{"title":"A Delphi Exploration of Toileting Activity Performance in Individuals With Cerebral Palsy Within the ICF-CY Framework: Unveiling Influential Factors.","authors":"Azade Riyahi, Malahat Akbarfahimi, Mehdi Rassafiani, Zahra Pournasiri, Maryam Ahmadi, Afsoon Hassani Mehraban","doi":"10.1155/2024/9994862","DOIUrl":null,"url":null,"abstract":"<p><p><b>Introduction:</b> Cerebral palsy (CP) is a common motor and postural developmental disability impacting daily activities like toileting. Despite its importance, toileting has often been undervalued in healthcare. This study is aimed at identifying and assessing the level of influence of various factors affecting toileting in individuals with CP using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) framework. <b>Methods:</b> The Delphi method was employed to reach a consensus on factors influencing toileting in individuals with CP. One hundred fifty-eight professionals from 17 countries, each with at least 3 years' experience in CP and/or toileting, participated in this two-round study. Ethical approval (IR.IUMS.REC.1400.1111) and informed consent were obtained. The questionnaire, available in Farsi and English, used a Likert scale (5 = <i>very high impact</i> to 1 = <i>no impact</i>). Factors with 75% agreement and a mean above 3.75 were included in the final list, while those with 50%-75% agreement or a mean between 2.5 and 3.75 proceeded to the second round. Factors were initially identified through a literature review and research team consultation and categorized according to the ICF-CY framework using the ICF 10 RULES. Validation and refinement were done through focus groups with caregivers and experienced professionals to ensure alignment with the framework and methodological rigor. <b>Results:</b> The study highlighted significant factors influencing toileting activities in individuals with CP. Within the ICF-CY framework, \"neuromusculoskeletal and movement-related functions\" scored highest at 94.5% in \"body functions and structures.\" \"Toilet environment\" scored 90.5% in \"environmental factors.\" Support and relationship factors scored 82.3%. Attitudes toward \"menstruation\" ranked highest at 92.9%. Associated deficits with CP ranked top in personal factors at 93.7%. <b>Conclusion:</b> The study identifies key factors influencing toileting activity performance in individuals with CP. \"Main caregiver\" emerges as a pivotal factor, followed by neuromusculoskeletal functions, personal factors, attitudes toward menstruation, the toilet environment, and support and relationships.</p>","PeriodicalId":49140,"journal":{"name":"Occupational Therapy International","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473173/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Occupational Therapy International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2024/9994862","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Cerebral palsy (CP) is a common motor and postural developmental disability impacting daily activities like toileting. Despite its importance, toileting has often been undervalued in healthcare. This study is aimed at identifying and assessing the level of influence of various factors affecting toileting in individuals with CP using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) framework. Methods: The Delphi method was employed to reach a consensus on factors influencing toileting in individuals with CP. One hundred fifty-eight professionals from 17 countries, each with at least 3 years' experience in CP and/or toileting, participated in this two-round study. Ethical approval (IR.IUMS.REC.1400.1111) and informed consent were obtained. The questionnaire, available in Farsi and English, used a Likert scale (5 = very high impact to 1 = no impact). Factors with 75% agreement and a mean above 3.75 were included in the final list, while those with 50%-75% agreement or a mean between 2.5 and 3.75 proceeded to the second round. Factors were initially identified through a literature review and research team consultation and categorized according to the ICF-CY framework using the ICF 10 RULES. Validation and refinement were done through focus groups with caregivers and experienced professionals to ensure alignment with the framework and methodological rigor. Results: The study highlighted significant factors influencing toileting activities in individuals with CP. Within the ICF-CY framework, "neuromusculoskeletal and movement-related functions" scored highest at 94.5% in "body functions and structures." "Toilet environment" scored 90.5% in "environmental factors." Support and relationship factors scored 82.3%. Attitudes toward "menstruation" ranked highest at 92.9%. Associated deficits with CP ranked top in personal factors at 93.7%. Conclusion: The study identifies key factors influencing toileting activity performance in individuals with CP. "Main caregiver" emerges as a pivotal factor, followed by neuromusculoskeletal functions, personal factors, attitudes toward menstruation, the toilet environment, and support and relationships.
期刊介绍:
Occupational Therapy International is a peer-reviewed journal, publishing manuscripts that reflect the practice of occupational therapy throughout the world. Research studies or original concept papers are considered for publication. Priority for publication will be given to research studies that provide recommendations for evidence-based practice and demonstrate the effectiveness of a specific treatment method. Single subject case studies evaluating treatment effectiveness are also encouraged. Other topics that are appropriate for the journal include reliability and validity of clinical instruments, assistive technology, community rehabilitation, cultural comparisons, health promotion and wellness.