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Factors contributing to defaulting scheduled therapy sessions by caregivers of children with congenital disabilities
Nota, A.; Chikwanha, T. M.; January, J. & Dangarembizi, N.
Abstract
Background
Defaulting scheduled rehabilitation therapy may result in increased
adverse outcomes such as permanent disability and increased healthcare
costs. Concomitantly, there is evidence to suggest that early and continued
rehabilitation of children with congenital disabilities can improve
outcomes significantly. This study was conducted to determine factors
contributing to caregivers’ defaulting scheduled rehabilitation therapy
sessions.
Methods
A descriptive cross sectional study was carried out at Chitungwiza Central
Hospital, a tertiary facility offering in and outpatient rehabilitation services
in Zimbabwe. Caregivers of children who had congenital disabilities
(N=40) and who had a history of defaulting treatment but were available
during the data collection period responded to an interviewer administered
questionnaire. Data were analysed for means and frequencies using
STATA 13.
Results
Factors that contributed to caregivers defaulting scheduled therapy
included economic constraints (52%), child related factors (43%), caregiver
related factors (42%), service centred factors (30%) and psychosocial
factors (58%). Majority of the caregivers (98%) were motivated to attend
therapy by observable improvements in their children. Other motivators
were incentives given in the rehabilitation department (45%), availability
of rehabilitation personnel to provide the required services (48%) and
psychosocial support from fellow caregivers, families and the rehabilitation
staff (68%). Although all the caregivers could not distinguish occupational
therapy from physiotherapy services they all reported that therapy was
important.
Conclusions
A combination of psychosocial, economic, child centred and service
centred factors contributed to caregivers defaulting scheduled therapy.
Interventions that may potentially improve caregiver attendance to
scheduled therapy include community outreach services, efficient
rehabilitation service provision at the hospitals, and facilitation of income
generating programmes for caregivers.
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