This thesis, framed in the research area of health and care sciences, describes children’s problems with functioning in everyday life after ending brain tumour treatment. Such problems can affect the child’s likelihood of participating in everyday life activities, that are important for their development and health. Therefore, it is important to comprehensively assess the child’s problems with functioning following brain tumour treatment, to find out what support is required and how the support can be given.

The overall aim of this thesis was to explore patterns of documented problems with functioning in everyday life for children who have completed brain tumour treatment and to develop a protocol to test the feasibility of a child directed intervention to meet these problems.

This thesis comprises four scientific papers (I-IV) that uses retrospective (I-III), case-focused (II-III), longitudinal (III) and prospective designs (IV), with qualitative and quantitative methods to meet the overall aim. In Papers I-III, data were collected by using a standardized data extraction form and retrospectively reviewing problems written in professional records after the child completed brain tumour treatment. Retrieved problems were linked to suitable codes within the International Classification of Functioning, disability and health (ICF) framework. Paper I uses descriptive statistics to portray frequency of ICF linked problems on service and group levels, with network diagrams displaying the inter-relatedness of the problems. Paper II illustrate variations of problems within body, activity, participation and environment, on individual and group levels. In Paper II-III, an in-depth analysis of tentatively constructed patterns of co-occurring problems with participation was performed, guided by the collaborative problem-solving (CPS) model. In Paper III, trends of problems in six-month periods over four years of follow-up in health care, habilitation and school, were shown. In paper IV, a child-directed intervention protocol based on the CPS model was developed to evaluate the feasibility of content and procedures.

The findings from Paper I revealed that most problems were documented in health care records, and few problems were documented in habilitation and school records. The most frequent documented problems were related to the child´s physical and psychological body function (fatigue, memory), followed by problems with activity (reading, fine hand use) and participation (education, peer relations). Problems related to environmental factors (aids, service support) were limited. The network diagrams showed that the ICF linked problems formed clusters of inter-related physical- (energy, movement), cognitive- (memory, sense-of-self), participation- (school, friendship) and environment-related problems (service support, aids). The findings from paper II showed individual variations in the proportion of problems within body, activity, participation and environment, when compared to the group. In the tentative constructed case analyses in paper II-III, the findings showed that all children had participation problems related to education and peer-relations, with the third child-case (Paper III) also having problems to care for personal health. The evaluation of the feasibility of the child-directed intervention protocol, described in paper IV, will be tested in a future research study.

Through the lens of a bio-psychosocial understanding of the child´s functioning in everyday life, professionals can contribute to identify facilitators and barriers for the child´s functioning, to furthermore tailor child- supportive interventions collaboratively, to enhance the child´s participation and thus their health in everyday life.