Serebral palsili çocukların tedavisinde Pediatrik Bobath Konsepti: Türk Bobath terapistlerinin görüşü

Abstract

Amaç: Pediatrik Bobath Konsepti (PBK), serebral palsi ve benzeri nörogelişimsel probleme sahip çocukların fonksiyonel becerilerini desteklemek amacıyla transdisipliner uygulanan aile-çocuk merkezli holistik bir konsepttir. Bu çalışmanın amacı, Türkiye'deki Bobath terapistlerinin bakış açısından PBK'nin çocuklara, ebeveynlere ve kendilerine etkilerini incelemekti. Yöntem: Bu gözlemsel çalışmaya yaş ortalaması 37.9+6.1 yıl olan 104 (%69.2 kadın) Bobath terapisti katıldı. Delphi yöntemi ile Pediatrik-Bobath Etki Anketi (P-BIQ) geliştirildi. İçerik geçerliliği (Lawshe's İçerik Geçerlik İndeksi-CVI) ve test-tekrar test güvenilirliği (Sınıfiçi Korelasyon Katsayısı-ICC) incelendi. Çocuklar, ebeveynler ve terapistlerdeki değişim oranları arasındaki ilişkiler Ki Kare (χ2) testi kullanılarak analiz edildi ve ilişkilerin etki büyüklükleri Cramer's V değerlerine göre incelendi. Bulgular: P-BIQ anketine (CVI=0.836, ICC>0.737) göre terapistlerin en az %74’ü PBK’nin çocukları (terapi ve ev programına uyum/motivasyon, vücut yapı ve fonksiyonları, aktivite ve katılımları, çevresel düzenlemeler), ebeveynleri (terapi ve ev programına uyum/motivasyon) ve kendilerini (mesleki yeterlilik hissi ve motivasyon) olumlu etkilediğini belirtti. Çocuk, ebeveyn ve terapistin uyumu/motivasyonu çocuğun aktivite, katılım düzeyleri ve çevresel düzenlemeler ile pozitif ilişkiliydi (p<0.001, Cramer’s V>0.20). Sonuç: Çocukların gelişimine olduğu kadar PBK, ebeveynlerin uyumuna ve terapistin eğitimine ve mesleki yeterlilik duygusuna da katkıda bulunur. Çocukların, ebeveynlerin ve terapistlerin artan uyumu, çocuğun işlevsel gelişimini, sosyal katılımını ve çevreye uyumunu destekler.

Keywords

• Serebral palsi
• Çocuk
• Geçerlik çalışması

Pediatric Bobath Concept in management of children with cerebral palsy: view of Turkish Bobath therapists

Abstract

Purpose: Pediatric Bobath Concept (PBC) is a family-child centered holistic concept applied interdisciplinary to support the functional skills of children with cerebral palsy. The aim of this study was to examine the effects of PBC on children, parents, and themselves from the perspective of Bobath therapists in Turkey. Methods: In this observational study, 104 (69.2% female) Bobath therapists with a mean age of 37.9+6.1 years participated. The Pediatric-Bobath Impact Questionnaire (P-BIQ) was developed by the Delphi method. Content validity (Lawshe's Content Validity Index-CVI) and test-retest reliability (Intraclass correlation coefficient -ICC) were examined. The relationships between the rates of change in children, parents, and therapists were analyzed using the Chi Square (χ2) test and the effect sizes of the relationships were analyzed according to Cramer's V values. Results: According to the P-BIQ (CVI=0.836, ICC >0.737), at least 74% of therapists reported that the PBC positively affected children (compliance with therapy and home program, body structure and function, activity and participation, environmental adaptations), parents (compliance with therapy and home program) and themselves (sense of professional competence and motivation). Compliance of the child, parent, and therapist was positively associated with the child's activity and participation levels and environmental adaptation (p<0.001, Cramer's V>0.20). Conclusion: PBC contributes to the development of children as well as to parental compliance, and to the therapist's training and sense of professional competence. Increased compliance of children, parents, and therapists supports the child's functional development, social participation, and adaptation to the environment.

Keywords

• Cerebral palsy
• Child
• Validation study

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