CHAPTER 8 212 Adaptation Everyone agreed on the need for the involvement of the parents (and/or caregiver) and a good therapeutic relation between therapist, parents and child. They felt that a hybrid format could enhance this therapeutic relation, but when performed with a home visit it also enhances the intervention because the physical context is then known by the OT and can be incorporated: (Yara’s OT: “When you go to the home you can really see what she looks like at her desk, what earrings she has or what shoes are in the closet. You can also say ‘oh then we will start with these shoes’.” Both the OTs and Zach’s mother stated that it would also be good to give more directions on the expectations from the intervention. Discussion The primary aim of this study was to explore the potential of the PRPP-Assessment to measure change in the meaningful activities of children with a mitochondrial disorder. As 13 of the 15 hypotheses on responsiveness were accepted, the results show the potential for the PRPP-Assessment to serve as an outcome measure for children. We also learned a lot about the method used to elicit changes in the patients – the PRPP-Intervention – within a home-based video coaching program. The content of the intervention was experienced positively, even when the child and parent experienced difficulty integrating the intervention into their daily lives. Furthermore, it resulted in clinically relevant improvements in eight out of nine activities, demonstrating the potential of the PRPP-Interventionwithin a home-based video coaching program. The results provided insight into the feasibility aspects, which showed good acceptability, and also several facilitators and concerns with regard to demand, implementation, practicality, integration and adaptation were discovered. When using the PRPP-Assessment as an evaluative measurement, implications for practice and researchwere determined and it is important that they are reproducible. Firstly, tasks and the criterion (i.e., task performance) were carefully selected and formulated to make sure that enough room for improvement was possible. This is in line with the recommendations of previous research23. Secondly, this study used a fixed-task analysis, leading to an acceptable ICC for the PRPP-M and fitting the knowledge that this increases the reproducibility of measurement23, 57. Thirdly, the context influences the validity of the measurement and therefore the measurement properties are dependent on the situation12. To illustrate, Yara used a new mascara for her post-intervention video, which made the brush glide easier and visible marks appear more quickly. Although Yara, her mother and the treating OT felt that she
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