Leanne Dreyer, Ibidun Fakoya, Capucine Jauffret, Naomi de Souza-Figueiredo
On average, four priorities were raised per patient. Priorities were distributed across ICF components, with 47% classified as activities and participation, 25% as body functions, 23% as environmental factors and 5% as body structures. Key concerns included behaviour/emotion, health/education navigation, fine hand use and societal attitudes. No significant demographic differences were found. A nonsignificant trend showed more body function and environmental priorities in primary and high school. Males and non-White patients continued clinic access into adolescence, with fewer non-White individuals in preschool.
BACKGROUND: Common outcomes of childhood stroke include physical, cognitive, psychological and social difficulties. Evidence indicates young people with acquired brain injury have a range of community neuropsychological priorities impacting participation; however, less is known about priorities following childhood stroke specifically, and the demographic influences on these. This knowledge is essential to ensure rehabilitation services meet their needs.
METHODS: Two-hundred twenty-two clinical priorities were extracted from the medical records of 59 children (66% male, 59% White, aged 1-17 years, median 7, all deprivation quintiles) attending an occupational therapy and neuropsychology Stroke Recovery Clinic: stroke type: 51% perinatal and 49% childhood. Priorities were coded using the International Classification of Functioning Disability and Health (ICF). Chi-square analysis identified associations between priorities and demographic factors.
RESULTS: On average, four priorities were raised per patient. Priorities were distributed across ICF components, with 47% classified as activities and participation, 25% as body functions, 23% as environmental factors and 5% as body structures. Key concerns included behaviour/emotion, health/education navigation, fine hand use and societal attitudes. No significant demographic differences were found. A nonsignificant trend showed more body function and environmental priorities in primary and high school. Males and non-White patients continued clinic access into adolescence, with fewer non-White individuals in preschool.
DISCUSSION: Children and their families have a range of priorities post-stroke, requiring patient and family centred, interdisciplinary and context specific approaches. These findings support longitudinal, integrated hospital, community and school care systems, which focus on children and young people's participation in their homes and communities well beyond the time of their stroke. Services must ensure interdisciplinary post-stroke care for children and young people is equitable and accessible, with priorities addressed in a timely manner.