital mental health platforms for use by families; and offers recommendations for future development, including platform co-design and formative evaluation.
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  • 文章类型: Journal Article
    背景:中风对患者及其家人都有负面影响,发病后必须面对多种变化。家庭照顾者必须面对新的问题,可能会有不足的感觉,压力和负担。我们的回顾性研究旨在评估中风患者康复过程中护理人员的负担。
    方法:这项研究纳入了诊断为中风的患者及其照顾者,曾在IRCCSNeurolesi中心的Day医院“Bonino-Pulejo”Messina,意大利,在2018年1月至2019年10月之间,使用电子恢复系统数据。最终样本由30名患者及其护理人员组成。
    结果:患者的认知和情绪评分显著改善,反映康复疗法的功效。此外,患者报告的焦虑水平和护理人员报告的抑郁水平之间出现了相关性,强调两组情绪状态之间的动态互动。
    结论:该研究强调了照顾者特征之间复杂的相互作用,患者结果,和护理背景下的家庭动态。旨在改善家庭复原力和应对机制的针对性干预措施对于优化护理人员和患者的福祉至关重要。
    BACKGROUND: Stroke negatively impacts both patients and their families, who must face multiple changes after the onset of the disease. Family caregivers must face new problems with a possible sense of inadequacy, stress and burden. Our retrospective study aimed to assess the burden of caregivers during the rehabilitation process of patients with Stroke.
    METHODS: This study included patients with a diagnosis of stroke and their caregiver, who attended the Day Hospital of the IRCCS Neurolesi Center \"Bonino-Pulejo\", Messina, Italy, between January 2018 and October 2019, using electronic recovery system data. The final sample consisted of 30 patients and their caregivers.
    RESULTS: Significant improvements were observed in patients\' cognitive and mood scores, reflecting the efficacy of rehabilitation therapies. Additionally, a correlation emerged between patients\' reported anxiety levels and caregivers\' reported depression levels, highlighting a dynamic interaction between the emotional states of the two groups.
    CONCLUSIONS: The study highlights the intricate interplay between caregiver characteristics, patient outcomes, and family dynamics in the context of caregiving. Targeted interventions aimed at improving family resilience and coping mechanisms are crucial to optimizing the well-being of both caregivers and patients.
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  • 文章类型: Journal Article
    目的:本研究的目的是确定家庭护理人员对压力性损伤(PI)预防的知识水平。
    方法:本研究采用横断面和描述性设计。数据是在2023年2月至5月之间收集的。该研究的人群包括家庭护理人员,这些家庭护理人员为有发生压力伤害风险的患者提供护理,并计划从医院住院病房出院。共有105名家庭照顾者参与了这项研究。
    结果:在所有患者中,61.9%(n=65)为女性,平均年龄为68.96岁(SD=18.07)。而30.48%(n=32)的患者因脑血管意外而卧床不起,28.57%(n=30)因年老而卧床不起,28.57%(n=30)患有PI。在所有的看护人中,71.43%(n=75)为女性,平均年龄为47.11岁(SD=14.85)。虽然97.14%(n=96)的护理人员之前没有接受过任何PI培训,90.48%(n=95)以前没有为PI患者提供护理。在压力性损伤预防知识测试(PIPKT)中,家庭护理人员平均得分为22.25分(SD=6.96),分为40分。知识测验成绩与文化程度和收入水平之间存在显着差异(P=0.006;P=0.002)。
    结论:发现家庭护理人员需要有关PI预防的信息。建议在家庭护理人员指南中制定有关PI预防的内容。
    OBJECTIVE: The purpose of this study is to determine family caregivers\' level of knowledge on pressure injury (PI) prevention.
    METHODS: This study used a cross-sectional and descriptive design. Data were collected between February and May 2023. The population of the study consisted of family caregivers providing care to patients who were at risk of developing pressure injuries and who were planned to be discharged from the inpatient wards of the hospital. A total of 105 family caregivers participated in the study.
    RESULTS: Of all the patients, 61.9 % (n = 65) were female and their average age was 68.96 years (SD = 18.07). While 30.48 % (n = 32) of the patients were bedridden due to Cerebrovascular Accident, 28.57 % (n = 30) were bedridden due to old age, and 28.57 % (n = 30) had PI. Of all the caregivers, 71.43 % (n = 75) were female, and their average age was 47.11 years (SD = 14.85). While 97.14 % (n = 96) of the caregivers had not received any training on PI before, 90.48 % (n = 95) had not provided care to a patient with PI before. Family caregivers scored an average of 22.25 (SD = 6.96) points out of 40 on the Pressure Injury Prevention Knowledge Test (PIPKT). A significant difference was detected between the knowledge test scores and education level and income level (P = 0.006; P = 0.002).
    CONCLUSIONS: Family caregivers were found to need information about PI prevention. It is recommended to develop content on PI prevention in the guidelines for family caregivers.
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  • 文章类型: Journal Article
    背景:家庭照顾者(FC)在患有慢性病的老年人中遇到各种健康问题,需要一定水平的健康知识才能获得,理解,评估和应用卫生信息和服务。这项研究旨在开发和验证用于测量患有慢性病的老年人FC中的健康素养的量表。
    方法:首先采用概念图来开发FC健康素养的概念模型。比例域来自概念模型,使用演绎和归纳法进行项目生成。定量方法,包括合并比例维度和项目,专家评审,认知访谈,和项目减少分析,被用来细化尺度。采用验证性因素分析验证量表的结构。并发有效性,内部一致性,还检查了测试-重测可靠性。
    结果:开发了一个20维概念模型,并为该量表生成了60个项目。专家审查(内容效度指数>0.85)和对FCs的认知访谈证实了大多数生成量表项目的相关性和清晰度。对451例慢性病老年人FC的验证性因子分析支持5因素结构(症状管理,日常个人护理和家务,护理协调,与受护理者的沟通和关系,和护理人员的自我护理)有42个最终量表项目,包括四个级别的健康素养技能(访问,理解,评估和应用健康信息)。与欧洲健康素养问卷(HLS-EU-Q47)的并发有效性令人满意(r=0.67,p<0.01)。量表的Cronbach'sα系数为0.96,子量表范围为0.84至0.91。两周重测信度为0.77(p<0.01)。
    结论:这项研究开发了一个概念模型,解释了患有慢性病的老年人FC中健康素养的概念和因素,这可以为未来研究开发相关的循证干预措施奠定基础。在这项研究中,开发了一种具有令人满意的心理测量特性的新的健康素养量表-家庭照顾者(HLS-FC),可用于识别健康素养不足的护理人员,并促进医疗保健专业人员的及时干预。
    BACKGROUND: Family caregivers (FCs) encounter a variety of health problems in older people with chronic illness, necessitating a certain level of health literacy to access, understand, appraise and apply health information and services. This study aimed to develop and validate a scale for measuring health literacy among FCs of older people with chronic illness.
    METHODS: Concept mapping was first employed to develop a conceptual model of health literacy of FCs. Scale domains were derived from the conceptual model, and item generation was performed using deductive and inductive methods. Quantitative methods, including merging scale dimensions and items, expert reviews, cognitive interviews, and item reduction analysis, were used to refine the scale. Confirmatory factor analysis was employed to validate the scale\'s structure. Concurrent validity, internal consistency, and test-retest reliability were also examined.
    RESULTS: A 20-dimension conceptual model was developed, and 60 items were generated for the scale. Expert review (content validity index > 0.85) and cognitive interview with FCs confirmed the relevance and clarity of the majority of the generated scale items. Confirmatory factor analysis with 451 FCs of older people with chronic illness supported a 5-factor structure (symptom management, daily personal care and household tasks, care coordination, communication and relationship with the care recipient, and self-care of caregivers) with 42 finalized scale items, including four levels of health literacy skills (accessing, understanding, appraising and applying health information). Concurrent validity with the European Health Literacy Questionnaire (HLS-EU-Q47) was satisfactory (r = 0.67, p < 0.01). The Cronbach\'s α coefficient of the scale was 0.96, with subscales ranging from 0.84 to 0.91. The two-week test-retest reliability was 0.77 (p < 0.01).
    CONCLUSIONS: This study developed a conceptual model explaining the concept and factors of health literacy among FCs of older people with chronic illness that could provide the groundwork for future studies in developing relevant evidence-based interventions. A new Health Literacy Scale-Family Caregiver (HLS-FC) with satisfactory psychometric properties was developed in this study, which can be utilized to identify caregivers with insufficient health literacy and facilitate timely interventions by healthcare professionals.
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  • 文章类型: Journal Article
    实现有效的社区融合对于最大程度地恢复创伤性脑损伤患者非常重要,同时限制照顾者负担并提高对生活质量的满意度。脑损伤后常见的某些医疗并发症可能会影响社区重返社会,并且应该由医生以系统的方法解决。此外,某些社会和环境因素,如流动性或返回工作或学校可能出现,并且应该由医生主动解决。具有病例管理和多学科团队的住院/住院或门诊计划可以促进患者重返社区,并应在可用时予以考虑。
    Achieving effective community reintegration is important to maximize recovery in patients with traumatic brain injury, simultaneously limiting caregiver burden and improving satisfaction with quality of life. Certain medical complications that are common after brain injury may impact community reintegration, and should be addressed by the physician in a systematic approach. Additionally certain social and environmental factors such as mobility or return to work or school may arise, and should be addressed proactively by the physician. Inpatient/residential or outpatient programs with case management and a multi-disciplinary team can facilitate community reentry for patients, and should be considered when available.
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  • 文章类型: English Abstract
    拒绝护理是老年医学中经常发生的事情,尤其是在患有神经认知疾病的人群中,特别是在高级阶段。这些拒绝护理是每天的负担,不仅仅是为了病人自己,还有他们的照顾者和照顾者。虽然可以预防,没有一个人,克服这些问题的简单策略对专业人士和护理人员来说都是一个真正的挑战。他们的管理要求一种基本上非药理学的方法,总是跨学科的,人文和道德基础。
    Refusal of care is a frequent occurrence in geriatric medicine, especially among people with neurocognitive diseases, particularly in the advanced stages. These refusals of care are a daily burden, not only for the patients themselves, but also for their carers and caregivers. Although they can be prevented, the absence of a single, simple strategy for overcoming them is a real challenge for professionals and carers alike. Their management calls for an approach that is essentially non-pharmacological, always interdisciplinary, humanistic and ethically grounded.
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  • 文章类型: Journal Article
    疫苗接种有助于降低患有主要神经认知障碍(MND)的老年人2019年冠状病毒病(COVID-19)感染的风险。然而,一些护理人员不愿让他们的老年家庭成员接种COVID-19疫苗。这项研究探讨了影响护理人员为老年家庭成员接种抗COVID-19MND疫苗的意愿的因素。共有232名患有MND的老年家庭成员的护理人员参加了这项研究。在这次调查中,有关COVID-19疫苗接种接受的数据,恐惧,副作用,家庭成员对疫苗接种的态度,心理健康状况,神经精神症状,并从患有MND的老年参与者中收集认知障碍。使用多变量线性回归分析模型检查了这些变量与护理人员为其老年家庭成员接种针对COVID-19的MND疫苗的意图之间的关联。结果显示,护理人员对疫苗接种的家庭支持,疫苗接种的感知价值,为老年家庭成员接种疫苗的自主权与护理人员为老年家庭成员接种MND的意愿呈正相关,而老年家庭成员的年龄与照顾者意愿呈负相关。这项研究表明,照顾者因素(感知的家庭支持,疫苗接种的价值,和自主性)和老年家庭成员的年龄与照顾者意愿相关。在制定干预措施时,应考虑这些因素,以增强护理人员为其老年家庭成员接种抗COVID-19MND疫苗的意图。
    Vaccination helps reduce the risk of coronavirus disease 2019 (COVID-19) infection in elderly individuals with major neurocognitive disorders (MNDs). However, some caregivers are hesitant to have their elderly family members with MNDs vaccinated against COVID-19. This study explored the factors influencing caregivers\' intentions to vaccinate elderly family members with MNDs against COVID-19. A total of 232 caregivers of elderly family members with MNDs participated in this study. In this survey, data regarding COVID-19 vaccination acceptance, fear, side effects, family members\' attitudes toward vaccination, mental health status, neuropsychiatric symptoms, and cognitive impairments were collected from the elderly participants with MNDs. The associations between these variables and the caregivers\' intention to vaccinate their elderly family members with MNDs against COVID-19 were examined using a multivariable linear regression analysis model. The results revealed that caregivers\' perceived familial support for vaccination, the perceived value of vaccination, and autonomy to vaccinate elder family members were positively correlated with caregivers\' intention to vaccinate elderly family members with MNDs, whereas elderly family members\' age was negatively correlated with caregiver intentions. This study demonstrated that caregiver factors (perceived familial support, value of vaccination, and autonomy) and elderly family members\' age were correlated with caregiver intention. These factors should be considered in developing interventions to enhance caregivers\' intentions to vaccinate their elderly family members with MNDs against COVID-19.
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  • 文章类型: Journal Article
    背景:在儿童职业治疗中,与父母的合作实践对于有意义的以家庭为中心的干预措施至关重要,然而,它仍然不确定和不一致的处理。这项研究旨在建立与父母在职业治疗中合作实践的基本概念,为儿童在该领域的发展提供通用描述。
    方法:本文包含了第二个数据集,即更大范围审查和咨询小组对调查结果的初步验证。数据来自使用MedLine与父母在儿童(0-10岁)职业治疗中的合作实践的索引来源,PsychInfo,ERIC,Embase,OTSeeker,Scopus,ProQuestCentral数据被提取,图表,并由配对的独立审稿人进行描述性分析。使用了JoannaBriggs研究所手册和系统审查的首选报告项目以及范围审查的荟萃分析扩展。合作实践的定义草案,根据初步审查结果和操作定义制定,由13名经验丰富的澳大利亚职业治疗师组成的咨询小组验证,他们的输入被整合到决赛中,对协作实践的全面描述。
    结果:范围审查涵盖了299个来源,揭示了协作实践的三个主要组成部分:“协作实践目标”,\'父母-治疗师伙伴关系\',和“协作策略”。咨询小组认可了定义草案,证实了它的专业相关性,并建议进行一些修改。
    结论:这项研究的主要结果是对儿童职业治疗中与父母的合作实践的基于证据和特定学科的初步描述。此描述为协作实践框架的未来发展提供了通用语言和基本概念,以指导实践和研究。未来的研究可以探索特定的成分,探索其机制和意义。需要进一步扩展验证,结合更广泛的职业治疗师和家庭社区的观点,以增强描述的适用性。
    BACKGROUND: In occupational therapy for children, collaborative practice with parents is crucial for meaningful family-centred interventions, yet it remains undefined and inconsistently addressed. This study aimed to establish foundational concepts for collaborative practice with parents in occupational therapy for children in progressing the field with a universal description.
    METHODS: This paper encompasses the second dataset of a larger scoping review and a preliminary validation of findings by an advisory panel. Data were gathered from indexed sources on collaborative practice with parents in occupational therapy for children (ages 0-10) using MedLine, PsychInfo, ERIC, Embase, OTSeeker, Scopus, and ProQuest Central. Data were extracted, charted, and descriptively analysed by paired independent reviewers. The Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-extension for Scoping Reviews were used. A draft definition of collaborative practices, developed based on preliminary review findings and an operational definition, was validated by an advisory panel of 13 experienced Australian occupational therapists, whose input was integrated into a final, comprehensive description of collaborative practice.
    RESULTS: The scoping review encompassed 299 sources, revealing three major components of collaborative practice: \'collaborative practice aims\', \'parent-therapist partnership\', and \'strategies for collaboration\'. The advisory panel endorsed the draft definition, confirmed its professional relevance, and suggested some modifications.
    CONCLUSIONS: The major outcome of this study is an evidence-based and discipline-specific preliminary description of collaborative practice with parents in occupational therapy for children. This description provides a common language and foundational concepts for the future development of a collaborative practice framework to guide practice and research. Future studies can explore specific components, exploring their mechanisms and significance. Further expanded validation is required, incorporating the perspectives of a wider community of occupational therapists and families to enhance the description\'s applicability.
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