The Effect of Pediatric Telerehabilitation on Parental Stress, Caregiver Burden, and Satisfaction of Children with Disabilities during the COVID-19 Outbreak in Thailand
Keywords:caregiver burden, COVID-19, pediatric, telerehabilitation, Thailand
Objectives: To assess the effect of pediatric telerehabilitation on parental stress, caregiver burden, and satisfaction of children with disabilities during the corona virus disease 2019 (COVID-19) outbreak in Thailand.
Study design: A retrospective cohort study.
Setting: Department of Rehabilitation Medicine, Siriraj Hospital, Thailand.
Subjects: A total of 40 caregivers of patients with disabilities who were followed up at the outpatient unit of the Pediatric Rehabilitation Service between February 1, 2021 and November 30, 2021 were divided into a participating telerehabilitation group (n = 20) and a non-participating telerehabilitation or non-intervention group (n = 20). Only caregivers who answered the questionnaires completely were included in the study.
Methods: The researchers collected information from caregivers using both pre-intervention questionnaires (before commencing telerehabilitation) and post-intervention questionnaires (after two months of telerehabilitation) including general data, the Depression Anxiety and Stress Scales (DASS-21), the Zarit Burden Interview (ZBI), and The Client Satisfaction Questionnaire (CSQ-8). The primary outcome of interest was pre-intervention to post-intervention change in DASS-21. The secondary outcomes were pre-intervention to post-intervention changes in ZBI in the telerehabilitation and non-intervention groups and telerehabilitation satisfaction (CSQ-8) in the telerehabilitation group
Results: Changes reduction in ZBI scores was statistically signi-ficantly greater in the telerehabilitation group than in the non-intervention group. Caregivers in the telerehabilitation group indicated high satisfaction and reported good compliance with the online intervention. However, there was no statistically significant difference in DASS-21 change between the telerehabilitation and non-intervention groups. No clinical complaints were reported in either group.
Conclusions: Pediatric telerehabilitation during the COVID-19 outbreak helped relieve caregiver burden with a high level of satisfaction and without clinical complaints.
Kandel I, Merrick J. The child with a disability: parental acceptance, management, and coping. The Scientific World JOURNAL [Internet]. 2007 [cited 2022 Jul 1];7:1799-809. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5901100/ doi:10.1100/tsw.2007.265
Kruse CS, Krowski N, Rodriguez B, Tran L, Vela J, Brooks M. Telehealth and patient satisfaction: a systematic review and narrative analysis. BMJ Open [Internet]. 2017 [cited 2022 Aug 15]; 7(8):e016242. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28775188 doi:10.1136/bmjopen-2017-016242
Ekeland AG, Bowes A, Flottorp S. Effectiveness of telemedicine: a systematic review of reviews. Int J Med Inform [Internet]. 2010 [cited 2022 Jul 1];79(11):736-71. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20884286 doi:10.1016/j.ijmedinf.2010.08.006
Camden C, Pratte G, Fallon F, Couture M, Berbari J, Tousignant M. Diversity of practices in telerehabilitation for children with disabilities and effective intervention characteristics: results from a systematic review. Disabil Rehabil [Internet]. 2020 [cited 2022 Jul 1];42(24): 3424-36. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30978110. doi:10.1080/09638288.2019.1595750
Kierfeld F, Ise E, Hanisch C, Gortz-Dorten A, Dopfner M. Effectiveness of telephone-assisted parent-administered behavioral family intervention for preschool children with externalizing problem behaviour: a randomized controlled trial. Eur Child Adolesc Psychiatry [Internet]. 2013 [cited 2022 Aug 15];22(9):553-65. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23463180 doi:10.1007/s00787-013-0397-7
Sourander A, McGrath PJ, Ristkari T, Cunningham C, Huttunen J, Lingley-Pottie P, et al. Internet-assisted parent training intervention for disruptive behavior in 4-year-old children: a randomized clinical trial. JAMA Psychiatry [Internet]. 2016 [cited 2022 Aug 15]; 73(4):378-87. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26913614 doi:10.1001/jamapsychiatry.2015.3411
Sanders MR, Markie-Dadds C, Tully LA, Bor W. The triplep-positive parenting program: a comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems. J Consult Clin Psychol [Internet]. 2000 [cited 2022 Aug 15];68(4):624-40. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10965638.
Cottrell MA, Galea OA, O’Leary SP, Hill AJ, Russell TG. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clin Rehabil [Internet]. 2017 [cited 2022 Jul 1]; 31(5):625-38. Available from: https://pubmed.ncbi.nlm.nih.gov/27141087/ doi:10.1177/0269215516645148
Polinski JM, Barker T, Gagliano N, Sussman A, Brennan TA, Shrank WH. Patients’ satisfaction with and preference for telehealth visits. J Gen Intern Med [Internet]. 2016 [cited 2022 Aug 15];31(3):269-75. Available from: https://pubmed.ncbi.nlm.nih.gov/26269131/ doi:10.1007/s11606-015-3489-x
Connell S, Sanders MR, Markie-Dadds C. Self-directed behavioral family intervention for parents of oppositional children in rural and remote areas. Behav Modif [Internet]. 1997 [cited 2022 Jul 1];21(4):379-408. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9337598. doi:10.1177/01454455970214001
Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther [Internet]. 1995 [cited 2022 Aug 15];33(3):335-43. Available from:https://www.sciencedirect.com/science/article/abs/pii/000579679400075U doi:10.1016/0005-7967(94)00075-u
Lovibond SH, Lovibond PF. Manual for the depression anxiety stress scales. 2nd ed. Sydney: Psychology Foundation; 1995.
Oei TP, Sawang S, Goh YW, Mukhtar F. Using the depression anxiety stress scale 21 (DASS-21) across cultures. Int J Psychol [Internet]. 2013 [cited 2022 Aug 15];48(6):1018-29. Available from: https://pubmed.ncbi.nlm.nih.gov/23425257/ doi:10.1080/00207594.2012.755535
Zarit SH, Zarit JM. The memory and behavior problems checklist and the burden interview. Gerontology Center: Penn State University; 1990.
Toonsiri C, Sunsern R, Lawang W. Development of the burden interview for caregivers of patients with chronic illness. J Nurs Educ [Internet]. 2011 [cited 2022 Aug 15];4:62-75. Available from: https://he01.tci-thaijo.org/index.php/JNAE/article/view/1559.
Pinyopornpanish K, Pinyopornpanish M, Wongpakaran N, Wongpakaran T, Soontornpun A, Kuntawong P. Investigating psychometric properties of the Thai version of the Zarit burden interview using Rasch model and confirmatory factor analysis. BMC Research Notes [Internet]. 2020 [cited 2022 Aug 15];13(1):120. Available from: https://doi.org/10.1186/s13104-020-04967-w doi: 10.1186/s13104-020-04967-w
Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD. Assessment of client/patient satisfaction: development of a general scale. Eval Program Plann [Internet]. 1979 [cited 2022 Aug 15]; 2(3):197-207. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10245370. doi:10.1016/0149-7189(79)90094-6
Hinton S, Sheffield J, Sanders MR, Sofronoff K. A randomized controlled trial of a telehealth parenting intervention: A mixed-disability trial. Res Dev Disabil [Internet]. 2017 [cited 2022 Aug 15];65:74-85. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28458049 doi:10.1016/j.ridd.2017.04.005
Al-Qahtani SA, Ngwakongnwi E. Usefulness of the client satisfaction questionnaire in measuring perceived satisfaction with wound care services. Wounds Middle East [Internet]. 2017 [cited 2022 Juy 1];4(2):6-8. Available from: https://www.woundsme.com/resources/details/usefulness-of-the-client-satisfaction-questionnaire-in-measuring-perceived-satisfaction-with-wound-care-services.
Dhiman S, Sahu PK, Reed WR, Ganesh GS, Goyal RK, Jain S. Impact of COVID-19 outbreak on mental health and perceived strain among caregivers tending children with special needs. Res Dev Disabil [Internet]. 2020 [cited 2022 Juy 1];107:103790. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33091712 doi:10.1016/j.ridd.2020.103790
Alenezi S, Temsah M-H, Alyahya AS, Almadani AH, Almarshedi A, Algazlan MS, et al. Mental health impact of COVID-19 on Saudi families and children with special educational needs and disabilities in Saudi Arabia: A national perspective. Frontiers in Public Health [Internet]. 2022 [cited 2022 Jul 1];10. Available from: https://pubmed.ncbi.nlm.nih.gov/36238239/ doi:10.3389/fpubh.2022.992658
Grumi S, Provenzi L, Gardani A, Aramini V, Dargenio E, Naboni C, et al. Rehabilitation services lockdown during the COVID-19 emergency: the mental health response of caregivers of children with neurodevelopmental disabilities. Disabil Rehabil [Internet]. 2021 [cited 2022 Aug 15];43(1):27-32. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33167738. doi:10.1080/09638288.2020.1842520
Edirippulige S, Reyno J, Armfield NR, Bambling M, Lloyd O, McNevin E. Availability, spatial accessibility, utilisation and the role of telehealth for multi-disciplinary paediatric cerebral palsy services in Queensland. J Telemed Telecare [Internet]. 2016 [cited 2022 Jul 1];22(7):391-6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26519377 doi:10.1177/1357633X15610720
Beckers L, Geijen MME, Kleijnen J, E AAR, M LAPS, R JEMS, et al. Feasibility and effectiveness of home-based therapy programmes for children with cerebral palsy: a systematic review. BMJ Open [Internet]. 2020 [cited 2022 July 1];10(10):e035454.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33028544 doi:10.1136/bmjopen-2019-035454
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.