Exploration of pediatric manual wheelchair confidence among children, parents, and occupational therapists: a qualitative study

Abstract

Purpose

Manual wheelchair (MWC) confidence is a predictor of adult life-space mobility and social participation. To date, scientific literature specific to pediatric MWC confidence is scarce which prevents in-depth understanding. The objective of this study was to explore the perceptions of pediatric MWC users (PMWU), parents, and occupational therapists regarding pediatric MWC confidence.

Methods

Five focus groups were conducted with PMWUs (n = 12) and occupational therapists (n = 9), and semi-structured interviews were conducted with parents of PMWUs (n = 2). Inductive thematic analysis was performed following verbatim transcription of audio recorded material.

Results

Three overarching themes were identified across PMWUs, parents, and occupational therapists: (1) “MWC confidence is not a clinical priority” depicted the construct’s varying level of clinical priority and perceived abstractness; (2) “MWC confidence is both a child and parent consideration” revealed nuances between the PMWU’s MWC confidence and the parents’ perception of the PMWU’s MWC confidence; and (3) “Opportunities to develop MWC confidence are context-specific” contrasted afforded and unafforded opportunities to experience independent MWC mobility.

Conclusions

Pediatric MWC confidence is an important aspect of wheelchair use that is shaped by a multitude of factors in PMWU’s lives. This new area of pediatric study provides support for the need to measure this important construct.

IMPLICATIONS FOR REHABILITATION

• This study is the first to explore children’s, parents’, and occupational therapists’ perceptions of pediatric MWC confidence.

• Pediatric MWC confidence impacts MWC use in a multifaceted fashion.

• Future studies should consider the development and validation of a self-report measure to assess pediatric MWC confidence.

Keywords:

• Confidence
• self-efficacy
• manual wheelchair
• occupational therapy
• pediatric rehabilitation
• qualitative studies

Acknowledgments

The authors wish to thank all participants for their interest, time, and generosity in sharing their perspectives. We also thank Patricia Turcotte for her help with the data collection. Paula W. Rushton and François Routhier were supported by a Fonds de recherche du Québec-Santé (FRQS) Junior 1 career award at the time of this study.

Disclosure statement

The authors report no conflicts of interest.