Hodgson, Xanthe; Alderson, Lucy; Katchburian, Lesley; Kelly, Paula; Shannon, Harriet; (2023) What are the perceptions of using an F-word framework by physiotherapists working with children and young people with cerebral palsy? Presented at: 77th AACPDM Annual Meeting, Chicago.

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Abstract

Background/objectives: The International Classification of Functioning, Disability and Health provides a holistic approach for assessment and treatment. Used to evaluate difficulties for children with cerebral palsy (CP) it shows impairment in body structure and function, activity limitation and restricted participation. Environmental factors of mobility, transport, support by and to parents, and the attitudes of individuals and institutions can act as barriers or facilitators to participation. The F-word model sets the ICF in a child-development context (Rosenbaum, Goeter 2011) and directs intervention towards meaningful participation. This study explores physiotherapists’ perceptions of using this model to plan interventions for children with CP./ / Methods: Participants: Community based (primary care) NHS physiotherapists drawn from a convenience sample of 5 NHS trusts. Inclusion criteria were physiotherapists working with children and young people with CP. Three focus groups were undertaken, two face-to-face, one virtual. A nominal group technique was used to generate ideas and facilitate contributions from all the group via individual generation of ideas and group discussion. Advantages and challenges of the F-word model were explored. Challenges were ranked in the groups and those thought most significant were further discussed to understand the problem and identify possible solutions. The focus groups were audo-recorded, data were transcribed and anonymised. Data were reviewed using reflexive thematic analysis / / Results: Twenty physiotherapists attended focus groups, with 1-25 years’ experience of working with children with CP. All agreed an ICF approach using the F-word model is beneficial when planning holistic intervention. Advantages included the focus on abilities, that it is fun and engaging, flexible, gives a broad view but is individual to the child. For participants the model provided structure to the approach thereby supporting clinical reasoning and ‘set the scene’ (of physiotherapy) for the family and professionals involved. Inclusion of the views and preferences of the family and child guided discussion, prompted individualised goal setting and promoted engagement. Challenges were that it could be overwhelming: a lot of information, complex ideas, possibly confronting, especially for families early in their journey. Misconceptions of physiotherapy, conflict between child and parent priorities and access to community activity also featured. Inconsistent use of the method between physiotherapists raised concerns over loss of transferability. / / Conclusion: Community based physiotherapists support using the F-word model when planning interventions. Findings suggests that successful implementation of the model requires establishing a standardised approach alongside resources (workshops, posters and videos) for parents and young people to help make it comprehensible and meaningful.

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