Giacobbi Meris [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]; Bò Maria Chiara [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]
Gengotti Francesca [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]; Dellamotta Daniela [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]
Fortunato Nunzia [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]; Foschi Mattia [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]
Retini Noemi [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]; Caronia Letizia [Dipartimento di Scienze dell’Educazione, Università degli studi di Bologna]
Ranzani Federica [Dipartimento di Scienze dell’Educazione, Università degli studi di Bologna]; Aulizio Vincenzo [Centro di Iniziativa Democratica degli Insegnanti (CIDI), Rimini]
Serafini Martina [Cooperativa Millepiedi, Rimini]; Bertini Simona [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]
Taddei Mia [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]; Bertozzi Monia [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]
Prati Paolo [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]; Bemporad Jonathan [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]
Zerbinati Paolo [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]; Mariotti Paolo [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]
Montesi Massimo [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]; Merlo Andrea [OPA Sol et Salus, Torre Pedrera Di Rimini, Rimini]
In pediatric healthcare, the balance between cure and care is essential, especially during prolonged periods of hospitalization [1]. At our institution, more than 300 underage children per year undergo neuro-orthopedic surgery (NOS), aimed at correcting limb deformities caused by neurological conditions. Patients remain hospitalized for about a month to begin rehabilitation. While cure aims to improve function and minimize the impact of a pathological condition, care focuses on socio-emotional well-being, the implementation of sensorimotor and cognitive skills, and attempts to reduce the impact of medicalization on quality of life [2]. The Inclusive Care (IC) project was designed to integrate these two key aspects into inpatient children’s stay at our institution.
This study explores the several steps followed in designing the IC project and describes its aims and the preliminary results obtained.
The design of IC involved the hospital management and the professionals responsible for several clinical (rehabilitation ward, physiotherapist – PT and nurse coordinators, psychologist, educator) and support services (engineering, quality, training, research).
Setting (S): We screened for suitable spaces, specific pathways to access them, and planned renovation work.
Management (M): We defined the professionals to be involved, detailing their activities and responsibilities. We set the frequency of the IC activities 3 times/week and drafted the process for collecting patients’ anamnestic, cognitive, and functional information before admission to support organization. Necessary documentation (e.g., privacy policy and informed consent) was prepared.
Research (R): We drafted the inclusion criteria for children eligible for IC-related studies and reviewed the current literature to identify outcome measures suitable for evaluating the IC effectiveness on children’s well-being and behaviors.
S: We renovated and furnished an outbuilding specifically for children with disabilities. To enhance accessibility, we marked the path to access it with colored road signs such as footsteps and wheelchairs.
M: The hospital signed a memorandum with the municipality of our city, the reference university in our region – Department of Education, and two volunteering associations. The IC includes educators, teachers, a pedagogical supervisor, and a psychologist. The presence of a nurse and PT during activities ensures safety and integration with ongoing rehabilitation. A list of pedagogical activities was drafted, including the necessary materials, tailored to the children’s needs.
R: From November 2023, the IC involved 125 children recovering from NOS. We used the Strengths & Difficulties Questionnaires to assess the impact of IC on a pilot sample of 10 patients. Parents were highly satisfied, and PTs reported overall increased compliance to the traditional rehabilitation program.
The IC project represents an innovative patient & family -centered paradigm in the rehabilitation field, where cure and care integrate each other, emphasizing the patient’s agency as well as family members’ core role, engagement and needs. Advanced surgical and rehabilitation procedures pair with structured playful moments with peer activities, supporting the relational and psychological needs of the children. Approaching children as such before treating them as patients may help them develop coping strategies and engage more actively in physiotherapy, potentially increasing its effectiveness. Moreover, the IC offers a privileged setting in which rehabilitation professionals can observe children and understand their needs, therefore designing tailored exercises. The IC also provides extensive support to caregivers, alleviating the stress and emotional burden they may experience by seizing the opportunity for a brief daily relief during playtime activities.
[1] G. Perasso, G. Camurati, E. Morrin, C. Dill, K. Dolidze, T. Clegg, I. Simonelli, H.Y.C. Lo, A. Magione-Standish, B. Pansier, S.C. Gulyurtlu, A. Garone, H. Rippen, Five Reasons Why Pediatric Settings Should Integrate the Play Specialist and Five Issues in Practice, Front Psychol 12 (2021). https://doi.org/10.3389/fpsyg.2021.687292.
[2] K. Koukourikos, L. Tzeha, P. Pantelidou, A. Tsaloglidou, The Importance of Play During Hospitalization of Children, Materia Socio Medica 27 (2015) 438. https://doi.org/10.5455/msm.2015.27.438-441.
