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      Towards developing a comprehensive treatment schedule for patients with cerebral palsy: factors influencing patient's adherence to physiotherapy treatment

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          Abstract

          Purpose

          This study is aimed to identify factors influencing patient's adherence to treatment in a bid to characterize the extent to which these factors are considered while developing a treatment schedule for patients with cerebral palsy in Nigeria

          Methods

          Descriptive cross-sectional study of physiotherapists involved in the care of patients with cerebral palsy. Factors influencing treatment adherence were assessed using a pre-tested, self-administered questionnaire. Participants were sampled from physiotherapists working at University of Nigeria Teaching Hospital, Enugu State, Nigeria. The data were analyzed using descriptive statistics of percentage and frequencies.

          Results

          A total of fifty three (31 males and 22 females) physiotherapists completed and returned the questionnaire. Participants (84.9%) agreed that patients occasionally forget to meet up with their appointment days; with majority of them agreeing that distance to the clinic and economic factor (cost of treatment and transportation) influence patient's adherence to treatment. Presence/absence of a caregiver and relationship between patients and their physiotherapist are also important factors influencing patient's treatment schedules.

          Conclusion

          Distance to the clinic when compared to other (economic, patient-therapist relationship) factors is the major barrier to patient's adherence to treatment and therefore should be considered while developing treatment schedules for patients with cerebral palsy

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          Most cited references41

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          A report: the definition and classification of cerebral palsy April 2006.

          For a variety of reasons, the definition and the classification of cerebral palsy (CP) need to be reconsidered. Modern brain imaging techniques have shed new light on the nature of the underlying brain injury and studies on the neurobiology of and pathology associated with brain development have further explored etiologic mechanisms. It is now recognized that assessing the extent of activity restriction is part of CP evaluation and that people without activity restriction should not be included in the CP rubric. Also, previous definitions have not given sufficient prominence to the non-motor neurodevelopmental disabilities of performance and behaviour that commonly accompany CP, nor to the progression of musculoskeletal difficulties that often occurs with advancing age. In order to explore this information, pertinent material was reviewed on July 11-13, 2004 at an international workshop in Bethesda, MD (USA) organized by an Executive Committee and participated in by selected leaders in the preclinical and clinical sciences. At the workshop, it was agreed that the concept 'cerebral palsy' should be retained. Suggestions were made about the content of a revised definition and classification of CP that would meet the needs of clinicians, investigators, health officials, families and the public and would provide a common language for improved communication. Panels organized by the Executive Committee used this information and additional comments from the international community to generate a report on the Definition and Classification of Cerebral Palsy, April 2006. The Executive Committee presents this report with the intent of providing a common conceptualization of CP for use by a broad international audience.
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            Traveling towards disease: transportation barriers to health care access.

            Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes.
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              Factors affecting therapeutic compliance: A review from the patient’s perspective

              Objective To explore and evaluate the most common factors causing therapeutic non-compliance. Methods A qualitative review was undertaken by a literature search of the Medline database from 1970 to 2005 to identify studies evaluating the factors contributing to therapeutic non-compliance. Results A total of 102 articles was retrieved and used in the review from the 2095 articles identified by the literature review process. From the literature review, it would appear that the definition of therapeutic compliance is adequately resolved. The preliminary evaluation revealed a number of factors that contributed to therapeutic non-compliance. These factors could be categorized to patient-centered factors, therapy-related factors, social and economic factors, healthcare system factors, and disease factors. For some of these factors, the impact on compliance was not unequivocal, but for other factors, the impact was inconsistent and contradictory. Conclusion There are numerous studies on therapeutic noncompliance over the years. The factors related to compliance may be better categorized as “soft” and “hard” factors as the approach in countering their effects may differ. The review also highlights that the interaction of the various factors has not been studied systematically. Future studies need to address this interaction issue, as this may be crucial to reducing the level of non-compliance in general, and to enhancing the possibility of achieving the desired healthcare outcomes.
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                Author and article information

                Journal
                Afr Health Sci
                Afr Health Sci
                African Health Sciences
                Makerere Medical School (Kampala, Uganda )
                1680-6905
                1729-0503
                June 2022
                : 22
                : 2
                : 573-580
                Affiliations
                Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria. www.unn.edu.ng
                Author notes
                Corresponding author: ChigozieUchenwokeIkenna, Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Nigeria. Tel: +2348060254107 chigozie.uchenwoke@ 123456unn.edu.ng
                Article
                jAFHS.v22.i2.pg573
                10.4314/ahs.v22i2.66
                9652679
                36407377
                63fb7ac5-7421-41c0-beb0-6b047e6478f9
                © 2022 Ikenna CU et al.

                Licensee African Health Sciences. This is an Open Access article distributed under the terms of the Creative commons Attribution License ( https://creativecommons.org/licenses/BY/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                cerebral palsy,treatment schedule,adherence,physiotherapy,nigeria

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