Cerebral palsy (CP) children turn burdensome for most of the families in Bangladesh, they used to live in four walls and the majority of the times their families suffer devastating financial problems to take care of them. Cerebral palsy is resulting from brain injury before cerebral development and it is happened during the prenatal, perinatal, or postnatal period [1],[2]. It is estimated that global incidence between 2 and 3 per 1000 live birth [3] and the prevalence of child disability in Bangladesh both rural and urban is 70/1000 among 2–9 years old who have all grades of severity and 22/1000 who suffers serious disability [4]. As CP children suffer a lot, the family members especially mothers undergo a lot of familial, social, and emotional difficulties [5]. To deal with the problem of chronic medical conditions and the types of disability, a multidisciplinary team (MDT) approach is needed to do medical and rehabilitation services [6]. As it is a slowly progressive disease so parents’ motivation is the prerequisite for child improvement. In Bangladesh different government [7] and non-government [8] organizations took initiatives to provide quality service for CP children, not only that but also they continuously doing awareness programs among parents and different media. Centre for the Rehabilitation of the Paralysed (CRP) carried out its therapy service from its initial setup, this organization provides 15 days of indoor service for CP where the main focus is to educate the mother about the conditions of the child as well as how to maintain the child with daily-based therapy at home. It provides the follow-up books and graphical presentations of treatment procedures that they follow at their homes. The evidence said that physiotherapy plays an important role in strengthening the muscular balance and physical fitness especially the strengthening program [9],[10] of CP children. Though the standard service is being provided; however, the main aim of this research is to know the reason behind, which makes parents come with their children for receiving the physiotherapy treatment.

Methods

This research is a quantitative cross-sectional survey where data were collected through face-to-face interview.

Study place

Centre for the Rehabilitation of the Paralysed is one of the largest tertiary levels of rehabilitation center in Southeast Asia which receives referrals from different hospitals from all over Bangladesh. It provides 15 days indoor treatment for pediatric child where MDT approach also maintained.

Data collection, management, and analysis

Data have been collected from the duration of one year from CRP indoor. A structured questionnaire has been deployed by preparing with Bangla format for easy understanding of the participants. A pilot study was performed for pre-testing the questionnaire. Here our aim is to receive the general impression of the parent’s not detailed examination of their attitudes. The questionnaire was structured with absolute and relative measure of the items. All the data kept secure and the analysis was done with using SPSS version 20. Descriptive analysis performs to find out the demographic profile and cross-tabulation between independent and dependent variables to explore the association.

Among 105 respondents, age category shows 0–5 years comprises 24 (22.9), 6–10 years comprises 72 (68.6%), and 11–15 years comprises 9 (8.6%). Male shows 10 (9.5) and female shows 95 (90.5). Fathers’ highest education showed masters 10 (9.6) and lowest was illiterate 6 (5.7%), most of them passed Higher Secondary Certificate (HSC) means 33 (31.4%). Mothers’ highest education showed masters 6 (5.7) and lowest educational background was illiterate 6 (5.7%), most of them were passed the Secondary School Certificate (SSC) 38 (36.2%). Fathers’ occupation showed that lion’s portion involved with service which comprises 57 (54.3%) and businessmen were 23 (21.9%). Mothers’ occupation showed that most of them were housewives 99 (94.3%).

Table 1 shows father’s education is strongly associated with PT attitude (p=70.37, x=0.000), PT co-operation (p=36.46, x=0.006), improvement from initial Rx (p=59.36, x=0.000), F7: PT experience (p=44.05, x=0.001), F8: Equipment used for Rx (p=41.83, x=0.001). F9: Environment of the organization (p=42.26, x=0.001), F10: Service delivery system of the organization (p=45.45, x=0.005), F11: Rx fees of the organization (p=49.43, x=0.002), F12: Home exercise log book form organization does not seem correlation (p=17.62, x=0.481). Mothers’ education strongly associated with every category. Fathers’ occupation looked poorly correlate with the categories two and three; however, there were strong correlation with category one of physiotherapist interpersonal skill (p=33.56, x=0.004), in category three treatment fees of the organization (p=31.90, x=0.044). Mothers’ occupation found poorly correlate with categories one, three, and four; however, category two found strong correlation with physiotherapy co-operation (p=14.97, x=0.020), improvement from initial treatment (p=22.81, x=0.004), physiotherapy experience (p=20.15, x=0.003), equipment used for treatment (p=16.10, x=0.013). We did not find any strong association with marital status.

Age category of children shows 0–5 years comprises 24 (22.9%), 6–10 years comprises 72 (68.6%), and 11–15 years comprises 9 (8.6%). Evidence shows that 4–16.7-year-old children in a randomized control trail reported positive changes after physical activity involvement four weeks after intervention [11]. Among parents male showed 10 (9.5%) and female showed 95 (90.5%). Fathers’ highest education showed masters 10 (9.6%) and lowest was illiterate 6 (5.7%), most of them passed HSC means 33 (31.4%). Mothers’ highest education showed masters 6 (5.7%) and lowest educational background was illiterate 6 (5.7%), most of them were passed the SSC 38 (36.2%). Fathers’ occupation shows lion’s portion involved with service which comprises 57 (54.3%) and businessmen were 23 (21.9%). Mothers’ occupation showed most of them were housewives 99 (94.3%) (Table 2). Fathers’ education was strongly associated with PT attitude (p=70.37, x=0.000), PT co-operation (p=36.46, x=0.006), improvement from initial Rx (p=59.36, x=0.000), PT experience (p=44.05, x=0.001), equipment uses for Rx (p=41.83, x=0.001). Environment of the organization (p=42.26, x=0.001), service delivery system of the organization (p=45.45, x=0.005), Rx fees of the organization (p=49.43, x=0.002), home exercise log book form organization does not seem correlation (p=17.62, x=0.481). Mothers’ education strongly associated with every category. A study shows higher the education has higher the chances of appointment whereas lower the educational status had not attended their appointment [12].

A perception study shows 13 parents faced problem with arranging money, time, and regular follow-up where 17 parents were satisfied [13]. Fathers’ occupation looked poorly correlate with the categories two and three; however, there are strong correlation with category one of physiotherapist interpersonal skill (p=33.56, x=0.004), in category three treatment fees of the organization (p=31.90, x=0.044). Mothers’ occupation found poorly correlate with categories one, three, and four; however, category two found strong correlation with physiotherapy co-operation (p=14.97, x=0.020), improvement from initial treatment (p=22.81, x=0.004), physiotherapy experience (p=20.15, x=0.003), equipment used for treatment (p=16.10, x=0.013). We did not find any strong association with marital status.

This study helps us to explore the influencing factor that is responsible for CP child’s parents to come for physiotherapy follow-up which is helpful to comply with the organizational policy. As this study is done with single centered, for better result if it is done with multiple centers with more data then the result could be more vibrant and acceptable by any policy maker and for organization get the proper direction.