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Research Article: Individualized Goal Setting for Pediatric Intensive Care Unit-Based Rehabilitation Using the Canadian Occupational Performance Measure

Date Published: 2023-05-31

Abstract:
The Canadian Occupational Performance Measure (COPM) is a client-centered outcome measure that facilitates the prioritization of individualized interventions. Given the rising emphasis on individualized intervention in pediatric intensive care units (PICUs), this cross-sectional study aimed to explore caregivers’ perspectives on their children’s functional goals within PICUs. From 1 September 2020 to 26 June 2022, caregivers of 41 children aged 1–18 years completed the COPM within 48 h of PICU admission. The study also explored the clinical variables predicting a high number of occupational performance goals (?4/5). Out of 190 goals proposed by caregivers, 87 (45.8%) pertained to occupational performance, while 103 (54.2%) were related to personal factors. Among the occupational performance goals, the majority were associated with functional mobility (55; 28.9%), followed by personal care (29; 15.2%) and quiet recreation (3; 1.6%). Among personal goals, physiological factors (68; 35.8%) were most common, followed by physical factors (35; 18.4%). We found caregiver anxiety, measured by the State-Trait Anxiety Inventory-State, to be a significant predictor of the number of occupational performance goals. These findings underscore the importance of caregiver psychological assessment in the PICU to facilitate personalized goal setting and improve rehabilitation outcomes.

Introduction:
Health systems recognized that morbidities affecting physical and cognitive health and health-related quality of life needed to be addressed [1,2,3,4,5], considering the decline in the mortality of children admitted to pediatric intensive care units (PICUs) [6]. Thus, PICU culture was transformed to facilitate early rehabilitation to minimize morbidities [7], and the emerging literature suggests that the implementation of a structured early mobilization program conducted as part of a multidisciplinary approach in…

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