Parents'/guardians' knowledge and attitudes regarding physiotherapy in the rehabilitation of children with Cerebral Palsy (CP) and their caregiver burden: A cross-sectional descriptive study at the Lady Ridgeway Hospital, Colombo

Abstract

Cerebral Palsy (CP) is one of the most common childhood disabilities, characterized by motor disorders resulting from damage to the developing brain of a foetus or infant. This study assessed parents’/guardians’ knowledge, attitudes, and caregiver burden regarding physiotherapy in CP rehabilitation and associated factors with those attending the Physiotherapy Department (PD), Lady Ridgeway Hospital (LRH), Colombo. This descriptive cross-sectional study was conducted among parents/guardians (grandparents/uncles/aunts/siblings) of children with CP attending the PD, recruited by convenience sampling. To minimize potential selection bias, consecutive recruitment was carried out across all clinic sessions with consistent inclusion criteria, and questionnaires were available in English, Sinhala, and Tamil to ensure inclusivity. The sample size was calculated using the equation for observational studies for continuous variables. Two self-administered questionnaires, developed to assess the level of knowledge and attitudes, were pilot-tested and translated from English into Sinhala and Tamil. The Caregiver Difficulties Scale (CDS), validated in Sri Lanka, is available in both English and Sinhala. It is being used with permission from the authors, and the Tamil translation was pilot tested. The levels of knowledge and attitude were categorized according to scoring systems from previous studies. Descriptive statistics, chi-square test, one-way ANOVA, and independent sample t-test were used for analysis. 62 participants, 55 females (88.7%), with an average age of 39.16 (± 7.99), were recruited. The mean CDS score was 45.56 (±9.48), indicating a moderate caregiver burden. The majority (69.3%, n=43) had a higher level of knowledge, while 62.9% (n=39) had an average level. While most caregivers had high knowledge regarding physiotherapy in CP rehabilitation, their attitudes remained average. These findings underscore the need for structured caregiver education, counseling, and psychosocial support within rehabilitation services to further enhance positive attitudes and alleviate caregiver burden. Strengthening multidisciplinary approaches at LRH could improve both caregiver well-being and the continuity of effective rehabilitation for children with CP.