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Understanding frames: A qualitative exploration of standing frame use for young people with cerebral palsy in educational settings.

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Title: Understanding frames: A qualitative exploration of standing frame use for young people with cerebral palsy in educational settings.
Authors: Goodwin, Jane, Lecouturier, Jan, Smith, Johanna, Crombie, Sarah, Basu, Anna, Parr, Jeremy R., Howel, Denise, McColl, Elaine, Roberts, Andrew, Miller, Keith, Cadwgan, Jill
Source: Child: Care, Health & Development. May2019, Vol. 45 Issue 3, p433-439. 7p. 1 Chart.
Subjects: Cerebral palsy treatment, Autonomy (Psychology), Communication, Confidence, Focus groups, Health care teams, Occupational therapists, Patient positioning, Pediatricians, Physical therapists, Professional ethics, School environment, Special education, Standing position, Qualitative research, Assistive technology, Job performance, Social boundaries, Thematic analysis, Parent attitudes, College teacher attitudes
Abstract: Background: Consensus opinion supports standing frame use as part of postural management for nonambulant young people with cerebral palsy. Most young people with cerebral palsy in the United Kingdom, who use standing frames, use them at nursery or school, rather than at home. In this paper we report professionals' and parents' experiences and views of standing frame use specifically in educational settings. This research was conducted as part of a large mixed methods study to determine the acceptability and inform the design of a future trial of standing frames. Methods: Qualitative methods were used: focus groups with educational professionals, parents and clinicians (paediatricians, physiotherapists and occupational therapists) were convened. Data were analysed thematically using framework analysis. Results: Five focus groups were conducted. The overarching theme "flexibility" encompassed four subordinate themes: (i) "balancing education and therapy," which described the way education professionals had to juggle different priorities from health professionals within a multi‐disciplinary team; (ii) "young people's autonomy," which highlighted participants' belief that standing frame use should be centred on the individual young person and their needs; (iii) "working within logistical boundaries," which demonstrated that "ideal" standing frame use was not always possible due to logistical issues (e.g., staffing and standing frame availability); and (iv) "competence and confidence," which highlighted that educational professionals felt that they lacked the training to confidently position young people in their standing frame. Conclusions: This paper highlights the complexity of standing frame use in the educational setting. If a standing frame programme is prescribed to be delivered in an educational setting, strong multidisciplinary and interagency communication is essential to balance therapy versus education. Training is required to ensure staff are competent in using the standing frame with the young person understanding their individual requirements. A flexible approach—inclusive of the young person's needs, logistical demands and resource—is necessary. [ABSTRACT FROM AUTHOR]
Copyright of Child: Care, Health & Development is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Understanding frames: A qualitative exploration of standing frame use for young people with cerebral palsy in educational settings.
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  Data: Background: Consensus opinion supports standing frame use as part of postural management for nonambulant young people with cerebral palsy. Most young people with cerebral palsy in the United Kingdom, who use standing frames, use them at nursery or school, rather than at home. In this paper we report professionals' and parents' experiences and views of standing frame use specifically in educational settings. This research was conducted as part of a large mixed methods study to determine the acceptability and inform the design of a future trial of standing frames. Methods: Qualitative methods were used: focus groups with educational professionals, parents and clinicians (paediatricians, physiotherapists and occupational therapists) were convened. Data were analysed thematically using framework analysis. Results: Five focus groups were conducted. The overarching theme "flexibility" encompassed four subordinate themes: (i) "balancing education and therapy," which described the way education professionals had to juggle different priorities from health professionals within a multi‐disciplinary team; (ii) "young people's autonomy," which highlighted participants' belief that standing frame use should be centred on the individual young person and their needs; (iii) "working within logistical boundaries," which demonstrated that "ideal" standing frame use was not always possible due to logistical issues (e.g., staffing and standing frame availability); and (iv) "competence and confidence," which highlighted that educational professionals felt that they lacked the training to confidently position young people in their standing frame. Conclusions: This paper highlights the complexity of standing frame use in the educational setting. If a standing frame programme is prescribed to be delivered in an educational setting, strong multidisciplinary and interagency communication is essential to balance therapy versus education. Training is required to ensure staff are competent in using the standing frame with the young person understanding their individual requirements. A flexible approach—inclusive of the young person's needs, logistical demands and resource—is necessary. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Child: Care, Health & Development is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/cch.12659
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        Text: English
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      – SubjectFull: Cerebral palsy treatment
        Type: general
      – SubjectFull: Autonomy (Psychology)
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      – SubjectFull: Communication
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      – SubjectFull: Confidence
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      – SubjectFull: Health care teams
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      – SubjectFull: Physical therapists
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      – SubjectFull: School environment
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      – SubjectFull: Special education
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      – SubjectFull: Standing position
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      – SubjectFull: Qualitative research
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      – SubjectFull: Assistive technology
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