Effectiveness of a postural care education programme

Development version 19/06/2012

1 of 48Effectiveness of a postural care training programme © 2012

Effectiveness of a postural care education programme

Chief Investigator (EKHUFT & CCCU) Eve Hutton, [email protected]

Research Associate (CHSS, UKC) Sarah HothamCo-Investigator (CHSS, UKC) Annette King

Co- Investigator (CHSS, UKC ) Kate Hamilton-West


Effectiveness of a postural care training programme © 2012

Background• Occupational Therapists & Physiotherapists support children at school.

•More children are educated in mainstream schools.

• Parents & teachers lack knowledge & confidence.

• This can affect a child’s function & well being (Hutton & Coxon 2011).



The A-Z of postural care



Aim

• The aim of the study is to determine whether the intervention ( a postural care education programme) improves parents’ and teachers’ knowledge and confidence in providing postural care



Methods• Intervention targeted at two groups: Inclusion criteria : care for a child who attends a mainstream primary school.

1. Parents2. Teachers and Teaching Assistants• Sample size: minimum 66 (based on G*Power

calculation).• Aimed to recruit 25-30 through each therapy team.



Methods: Recruitment3 x Therapy

Team

Admin based in therapy

team invites parents

Therapists identify children

Research team invites

teaching staff

Therapists identify schools



Intervention• Two key aims:1. To improve knowledge and understanding of postural care2. To improve confidence in providing postural care• Facilitated by physiotherapists and occupational therapists in each

locality. • Intervention take place over 6-weeks consists of 3 main parts: 1. Postural Care Training 2-hour workshop 2. One-to-one visit 3. Telephone support



Evaluation of Intervention• Use validated outcome measure.• Baseline measurements. Prior to start of training workshop participants complete postural care questionnaire (Time 1).• End of 6-week intervention complete postural care questionnaire again (Time 2).• Changes in knowledge, understanding and confidence?• ANOVAs comparing Time 1 vs. Time 2.• Focus groups and child interviews to gather qualitative feedback.



Outcome Measure•Majority of questions scored on a 4 point-Likert scale (1= Strongly disagree to 4 = Strongly agree).• Higher scores = more knowledge /understanding & confidence.• “ I understand how postural care may affects a child’s physical health”• “I feel confident about providing postural care”• Higher scores =more concerns.• “ I am concerned I might be doing more harm than good”



Timeline: May – August 2013

May: T2 data

collection & Focus groups

July: T2 data

collection & Focus groups

Aug:Analysis of

qualitative & quantitative

data

Sept:Final report



Results (Time 1): N = 71

2

20

Site 1ParentsTeaching Staff

6

17


9

18




Results: Reliability• Cronbach’s Alpha : Above .70 indicates satisfactory reliability

1. Knowledge and Understanding (21 items) : α = .87

2. Confidence (23 items) : α = .85

3. Concerns (7 items) : α = .84



Results: Correlations• Preliminary data from Time 1 outcome measure.• Years of experience related to higher levels of confidence, lower levels of concerns.• Positive correlation between levels of knowledge and confidence.•Higher levels of knowledge = higher levels of confidence.• Negative correlation between levels of concerns, knowledge and confidence.• Lower levels of concerns = higher levels of knowledge and confidence.



Results: Area Breakdown

Knowledge Confidence Concerns2

2.12.22.32.42.52.62.72.8

Site 1Site 2Site 3

Low

-Hig

h M

ean

Resp

onse



Results: Parents vs. Teaching Staff

Parents Teaching Staff2

2.25

2.5

2.75

KnowledgeConfidenceConcerns

Role

Mea

n Re

spon

se

*p<.05



Cost analysis and qualitative study • NHS costs of the intervention • Via process logs of activities

• Feedback from participants• Group discussion and interviews with workshop participants • Group discussion with therapist about their experience

• Interviews with children who have experience of postural care• Using visual communication approach (talking mats)



Final ThoughtsImpact:• On-going partnership between the researchers and service users throughout. • A parent is a co-applicant & other parents & teachers have been involved in the design & development of the intervention. • Linking parents and teachers – sharing

experiences.• Highlights importance of postural care for the child and the need for a ‘whole school approach’.

Implications:• Promote knowledge sharing & closer working between parents, therapists & teachers.



ThanksThis presentation presents independent research

commissioned by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB)

Programme (Grant Reference Number PB-PG-0110-21045).

The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of

Health

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Effectiveness of a postural care education programme