Parental empowerment in paediatric rehabilitation: Exploring the role of a digital tool to help parents prepare for consultation with a physician.
Mattijs W Alsem, Marjolein Verhoef, Jessica Braakman and 5 others
PMID 31276605WHAT IT FOUND
Parents using a digital preparation tool before a physician consultation did not show higher family empowerment scores than parents who did not use it.
They were more likely to report looking up information online.
Key findings
01The primary outcome, family empowerment, showed no significant difference between parents who used the WWW-roadmap before consultation and parents who did not.
02Parents who used the WWW-roadmap were more likely to report looking up information on the Internet before the consultation.
03Interviews found the tool helped parents formulate questions and decide which professional to ask, but parents also perceived that it did not change the consultation or their role during it.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Parents were not randomly assigned. The first 10 parents in each team were allocated to the control group and the next 10 parents to the intervention group, so group differences could affect the result. The study was posttest only and could not establish causality. The authors say a randomised, blinded design was not possible because physicians could be influenced by parents who had used the tool. No reliable power calculation was possible, and the sample size limited subgroup analysis. Only 10% of respondents were fathers, so the result may not reflect fathers' experiences. Parents needed Dutch language skills, computer or internet access, and time to use the tool, so the findings may not apply to families without these resources. 14 parents in the intervention cohort did not use the tool and were excluded, so the analysed group may differ from all parents offered it.
Declared interests
The authors declared no conflict of interest. The study was funded by AGIS Zorginnovatiefonds, Revalidatiefonds, Johanna Kinderfonds, and Stichting Rotterdams Kinderrevalidatie Fonds Adriaanstichting.
The easy way to misread this
Do not conclude that the WWW-roadmap improves parental empowerment or family-centred care because parents said it helped them prepare. The primary empowerment outcome showed no significant difference between groups, and the study used a posttest only sequential cohort design without randomisation or blinding, so it cannot show causality.