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  • 1.
    Donlau, Marie
    et al.
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Habilitation in Central County. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics.
    Imms, Christine
    School of Occupational Therapy, La Trobe University and Murdoch Children’s Research Institute, Melbourne, Vic., Australia.
    Glad Mattsson, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Mattsson, Sven
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Sjörs, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Falkmer, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Habilitation in Central County.
    Children and youth with myelomeningoceles independence in managing clean intermittent catheterization in familiar settings2011In: ACTA PAEDIATRICA, ISSN 0803-5253, Vol. 100, no 3, p. 429-438Article in journal (Refereed)
    Abstract [en]

    Aim: To examine the ability of children and youth with myelomeningocele to independently manage clean intermittent catheterization. Methods: There were 50 participants with myelomeningocele (5-18 years); 13 of them had also participated in a previous hospital-based study. Their abilities and interest in completing the toilet activity were examined at home or in school using an interview and the Canadian Occupational Performance Measure (COPM). Actual performance was observed and rated. Background variables were collected from medical records and KatAD+E tests. Results: In total, 48% were observed to perform the toilet activity independently, in comparison with 74% who self-reported independence. Univariate analyses found KatAD+E could predict who was independent. COPM failed to do so. Ability to remain focused and ambulation were predictors of independence, but age, sex and IQ were not. Multivariable analysis found time to completion to be the strongest predictor of independence. Four children were independent in their familiar environment, but not in the hospital setting, and six of 13 children maintained focus only in their familiar environment. Conclusions: Interviews were not sufficiently accurate to assess independence in the toilet activity. Instead, observations including time to completion are recommended. The execution of the toilet activity is influenced by the environmental context.

  • 2.
    Donlau, Marie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Mattsson, Sven
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Glad Mattsson, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Children with myelomeningocele and independence in the toilet activity: A pilot study2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 1, p. 64-70Article in journal (Refereed)
    Abstract [en]

    Objective: Regarding adult life and independence the most common obstacles for young adults with myelomeningocele (MMC) are cognitive dysfunction and difficulties in performing toilet activities. A step-by-step method with goal setting for the training of self-care in toilet activities for children with MMC was evaluated. Method: Twenty-two children with MMC and bladder and bowel dysfunction (12 girls, 10 boys) aged 3-17.2 (m 9.1) were included. The toilet activities were observed at home jointly by an occupational therapist and urotherapist. Goal-setting procedures of self-training were promoted. Observation scores before and after intervention were compared, the goal setting being evaluated on a Goal Attainment Scale (GAS). Results: Fifteen children who trained in self-catheterization had a median observation score of 22 before and 37 after the training period (p = 0.002). Another seven trained in trans-rectal irrigation with a median score of 30 before and 49 after (p = 0.02). As a result of GAS all children improved, of whom 17 reached the goal or even more so than expected. Conclusions: In this pilot study mutual goal setting in a step-by-step training programme based on professional observation of the toilet activity at home showed a better outcome than traditionally performed training in a hospital setting or with traditional habilitation support.

  • 3.
    Gribble, Nigel
    et al.
    Curtin University, Perth, Western Australia.
    Parsons, Richard
    Curtin University, Perth, Western Australia.
    Donlau, Marie
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Adult Habilitation.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Perth, Western Australia.
    Predictors of time to complete toileting for children with spina bifida2013In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 60, no 5, p. 343-349Article in journal (Refereed)
    Abstract [en]

    Background/aim

    Previous research has shown that children with spina bifida use clean intermittent catheterisation for urination, a rather complex procedure that increases the time taken to completion. However, no studies have analysed the factors impacting on the time taken to complete the urination that could inform occupational therapy practice. Therefore, the aim was to identify the variables that predict extended time children with spina bifida take to complete urination.

    Methods

    Fifty children, aged 5–18 years old with spina bifida using clean intermittent catheterisation, were observed while toileting and responding to a set of assessments tools, among them the Canadian Occupational Performance Measure. A logistic regression was used to identify which variables were independently associated with an extended toileting time.

    Results

    Children with spina bifida do take long time to urinate. More than half of this study's participants required more than five minutes completing urination, but not all required extended times. Ambulant, independent girls were more likely to perform toileting in less than six minutes compared with other children with spina bifida. However, age, IQ, maintained focus on the task, Canadian Occupational Performance Measure, time processing abilities and self-reported ratings of independence appeared to be of no relevance, to predict extended toileting times.

    Conclusion

    To minimise occupational disruption caused by extended toileting times, occupational therapists should utilise the relevant predictors: gender, independence and ambulation when they prioritise children for relevant interventions.

     

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