Neuropsychology reports for childhood brain tumor survivors: implementation of recommendations at home and school.
BACKGROUND
As pediatric brain tumor survivors may experience cognitive decline post-treatment, a neuropsychology assessment is often conducted. The assessment evaluates the child's cognitive functioning and highlights potential challenges. Whilst neuropsychology reports provide recommendations for the home and school, how this translates in practice is under researched. This study explored parent and teacher understanding of neuropsychology reports, implementation rates for recommendations and their perceived effectiveness. Barriers to implementation were also investigated.


METHODS
Twenty-five semi-structured interviews were conducted with 17 parents and 8 teachers of childhood brain tumor survivors from 15 Australian families who had received a neuropsychology report within 2 years of the interview. Twenty-four neuropsychology reports encompassing 131 recommendations were reviewed. The qualitative methodological framework of Miles and Huberman [Miles M, Huberman A. Qualitative data analysis: An expanded sourcebook. London: Sage; 1994] was used to analyze interview transcripts with QSR NVivo 9.0.


RESULTS
The majority of parents and teachers had a sound understanding of the report. Implementation of recommendations at home and school was 47% and 41%, respectively. Recommendations that did not require extra effort and organization appeared more likely to be implemented, however, those perceived to be more effective or helpful did not necessarily have higher implementation rates. Key reported barriers to implementation barrier were patient reluctance, and a lack of parents' willingness to adopt the recommendation.


CONCLUSIONS
Patient understanding and willingness play a significant role in the implementation of neuropsychology recommendations. Collaboration and clear communication between the patient, teacher, parent, and neuropsychologist is vital for effective management.
School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Lorraine L T
LL
Cheung
Claire E
CE
Wakefield
Sarah J
SJ
Ellis
Anna
A
Mandalis
Eleanor
E
Frow
Richard J
RJ
Cohn
D000293:Adolescent; D001315:Australia; D001932:Brain Neoplasms / Q000150:complications / Q000523:psychology / Q000534:rehabilitation* / Q000628:therapy; D002648:Child; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D004519:Education, Special; D005260:Female; D019983:Guideline Adherence; D006701:Home Nursing; D006801:Humans; D007859:Learning Disabilities / Q000209:etiology / Q000534:rehabilitation*; D008297:Male; D009483:Neuropsychological Tests; D009484:Neuropsychology; D010290:Parents / Q000523:psychology; D011368:Professional-Family Relations; D015397:Program Evaluation; D012017:Referral and Consultation; D012574:Schools; D017741:Survivors / Q000523:psychology*
behavioral studies; brain tumors; neuro-oncology; pediatric oncology; psychosocial