This study systematically reviewed performance-based outcome measurement instruments (PerFOMs) for mealtime performance in Parkinson’s disease and appraised their measurement domains and properties using the ICF framework and COSMIN methodology. PubMed, Embase, ProQuest, and CINAHL were searched for studies published between January 2006 and July 2026. Eligible studies used observer-administered PerFOMs that evaluated comprehensive ingestive skills during meals. Patient-reported outcome measures and screening tools limited to isolated swallowing tasks were excluded. Instrument items were linked to ICF components, and measurement properties were appraised using COSMIN. Two studies were included, identifying two PerFOMs: the Mealtime Assessment Scale (MAS) and the modified Older Americans Resources and Services (OARS) scale. The MAS was linked to all four ICF components, whereas the modified OARS scale was limited to utensil use. Neither instrument had undergone independent content-validity testing. The MAS showed adequate methodological quality with sufficient results for measurement error and convergent validity, whereas the modified OARS scale lacked evidence for most measurement properties. The evidence base for comprehensive mealtime assessment in PD remains limited and preliminary. Existing instruments differ in ICF coverage and lack content validation. Further research should establish psychometric evidence and address multiple dimensions of mealtime performance in PD. Mealtime difficulties in Parkinson’s disease extend beyond swallowing and involve posture, utensil handling, and cognitive-attentional demands.Patients with Parkinson’s disease may overestimate their own eating ability, so direct observation of mealtime performance should complement self-report.This review found that only two performance-based mealtime assessments exist for this population, and neither has been fully validated.Rehabilitation professionals should assess mealtime performance across ICF domains, rather than swallowing alone, to guide individualized rehabilitation in Parkinson’s disease. Mealtime difficulties in Parkinson’s disease extend beyond swallowing and involve posture, utensil handling, and cognitive-attentional demands. Patients with Parkinson’s disease may overestimate their own eating ability, so direct observation of mealtime performance should complement self-report. This review found that only two performance-based mealtime assessments exist for this population, and neither has been fully validated. Rehabilitation professionals should assess mealtime performance across ICF domains, rather than swallowing alone, to guide individualized rehabilitation in Parkinson’s disease.
Purpose: To identify facilitators and barriers to the development and implementation of national rehabilitation strategic plans across five World Health Organization (WHO) regions and 19 low- and middle-income countries. Materials and methods: A qualitative descriptive design was used. Ministry of Health personnel, WHO staff, international consultants, and development partners were purposively sampled. Data were analyzed using directed content analysis. Results: Five shared facilitators were identified: clarity of priorities, processes, impact, and contextual understanding; high-level political commitment, strong Ministry of Health leadership capacity and ownership; WHO’s sustained policy influence and diversified support; capacity, interest, and engagement of all relevant stakeholders; and enabling environments and institutional support mechanisms. Three shared barriers were identified: misconceptions and a narrow framing of rehabilitation; long-standing rehabilitation sector challenges; and gaps in rehabilitation data and information systems. Conclusions: Effective leadership, flexible processes, multisectoral collaboration, and prompt international assistance were key facilitators. However, persistent misconceptions about rehabilitation, insufficient data, fragmented governance, and frequent leadership changes were impeding progress and momentum. Aligning leadership, governance, and data systems is essential to move rehabilitation from policy intention to sustained, system-wide implementation.
PURPOSE Physiotherapy and occupational therapy can improve quality of life and help to manage complex cancer and treatment-related side effects, but these rehabilitation services remain underutilised. This study aimed to co-produce knowledge for improving patient-centred services in the oncological rehabilitation continuum in Austria. METHODS A 3-days transdisciplinary workshop programme was facilitated in a world café format with 36 participants: people living with and beyond cancer (n = 13), relatives (n = 1), health professionals (n = 11) and researchers (n = 11). Based on the participatory paradigm and co-production principles, a range of participatory research techniques were employed co-producing, analysing, and interpreting data (in-situ thematic analysis). RESULTS Four main themes emerged: (a) physiotherapy and occupational therapy in the oncological rehabilitation continuum; (b) relationship-building; (c) continued and interconnected services; and (d) visions for an ideal rehabilitation. The findings display a vast diversity of lived experiences and illness trajectories as well as opportunities for improving services and enabling human agency. CONCLUSIONS Physiotherapy and occupational therapy should be better integrated in all care settings, interconnected across all rehabilitation continuum phases, person-centred and tailored to diverse experiences, needs and rehabilitation trajectories. Peer-support, information and guidance for patients must be provided early from diagnosis and continuously throughout the care pathways for promoting continuity.
PURPOSE This study explored how caregivers exercise agency in supporting their children's academic, social, and independent development, alongside their overall well-being in South Africa. METHODS A secondary analysis of data from semi-structured interviews was conducted with seven purposively selected caregivers of children who are deafblind. Data were analysed using reflexive thematic analysis, guided by Braun and Clarke's framework. RESULTS Three main themes emerged from the data. First, caregivers as advocates for their children's future captures how caregivers actively prioritised education, nurtured their children's unique talents, and encouraged play and skill development to foster independence and self-expression. Second, facilitating independence through environmental and sensory adaptation reflects how caregivers structured routines and familiar environments to support behavioural and sensory development. Third, fostering well-being through social and physical engagement highlights caregivers' efforts to promote social inclusion, physical activity, and holistic well-being. Across these themes, caregivers' agency was accompanied by considerable personal cost, including sustained time, vigilance, and sacrifice. CONCLUSION The study highlights parental agency as vital in managing deafblindness challenges while highlighting the psychological toll on caregivers. It calls for enhanced systemic support, including specialised communication training, mental health resources, and inclusive education policies to strengthen caregiver resilience and improve outcomes for children with deafblindness.
