Research article

Psychosocial problems among mothers of children with cerebral palsy attending physiotherapy outpatient department of two selected tertiary health centres in Ogun state: A pilot study

  • Background: Caring for a child with cerebral palsy (CP) can be exhausting and stressful. There is paucity of information on the consequence of having a child with CP on mothers of these children. This study explored psychosocial problems encountered by mothers of children with CP receiving physiotherapy care in two selected tertiary health centres in Ogun State, Nigeria. Methods: A qualitative study was conducted through focus group discussion (FGD) utilizing 17 questions identified in the literature as a FGD guide. Participants were seven mothers of children with CP. The framework approach was used for thematic analysis of data. Results: The psychosocial challenges encountered by the mothers were associated with nine common sub-themes. These are: (i) stress of caring for over dependent child; (ii) mothers’ restricted participation in the society; (iii) financial constraint experienced by the mothers of children with CP; (iv) health problems experienced by mothers of children with CP; (v) feelings of uncertainty about the child’s future; (vi) society’s negative perception of child’s problems; (vii) support obtained by the caregivers from others; (viii) availability of support from healthcare facilities; and (ix) Personal belief about condition. Conclusion: Mothers of children with cerebral palsy experience substantial psychological and social problems that are often ignored by the general populace.

    Citation: Ogunlana Michael, Oyewole Olufemi, Falola Jasola, Davis Abigail, Lateef Adetutu, Adepoju Modinat. Psychosocial problems among mothers of children with cerebral palsy attending physiotherapy outpatient department of two selected tertiary health centres in Ogun state: A pilot study[J]. AIMS Medical Science, 2019, 6(2): 158-169. doi: 10.3934/medsci.2019.2.158

    Related Papers:

    [1] Tariq Shah, Muhammad Zohaib, Qin Xin, Bander Almutairi, Muhammad Sajjad . Generalization of RSA cryptosystem based on 2n primes. AIMS Mathematics, 2023, 8(8): 18833-18845. doi: 10.3934/math.2023958
    [2] Hanan Alohali, Muhammad Bilal Khan, Jorge E. Macías-Díaz, Fahad Sikander . On $ \left(\mathit{p}, \mathit{q}\right) $-fractional linear Diophantine fuzzy sets and their applications via MADM approach. AIMS Mathematics, 2024, 9(12): 35503-35532. doi: 10.3934/math.20241685
    [3] Xiaodan Yuan, Jiagui Luo . On the Diophantine equation $\frac{1}{x}+\frac{1}{y}+\frac{1}{z}=\frac{1}{3p}$. AIMS Mathematics, 2017, 2(1): 111-127. doi: 10.3934/Math.2017.1.111
    [4] Ramkumar Kasinathan, Ravikumar Kasinathan, Dumitru Baleanu, Anguraj Annamalai . Well posedness of second-order impulsive fractional neutral stochastic differential equations. AIMS Mathematics, 2021, 6(9): 9222-9235. doi: 10.3934/math.2021536
    [5] Limin Zhou, Qiuyang Wang . Simple PKE schemes from the TSPEM problem. AIMS Mathematics, 2024, 9(8): 22197-22212. doi: 10.3934/math.20241079
    [6] Majid Khan, Hafiz Muhammad Waseem . An efficient confidentiality scheme based on quadratic chaotic map and Fibonacci sequence. AIMS Mathematics, 2024, 9(10): 27220-27246. doi: 10.3934/math.20241323
    [7] Yuchan Qi, Huaning Liu . Binary sequences and lattices constructed by discrete logarithms. AIMS Mathematics, 2022, 7(3): 4655-4671. doi: 10.3934/math.2022259
    [8] Wedad Albalawi, Muhammad Imran Liaqat, Fahim Ud Din, Kottakkaran Sooppy Nisar, Abdel-Haleem Abdel-Aty . Well-posedness and Ulam-Hyers stability results of solutions to pantograph fractional stochastic differential equations in the sense of conformable derivatives. AIMS Mathematics, 2024, 9(5): 12375-12398. doi: 10.3934/math.2024605
    [9] Shuqin Zhang, Jie Wang, Lei Hu . On definition of solution of initial value problem for fractional differential equation of variable order. AIMS Mathematics, 2021, 6(7): 6845-6867. doi: 10.3934/math.2021401
    [10] Muhammad Asim Khan, Norma Alias, Umair Ali . A new fourth-order grouping iterative method for the time fractional sub-diffusion equation having a weak singularity at initial time. AIMS Mathematics, 2023, 8(6): 13725-13746. doi: 10.3934/math.2023697
  • Background: Caring for a child with cerebral palsy (CP) can be exhausting and stressful. There is paucity of information on the consequence of having a child with CP on mothers of these children. This study explored psychosocial problems encountered by mothers of children with CP receiving physiotherapy care in two selected tertiary health centres in Ogun State, Nigeria. Methods: A qualitative study was conducted through focus group discussion (FGD) utilizing 17 questions identified in the literature as a FGD guide. Participants were seven mothers of children with CP. The framework approach was used for thematic analysis of data. Results: The psychosocial challenges encountered by the mothers were associated with nine common sub-themes. These are: (i) stress of caring for over dependent child; (ii) mothers’ restricted participation in the society; (iii) financial constraint experienced by the mothers of children with CP; (iv) health problems experienced by mothers of children with CP; (v) feelings of uncertainty about the child’s future; (vi) society’s negative perception of child’s problems; (vii) support obtained by the caregivers from others; (viii) availability of support from healthcare facilities; and (ix) Personal belief about condition. Conclusion: Mothers of children with cerebral palsy experience substantial psychological and social problems that are often ignored by the general populace.


    The number of studies and discussions in terms of sustainable supply chain management (SSCM) has been increasing rapidly in recent years. As a result, emerged concepts related to sustainability, such as sustainable production and sustainable development, have gradually become more popular globally under various industries [1,2]. Incredibly, although it is easier to focus on the manufacturers and assess their efforts towards sustainability by eco-friendly products, conducted sustainability standards [1,3]. It is nevertheless clear that the SSCM can only be obtained by the contributions of all stakeholders in the supply chain consist of suppliers or customers [4]. In recent years, managers' cognition has been changed in this regard. In general, all issues related to the natural environment, community, or financial benefits are carefully considered under global competitive conditions [5,6]. Consequently, several scholars believed that the top management should integrate sustainability philosophy into business strategies to solve the pressures from stakeholders [3,7]. The evolution of the sustainability philosophy has influenced the organizations' development strategy. Some recent studies documented that under different research contexts would identify various parameters as well as barriers [1,8]. Such as, Zimon et al. (2020) have highlighted various drivers and barriers for the SSCM through the conditions of seventeen Sustainable Development Goals (SDGs) of the United Nations [2]. Combination employing ISM and AHP approach to pointed out twenty most essential factors of the SSCM by the Indian engine sector [9]. In the Iranian mining industries, forty-one SSCM barriers have been identified [10]. Besides, the different research methods of the scholars will also present inconsistent findings related to the parameters' importance, such as Delphi technique [7,11]; ISM approach [3,12]; or conducting simultaneously two techniques to address research objectives [8,9]. Thus, it is clear that these diversities have suggested many promising future research gaps for other scholars to be concerned with the SSCM practice topic in identifying the prevailing parameters.

    In Taiwan, numerous sustainability initiatives have been discussed and widely adopted in the various supply chains [13]. However, most studies only focus on Taiwan's vital industries, such as semiconductor manufacturing or electronics assembly [13,14]. Lack of research about the SSCM of agriculture sectors; meanwhile, the agricultural industries have great significance to the households of indigenous people, especially in rural areas [15]. Besides, several sustainable development policies have been published to improve the livelihood of that community group [16]. Recently, Taiwan's fresh fruit export industry is seriously affected by import bans from the Chinese market, and the total expected export value will be reduced by twenty percent in 2021 [17]. Thereby, this problem has a significant impact on Taiwan's fruit supply chain, particularly affecting farmers' livelihoods. Besides, excessive dependence on one market has seriously affected the sustainability of this supply chain. Thus, forcing Taiwan's fruit supply chain to change to ensure sustainability. According to the existing literature on the sustainable supply chain management topic, the authors aim to identify which essential parameters are given the attention and effect on the SSCM of the industry. Therefore, the Taiwanese fresh-fruit sector has been chosen for practical research to examine which parameters must be considered. This article aims to solve research objectives as follows: RO1. Identification of critical parameters for SSCM under the Taiwanese fresh-fruit sector; RO2. Evaluation to identify the most significant SSCM parameters in this context.

    Concentrating on the discussion in parameters contribute to the Taiwanese sustainable fresh-fruit supply chain context as a unique research and promising. The Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) is one of the multi-criteria decision-making methods and is an outstanding technique to widely conducted [4]. Its ability has an excellent quality to solve complex problems and evaluate the importance of parameters [4,18]. Thereby, to solve two research objectives that this manuscript would conduct the TOPSIS tool to present the most significant SSCM parameters by the empirical research in Taiwan. Hence, this study would reveal some new methodological insights that bridge academia and practice for SSCM regard. Importantly, the research findings will contribute several theoretical implications for the SSCM literature. Besides, it would suggest some suggestions for managers several practical implications in this regard.

    The existing literature recently revealed that the SSCM implementation topic had gained significant discussion in academics and practices thanks to the positive impact of sustainability in order to enhance business performance [2,19]. Although there are still controversial discussions about the definition of SSCM; however, most scholars agree that the SSCM implementation is in line with the economic, social, and environmental considerations to making business strategies [2,8]. Several recent studies indicated that under different research contexts would identify various parameters and barriers [1]. The examples can be Narimissa et al. (2020) suggested ten drivers and barrier to implement SSCM in the Iranian oil sector [7]. Consistent with that, Zimon et al. (2020) proposed the model for conducting SDGs in the SSCM [2]. After that, Pandey et al. (2021) employed the hybrid method to pointed out twenty most essential factors of the SSCM by the Indian engine sector [9]. Hence, these studies suggested promising future research gaps for other scholars to be concerned with the SSCM practice topic in identifying the prevailing parameters.

    Furthermore, to determine the research gaps and identify the critical variables for SSCM; hence, the authors collect all papers related to SSCM practices and relevant impact elements based on the WoS and SCOPUS database. Several keywords for searching include "sustainable"; "supply chain management"; "parameter"; "barriers"; "elements"; "critical factors". As a result, a total of thirty-one journal papers have been assembled. They are discussed in various contexts, such as nations, industries, and approaches. A systematic analysis of all previous studies on the SSCM implementation topic has been conducted (presented Figure 1). The research gaps are identified in the following points relying on the existing SSCM implementation studies.

    Figure 1.  Analysis of co-occurrence of author keywords.

    Firstly, the SSCM literature has witnessed the lack of empirical research in Taiwan, especially agriculture sector [13,14]; meanwhile, developing nations are the most preferred research context, for instance, India (n = 10) and China (n = 4). This is the first empirical research in Taiwanese food industry for the SSCM practices regard.

    Secondly, sustainability studies regarding supply chain management have focused mainly on manufacturing, while the agricultural sector has experienced no specific research. Moreover, Taiwan's economy was well-known by the semiconductor manufacturing industry [14]; thus, conducting the study for the fresh-fruit supply chain has a significant impact on Taiwan's sustainable development, notably would broaden the SSCM practices literature in various sectors.

    Thirdly, in terms of research method conducted, the majority of documents prioritize employed qualitative methods, such as ISM (n = 9) and Delphi (n = 6). However, the existing literature does not record any studies that have conducted the TOPSIS approach to consider this issue. Besides, some researchers proposed the TOPSIS as an outstanding technique, its ability is deemed good-quality to solve complex problems and enough to evaluate the importance of elements [4,18]. Hence, conducting the TOPSIS technique in this study would offer some new methodological insights that bridge academia and practice for SSCM regard.

    According to the existing sustainability literature about supply chain management, twelve critical parameters reported to contribute to SSCM practices are demonstrated in Table 1.

    Table 1.  Identification the Critical Parameters of SSCM.
    Coding Parameters Brief Description Sources
    P1 Planning & Implementation The optimal design of the fresh fruit supply chain is inevitable, and it requires proper planning and implementation. [4,7,20,21,22]
    P2 Knowledge & Training of fruit preservation The preservation of post-harvest products needs to apply the latest knowledge and disseminate it to the stakeholders of the chain, particularly in farms and micro corporates. [4,23,24,25]
    P3 Farming area/ farmer As the first stage of the food supply chain, the essential role of farms to provide fresh products to the wholesalers, factories, and end customers. [5,15,26,27,28]
    P4 Processing & Packaging Fresh products need to maintain optimum quality for the longest time. Therefore, standardization and synchronization of processing and packaging must be attention for all the stages. [4,20,29,30,31]
    P5 Warehouse/Storage Warehouse acts as a transit station in the middle of the food supply chain, the quality of products will be significantly affected by storage operation in warehouses. [18,24,30,32]
    P6 Distribution & Logistics service The smooth flow of goods in the food supply chain will depend heavily on distribution channels and logistics services. [5,18,33,34]
    P7 Product quality & Safety Fresh goods have stringent requirements for standard product quality and safety. It is the participation of the whole chain and must be guaranteed from the stage of planting and harvesting to the end stage. [4,35,36]
    P8 Contracting Offering a variety of contracts for choose to ensure the benefits of each counterpart in the food supply chain. Thereby, it helps to reduce risks and conflicts among members. [12,18,37,38]
    P9 Technology adoption Adopting the latest technology to the supply chain is part of the stakeholders' efforts to obtain sustainability, such as minimizing the impact on the natural environment, reducing costs. [39,40,41]
    P10 Customer As the end-stage in the supply chain and consume products, the perceptions and reactions of this group is the driver and will significantly impact the sustainability initiatives of other stakeholders. [20,34,42,43]
    P11 Organizational social responsibilities Conducting social programs for the local communities has been launched in the sustainable development goals. Forcing the various organization to perform. [1,21,44,45]
    P12 Collaboration Collaboration among supply chain members would reinforce sustainability and obtain better performance by reducing financial constraints and production scale. [5,6,31,46,47].

     | Show Table
    DownLoad: CSV

    Pointing out optimal solutions according to various parameter selections, these results can be a resource to refer to before decision-making in many different practice situations. The authors assemble data through surveying with ten professionals in the SSCM expertise. They would play the role of decision-makers relying on their experience and knowledge. Collecting data has been done based on twelve clarified SSCM parameters. Employing the TOPSIS approach analyzes the expert's response to solving the second research objective.

    The authors can rank all SSCM parameters to determine the most significant variables for the current Taiwanese fresh-fruit supply chain. In this study, ten experts in the Taiwanese fresh-fruit supply chain were asked to rate all criteria. The language terms will be defined from 1 to 10; in detail, "1" means "Extremely unimportant", and "10" means "Extremely important". Consequently, the TOPSIS algorithm could be conducted by the following process:

    Step one: Relying on m alternative and n criteria having a rating of ith decision-makers and jth criteria. A matrix format as ${{\text{[}}{x_{ij}}{\text{]}}_{m*n}}$ can be expressed for a MCDM issues as below.

    $ \left\{ x11x12......x1nx21x22......x2n..xm1xm2......xmn
    \right\} i = 1, 2, ..., m ; j = 1, 2, ... , n $

    Step two: The normalize decision matrix has been calculated in Eq 1, where i = 1, 2, ..., n; and j = 1, 2, ..., m. And then, obtaining the normalized decision matrix by calculate the value ${{{r}}_{ij}}$.

    $ {r_{ij}} = \frac{{x_{ij}^{}}}{{\sqrt {\sum\limits_{i = 1}^n {x_{ij}^2} } }} $ (1)
    $ \left\{ r11r12......r1nr21r22......r2n..rm1rm2......rmn
    \right\} $

    Step three: The authors then construct the weighted normalized matrix by calculate $ {{{v}}_{ij}} $.

    $ {v_{ij}} = {{\text{w}}_j}*{{\text{r}}_{ij}} $ (2)
    $ \left\{ v11v12......v1nv21v22......v2n..vm1vm2......vmn
    \right\} $

    In details, wj = weights of different attributes; (i = 1, 2, …, n; j = 1, 2, …, m)

    Step four: Identifying the ideal solution consist of positive ideal solution (A+) and negative ideal solution (A-), the distance of these ideal solutions has been revealed by maximum and minimize value as below.

    $ {A^ + } = \left( {v_1^ + , v_2^ + , ..., v_n^ + } \right) \;\;\; {\rm{with}} \;\;\;\;{v_j}^ + = \left\{ {\max {x_i}.{v_{ij}}, {{\min }_i}.{v_{ij}}} \right\} $ (3)
    $ {A^ - } = \left( {v_1^ - , v_2^ - , ..., v_n^ - } \right) \;\;\;\;{\rm{with}} \;\;\;\;{v_j}^ - = \left\{ {{{\min }_i}.{v_{ij}}, \max {x_i}.{v_{ij}}} \right\} $ (4)

    Step five: Determining each alternative's distance by calculating the Euclidean distance from the positive and negative ideal solutions. Those solutions are calculated by two values as $s_i^ + $ and $s_i^ - $, and can be shown in Eqs 5 and 6, respectively.

    $ s_i^ + = \sqrt {\sum\limits_j {{{\left( {v_{ij}^ + - v_j^ + } \right)}^2}} } $ (5)
    $ s_i^ - = \sqrt {\sum\limits_j {{{\left( {v_{ij}^ - - v_j^ - } \right)}^2}} } $ (6)

    with i = 1, 2, ..., m and j = 1, 2, ..., n.

    Step six: The authors calculate the closeness coefficient values (CCi) of each alternative by the Eq 7:

    $ C{C_i} = \frac{{s_i^ - }}{{s_i^ - + s_i^ + }} \;\;\;\; {\rm{with}}\; i = 1, 2, ..., {\rm{m}} $ (7)

    Step seven: Determining the optimal solutions according to the CCi values range from 0 to 1 scale, the great solution according to the alternative value closest to 1 cutoff. Further, the authors also can determine exactly the rank of these alternatives thanks to these CCi values. These values will provide the key findings for the study to discuss.

    Integration sustainability initiatives into business strategies are widely conducted in almost all Taiwanese sectors, most of them concentrated on essential industries like semiconductor manufacturing or electronics assembly compared to agriculture industries [13,14,48]. However, the agriculture sector has a significant influence on the indigenous people's livelihood are struggling with different risks to obtain sustainable development goals [16]. For instance, in recent years observed that Taiwan's fresh fruit supply chain has been easily vulnerable to customer pressuring [17]. Thereby, this problem has a significant impact on social performance, particularly affecting farmers' livelihoods. Thus, forcing Taiwan's fruit supply chain to change to attain sustainability through identifying SSCM prevailing parameters.

    The authors assemble data for this study by interviewing ten experts regarding the Taiwanese fresh fruit supply chain. These respondents have a long experience along with their expertise in SSCM practices. Besides, they offer responses about twelve SSCM parameters. The respondents' personal information was also described in Table 2.

    Table 2.  Summary of respondent's demographic.
    Category Frequency Percentage
    Gender Male 7 70.0%
    Female 3 30.0%
    Age group 31-40 3 30.0%
    41-50 5 50.0%
    51-60 1 10.0%
    over 60 1 10.0%
    Degree Bachelor degree 4 40.0%
    Master degree 4 40.0%
    Ph.D. degree 2 20.0%
    Organizational Process Manufacturing 6 60.0%
    Service 4 40.0%
    Working Position Top Managers 3 30.0%
    Sales Department 3 30.0%
    Financial Management 1 10.0%
    Human Resource Management 2 20.0%
    Production Management 1 10.0%

     | Show Table
    DownLoad: CSV

    The second research objective requires determining the importance level of SSCM parameters. The Taiwanese fresh-fruit supply chain has been chosen for this empirical research to address this objective. The study assembles data for analysis relying on the excellent knowledge and experiences of ten experts (Es) in this regard. Following the sequence of seven steps in TOPSIS analysis, the findings would report the significance of all twelve SSCM parameters. Further, they are considered good suggestions for the top managers in the Taiwanese fresh-fruit supply chain toward sustainability.

    According to the years of experience of each respondent, that decides the weightage for each decision-maker (presented in Table 3). The normalized matrix of the respondents' answers has been conducted (follow Eq 1) to determine (${x_{ij}}$) values.

    Table 3.  The weighted normalized matrix.
    Parameters E1 E2 E3 E4 E5 E6 E7 E8 E9 E10
    Weight 0.13 0.10 0.18 0.12 0.11 0.11 0.06 0.05 0.05 0.09
    P1 0.0414 0.0319 0.0574 0.0489 0.0315 0.0160 0.0142 0.0177 0.0052 0.0276
    P2 0.0322 0.0283 0.0574 0.0381 0.0315 0.0279 0.0142 0.0132 0.0173 0.0221
    P3 0.0460 0.0212 0.0574 0.0272 0.0276 0.0359 0.0142 0.0132 0.0138 0.0166
    P4 0.0184 0.0319 0.0319 0.0272 0.0394 0.0279 0.0170 0.0155 0.0173 0.0276
    P5 0.0322 0.0177 0.0447 0.0326 0.0355 0.0319 0.0227 0.0132 0.0173 0.0276
    P6 0.0414 0.0319 0.0574 0.0272 0.0315 0.0359 0.0198 0.0110 0.0173 0.0276
    P7 0.0414 0.0354 0.0319 0.0326 0.0315 0.0359 0.0142 0.0110 0.0173 0.0276
    P8 0.0414 0.0354 0.0574 0.0272 0.0355 0.0319 0.0113 0.0132 0.0138 0.0276
    P9 0.0368 0.0248 0.0447 0.0326 0.0276 0.0359 0.0198 0.0177 0.0173 0.0276
    P10 0.0414 0.0319 0.0574 0.0381 0.0276 0.0319 0.0198 0.0132 0.0017 0.0221
    P11 0.0276 0.0212 0.0574 0.0326 0.0276 0.0279 0.0170 0.0199 0.0104 0.0276
    P12 0.0414 0.0283 0.0574 0.0435 0.0315 0.0359 0.0198 0.0110 0.0138 0.0276

     | Show Table
    DownLoad: CSV

    Then, conducting two Eqs 2 and 3 to explore (${{{r}}_{ij}}$) and ($ {{{v}}_{ij}} $) values, respectively. Table 3 demonstrate the weighted normalized decision matrix for this research.

    Thereby, the next step can be shown in Table 4, in detail, two essential values are pointed out includes positive (${A^ + }$) and negative ($ {A^ - } $) ideal solutions.

    Table 4.  The ideal solutions.
    Ideal Solutions E1 E2 E3 E4 E5 E6 E7 E8 E9 E10
    Positive (${A^ + }$) 0.0460 0.0354 0.0574 0.0489 0.0394 0.0359 0.0227 0.0199 0.0173 0.0276
    Negative ($ {A^ - } $) 0.0184 0.0177 0.0319 0.0272 0.0276 0.0160 0.0113 0.0110 0.0017 0.0166

     | Show Table
    DownLoad: CSV

    The Euclidean distance would be considered in step five by conducting two Eqs as 5 and 6 for each SSCM parameter. As a result, Table 5 and Table 6 are illustrate the positive and negative ideal solution values, respectively.

    Table 5.  Distance from the positive ideal solution.
    Parameters E1 E2 E3 E4 E5 E6 E7 E8 E9 E10
    P1 0.0046 0.0035 0 0 0.0079 0.0200 0.0085 0.0022 0.0121 0
    P2 0.0138 0.0071 0 0.0109 0.0079 0.0080 0.0085 0.0066 0 0.0055
    P3 0 0.0142 0 0.0218 0.0118 0 0.0085 0.0066 0.0035 0.0110
    P4 0.0276 0.0035 0.0255 0.0218 0 0.0080 0.0057 0.0044 0 0
    P5 0.0138 0.0177 0.0128 0.0163 0.0039 0.0040 0 0.0066 0 0
    P6 0.0046 0.0035 0 0.0218 0.0079 0 0.0028 0.0088 0 0
    P7 0.0046 0 0.0255 0.0163 0.0079 0 0.0085 0.0088 0 0
    P8 0.0046 0 0 0.0218 0.0039 0.0040 0.0113 0.0066 0.0035 0
    P9 0.0092 0.0106 0.0128 0.0163 0.0118 0 0.0028 0.0022 0 0
    P10 0.0046 0.0035 0 0.0109 0.0118 0.0040 0.0028 0.0066 0.0155 0.0055
    P11 0.0184 0.0142 0 0.0163 0.0118 0.0080 0.0057 0 0.0069 0
    P12 0.0046 0.0071 0 0.0054 0.0079 0 0.0028 0.0088 0.0035 0

     | Show Table
    DownLoad: CSV
    Table 6.  Distance from the negative ideal solution.
    Parameters E1 E2 E3 E4 E5 E6 E7 E8 E9 E10
    P1 0.0230 0.0142 0.0255 0.0218 0.0039 0 0.0028 0.0066 0.0035 0.0110
    P2 0.0138 0.0106 0.0255 0.0109 0.0039 0.0120 0.0028 0.0022 0.0155 0.0055
    P3 0.0276 0.0035 0.0255 0 0 0.0200 0.0028 0.0022 0.0121 0
    P4 0 0.0142 0 0 0.0118 0.0120 0.0057 0.0044 0.0155 0.0110
    P5 0.0138 0 0.0128 0.0054 0.0079 0.0160 0.0113 0.0022 0.0155 0.0110
    P6 0.0230 0.0142 0.0255 0 0.0039 0.0200 0.0085 0 0.0155 0.0110
    P7 0.0230 0.0177 0 0.0054 0.0039 0.0200 0.0028 0 0.0155 0.0110
    P8 0.0230 0.0177 0.0255 0 0.0079 0.0160 0 0.0022 0.0121 0.0110
    P9 0.0184 0.0071 0.0128 0.0054 0 0.0200 0.0085 0.0066 0.0155 0.0110
    P10 0.0230 0.0142 0.0255 0.0109 0 0.0160 0.0085 0.0022 0 0.0055
    P11 0.0092 0.0035 0.0255 0.0054 0 0.0120 0.0057 0.0088 0.0086 0.0110
    P12 0.0230 0.0106 0.0255 0.0163 0.0039 0.0200 0.0085 0 0.0121 0.0110

     | Show Table
    DownLoad: CSV

    Finally, the authors calculate the closeness ratio (CCi) values for all essential SSCM parameters to determine the importance level by Eq 7. Table 7 reports the ranking of twelve SSCM parameters for the Taiwanese fresh fruit sector based on their CCi values. Consequently, the final rank of the SSCM parameters in terms of the Taiwanese fresh-fruit industry is P12 > P6 > P10 > P8 > P1 > P2 > P9 > P3 > P7 > P5 > P11 > P4. Additionally, Figure 2 is expressed the results of these findings analysis related to the comparison among the ranked key parameters of SSCM implementation on the basis of CCi values.

    Table 7.  The ranking of SSCM parameters of the Taiwanese fresh-fruit sector.
    Parameters $s_i^ + $ $s_i^ - $ $ C{C_i} $ Ranking
    Collaboration (P12) 0.0162 0.0481 0.7485 1
    Distribution & Logistic service (P6) 0.0256 0.0472 0.6485 2
    Customer (P10) 0.0251 0.0431 0.6318 3
    Contracting (P8) 0.0266 0.0456 0.6313 4
    Planning & Implementation (P1) 0.0268 0.0453 0.6286 5
    Knowledge & Training of fruit preservation (P2) 0.0251 0.0389 0.6079 6
    Technology adoption (P9) 0.0279 0.0382 0.5777 7
    Farming area/ farmer (P3) 0.0326 0.0445 0.5772 8
    Product quality & Safety (P7) 0.0339 0.0407 0.5453 9
    Warehouse/Storage (P5) 0.0317 0.0346 0.5214 10
    Organizational social responsibilities (P11) 0.0330 0.0350 0.5151 11
    Processing & Packaging (P4) 0.0449 0.0300 0.4006 12

     | Show Table
    DownLoad: CSV
    Figure 2.  The SSCM parameters of the Taiwanese fresh-fruit sector.

    The experts' responses have documented that "Collaboration" has obtained the highest priority (CCi = 0.7485) among the SSCM parameters in the Taiwanese fresh-fruit sector. Meanwhile, the second importance level belongs to "Distribution & Logistics service" (CCi = 0.6485), and followed by "Customer" issues (CCi = 0.6318). On the contrary, the TOPSIS analysis reported that three parameters consist of "Warehouse/Storage" (CCi = 0.5214), "Organizational social responsibilities" (CCi = 0.5151), and "Processing & Packaging" (CCi = 0.4006) are located at the bottom of the ranking table. In the middle of the rankings are other variables; in detail, "Contracting" (CCi = 0.6313) and "Planning & Implementation" (CCi = 0.6286) have ranked fourth and fifth place, respectively. Meanwhile, other parameters consist of "Knowledge & Training of fruit preservation" (CCi = 0.6079), "Technology adoption" (CCi = 0.5777), "Farming area/ farmer" (CCi = 0.5772) and "Product quality and safety" (CCi = 0.5453) are the less critical level consecutively. These criteria have been recognized as critical parameters for the sustainability of the Taiwanese fresh-fruit supply chain, their importance level as the reference sources for this industry to consider and carry out. Particularly in the current competitive period, when even the most minor efforts are attention and could improve performance.

    In Taiwan's context, the agricultural industry has great significance to the livelihood of indigenous people, especially in remote areas [15]. Meanwhile, several sustainable development policies have been launched to enhance living conditions and improve the livelihood of the indigenous people [16]. Further, connecting sustainable agricultural development to other fields and therefore make a meaningful contribution towards sustainability [15]. Regarding the food supply chain, particularly in the fresh-fruit supply chain, which should face various risks from the production process to the end customers [1,34]. Thus, the Taiwanese fresh-fruit sector can refer to these twelve identified SSCM parameters as a reference resource in making decisions through these research findings. To contribute some managerial implications, based on ten experts' opinions, the data has been collected to analyze and discuss twelve identified parameters. The results analysis report that these variables have a different ranking from highest-priority to lowest. These findings indicate the importance level of various parameters for the SSCM of the Taiwanese fresh-fruit sector.

    In terms of the food supply chain, there is a presence and participation of many different stakeholders [5]. Thus, several solutions regarding collaboration have been discussed to promote and improve intimate cooperation among members in the food supply chain, besides targeting further obtaining supply chain sustainability [47]. Importantly, collaborating among suppliers will achieve better performance due to they could remove financial constraints and production scale, particularly suitable in the context of small and medium enterprises of agriculture industries [46]. Hence, in line with previous studies regarding the "Collaboration" variable [6,46,47], ten experts in this study believed that collaboration among members of the Taiwanese fresh-fruit supply chain is the most significance to obtain sustainability. In this research, "Distribution & Logistics service" variable obtained second place in the preoccupation of experts about SSCM practices. As the risk sector, the agriculture industry must determine the optimal time from the stage in collecting fresh products in various farms, distribution to the warehouses, then sending to the end customers [5]. Besides, avoiding damage to fresh fruit during transportation is very essential [33,34]. Dhaoui et al. (2020) explored the close relationship between the consumers' and distribution channels of these fresh products in Greece, such as fruit and vegetables. "Customer" parameter is rated higher than "Contracting" variable, two criteria are statistically significant at third and fourth positions, respectively. An interesting fact in the supply chain is that manufacturers that act as suppliers can also be customers of other suppliers [18]. The critical role of the customers variable in the food supply chain has been proven in other prior studies [34,42]. Thus, customers' expectations have become the targets of various suppliers [20,43]. To avoid risks from customers parameter, expanding the market scope to find more different customers has become a solution for suppliers in this area [31].

    Notably, considering "Contracting" as the supply chain parameters, Shen et al. [37] have divided into nine contracting clusters based on information. Besides, contracting with information updating among counterparts has been suggested to attain a sustainable supply chain. Surprisingly, these findings are consistent with the exploring of Chaudhuri et al. [12] and Xiao et al. [38], they have identified and particularly interested in contracting to reduce the risk for the food supply chain in India and China, respectively. Further, the study findings have contributed to the existing literature some promising ideas for the top managers when considering various proposed SSCM parameters. Although the remaining variables have lower CCi values; however, their significance for the food supply chain has been determined and verified once again by the fresh-fruit supply chain in Taiwan. Consequently, unfortunately, the analysis results witnessed the lowest values of some parameters, for instance, "Warehouse/Storage" [24,30,32], "Organizational social responsibilities" [1,44,45], and "Packaging & Processing" [4,20,30]. But the role of these criteria should not be underestimated or ignored. Ideally, to attain SSCM needs to conduct simultaneously different blueprints by the best efforts of all members.

    Sustainability target is an inevitable trend worldwide [23]. It forces all various industries and nations to adopt different solutions to obtain [1]. In fact, fresh agriculture products have great significance on the livelihoods of the Taiwanese indigenous communities [15,16]. Therefore, determining critical parameters for the fruits chain in Taiwan is the main contribution insight; as a result, twelve essential variables have been identified. Moreover, as a different approach insight, the authors employed the TOPSIS technique for this study to explore the importance level of all parameters. It is considered an excellent tool to address research objectives through comparison among closeness coefficients. Consequently, based on the experts' responses, this study successfully determined the role of these essential variables in the Taiwanese fresh-fruit chain. Analysis outcomes revealed that "Collaboration" at the peak of the list, "Distribution & Logistics service" obtained second place, and followed by "Customer" get the third position with their CCi values as 0.7485, 0.6485, 0.6318, respectively. On the contrary, at the bottom of the prioritized list is three essential parameters consisting of "Warehouse/Storage", "Organizational social responsibilities", and "Processing & Packaging" with their CCi values as 0.5214, 0.5151, 0.4006, respectively. Unsurprisingly, collaboration with the right partner toward obtain sustainability together is very emerging attention; for instance, Song et al. [49] reported that it is the most considerable risk factor in the telecommunications sector. Meanwhile, Pandey et al. [9] considered the collaboration parameter less essential in an engine manufacturing industry. The contradictory assessments compared to the findings of this study have presented in some previous studies, such as, Prasad et al. [50] believed that customer's influence ranks bottom among the twenty SSCM critical factors of the Indian steel industry. Hence, differences in the importance ranking of SSCM components in practices have been observed depending on various industries and countries' contexts, consistent with the suggestions of Panigrahi et al. [1] and Zimon et al. [2].

    As part of agricultural sustainability, the whole fruit supply chain members must carry out simultaneously these twelve identified critical parameters. Hence, these research results are a positive signal for senior managers to refer to making business decisions. This research is the first empirical research concentrating on the fresh-fruit supply chain in Taiwan to determine essential SSCM parameters, and provide the new theoretical insights to existing supply chain literature; unfortunately, this study cannot avoid certain limitations. Nevertheless, it can become promising suggestions to consider for others scholars to develop further. Firstly, this manuscript adopted the TOPSIS technique to analyze only ten professionals' responses. Therefore, the survey on a broader scale can be conducted to examine the impact of these variables on the SSCM performance in practices. Secondly, to broaden the concern of SSCM literature, particularly in the food supply chain, other scholars can suggest more parameters contribute to SSCM implementation. Thirdly, the Taiwanese fresh-fruit supply chain is considered as the case to examine the appropriateness of these SSCM parameters. Hence, the authors believe that these proposed SSCM criteria need to explore in another context, such as the national context, different supply chains of the agriculture sectors.

    The authors acknowledge the chief editor and the reviewers for their valuable comments to improve the manuscript.

    All authors declare no conflicts of interest in this paper.


    Abbreviation CP: Cerebral Palsy; FGD: Focus Group Discussion; CDC: Centre for Disease Control; QSR: Quality Service Regulation;
    Acknowledgments



    Ethics approval and consent to participate: Ethical approval was sought and obtained from the Federal Medical Centre Abeokuta Health Research Ethics Committee with protocol number FMCA/470/HREC/07/2017/13. Informed consent of the parents of children with cerebral palsy was obtained before participating in this research.
    Consent for publication: Alongside the informed consent form, consent for publication was obtained from the participants with assurance that no identifying information will be published.
    Availability of data and material: The datasets generated during and/or analysed during the current study are not publicly available because they contain individual person's information but are available from the corresponding author on reasonable request.
    Competing interests: The authors declare that they have no competing interests.
    Funding: The research was self funded by the authors.
    Authors' contributions: DAO and OOO were involved in recruiting participants for the study. The FGDs were facilitated by a team, comprising one moderator (OOM, OOO), one recorder (FLJ), one observer (DAO), and two persons (AMO, LAI) taking; written notes. OOM, OOO and FLJ analysed the data and composed the manuscript. All authors critically review the manuscript.
    Acknowledgements: We acknowledge the heads of department at the selected hospitals for their support towards the success of this research. We also acknowledge the participants for their patience and candor during the FGD sessions.

    Conflict of interest



    The author declares no conflicts of interest in this paper.

    [1] Arneson CL, Durkin MS, Benedict RE, et al. (2009) Prevalence of cerebral palsy: Autism and Developmental Disabilities Monitoring Network, three sites, United States, 2004. Disabil Health J 2: 45–48. doi: 10.1016/j.dhjo.2008.08.001
    [2] Christensen D, Van Naarden Braun K, Doernberg NS, et al. (2014) Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning-Autism and Developmental Disabilities Monitoring Network, USA, 2008. Dev Med Child Neurol 56: 59–65.
    [3] Odding E, Roebroeck ME, Stam HJ (2006) The epidemiology of cerebral palsy: incidence, impairments and risk factors. Disabil Rehabil 28: 183–191. doi: 10.1080/09638280500158422
    [4] Basaran A, Karadavut KI, Uneri SO, et al. (2013) The effect of having a children with cerebral palsy on quality of life, burn-out, depression and anxiety scores: a comparative study. Eur J Phys Rehabil Med 49: 815–822.
    [5] Olawale OA, Deih AN, Yaadar RK (2013) Psychological impact of cerebral palsy on families: The African perspective. J Neurosci Rural Pract 4: 159. doi: 10.4103/0976-3147.112752
    [6] Surender, S, Gowda VK, Sanjay KS, et al. (2016) Caregiver-reported health-related quality of life of children with cerebral palsy and their families and its association with gross motor function: A South Indian study. J Neurosci Rural Pract 7: 223–227. doi: 10.4103/0976-3147.178657
    [7] Parkes J, McCullough N, Madden A, et al. (2009) The health of children with cerebral palsy and stress in their parents. J Adv Nurs 65: 2311–2323. doi: 10.1111/j.1365-2648.2009.05089.x
    [8] Davis E, Shelly A, Waters E, et al. (2010) The impact of caring for a child with cerebral palsy: quality of life for mothers and fathers. Child Care Health Dev 36: 63–73. doi: 10.1111/j.1365-2214.2009.00989.x
    [9] Parkes J, Caravale B, Marcelli M, et al. (2011) Parenting stress and children with cerebral palsy: a European cross-sectional survey. Dev Med Child Neurol 53: 815–821. doi: 10.1111/j.1469-8749.2011.04014.x
    [10] Bhatia M, Joseph B (2000) Rehabilitation of cerebral palsy in a developing country: the need for comprehensive assessment. Pediatr Rehabil 4: 83–86.
    [11] Ketelaar M, Volman MJ, Gorter JW, et al. (2008) Stress in parents of children with cerebral palsy: what sources of stress are we talking about? Child Care Health Dev 34: 825–829. doi: 10.1111/j.1365-2214.2008.00876.x
    [12] Adogu PO, Ubajaka CF, Egenti NB, et al. (2016) Evaluation of risk factors of cerebral palsy in a tertiary health facility, Nnewi, Nigeria: a case–control study. Int J Med Sci Public Health 5: 109–114. doi: 10.5455/ijmsph.2016.2807201529
    [13] Frank-Briggs AI, Alikor EAD (2011) Sociocultural issues and causes of cerebral palsy in Port Harcourt, Nigeria. Niger J Paediatr 38: 115–119.
    [14] Ogunlesi T, Ogundeyi M, Ogunfowora O, et al. (2008) Socio-clinical issues in cerebral palsy in Sagamu, Nigeria. South Afr J Child Health 2.
    [15] Gale NK, Heath G, Cameron E, et al. (2013) Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol 13: 117. doi: 10.1186/1471-2288-13-117
    [16] Ansari NJ, Dhongade RK, Lad PS, et al. (2016) Study of Parental Perceptions on Health & Social Needs of Children with Neuro-Developmental Disability and It's Impact on the Family. J Clin Diagn Res 10: 16–20.
    [17] Chiluba BC, Moyo G (2017) Caring for a cerebral palsy child: a caregivers perspective at the University Teaching Hospital, Zambia. BMC Res Notes 10: 724. doi: 10.1186/s13104-017-3011-0
    [18] Gona JK, Mung'ala-Odera V, Newton CR, et al. (2011) Caring for children with disabilities in Kilifi, Kenya: what is the carer's experience? Child 37 175–183.
    [19] Gallagher S, Phillips AC, Carroll D (2010) Parental stress is associated with poor sleep quality in parents caring for children with developmental disabilities. J Pediatr Psychol 35: 728–737. doi: 10.1093/jpepsy/jsp093
    [20] Mohammed FMS, Ali SM, Mustafa MAA (2016) Quality of life of cerebral palsy patients and their caregivers: A cross sectional study in a rehabilitation center Khartoum-Sudan (2014–2015). J Neurosci Rural Pract 7: 355–361. doi: 10.4103/0976-3147.182778
    [21] Dambi JM, Jelsma J, Mlambo T (2015) Caring for a child with Cerebral Palsy: The experience of Zimbabwean mothers. Afr J Disabil 4: 168.
    [22] Michelsen SI, Flachs EM, Madsen M, et al. (2015) Parental social consequences of having a child with cerebral palsy in Denmark. Dev Med Child Neurol 57: 768–775. doi: 10.1111/dmcn.12719
    [23] Nimbalkar S, Raithatha S, Shah R (2014) A Qualitative Study of Psychosocial Problems among Parents of Children with Cerebral Palsy Attending Two Tertiary Care Hospitals in Western India. ISRN Fam Med 2014: 769619.
    [24] Paget A, Mallewa M, Chinguo D, et al. (2016) "It means you are grounded"-caregivers' perspectives on the rehabilitation of children with neurodisability in Malawi. Disabil Rehabil 38: 223–234. doi: 10.3109/09638288.2015.1035458
    [25] Yamaoka Y, Tamiya N, Moriyama Y, et al. (2015) Mental Health of Parents as Caregivers of Children with Disabilities: Based on Japanese Nationwide Survey. PLoS ONE 10: e0145200. doi: 10.1371/journal.pone.0145200
    [26] Al-Gamal E, Long T (2013) Psychological distress and perceived support among Jordanian parents living with a child with cerebral palsy: a cross-sectional study. Scand J Caring Sci 27: 624–631. doi: 10.1111/j.1471-6712.2012.01071.x
    [27] Jeong YG, Jeong YJ, Bang JA (2013) Effect of social support on parenting stress of Korean mothers of children with cerebral palsy. J Phys Ther Sci 25: 1339–1342. doi: 10.1589/jpts.25.1339
  • This article has been cited by:

    1. Abbott Po Shun Chen, Yung-Fu Huang, Manh-Hoang Do, Exploring the Challenges to Adopt Green Initiatives to Supply Chain Management for Manufacturing Industries, 2022, 14, 2071-1050, 13516, 10.3390/su142013516
    2. Nahiyah Jaidi, Jane Liu, Zahrotush Sholikhah, Mega Murti Andhini, Ambidexterity Behavior of Creative SMEs for Disruptive Flows of Innovation: A Comparative Study of Indonesia and Taiwan, 2022, 8, 2199-8531, 141, 10.3390/joitmc8030141
    3. Vu-Dung-Van Phan, Yung-Fu Huang, Thi-Them Hoang, Manh-Hoang Do, Evaluating Barriers to Supply Chain Resilience in Vietnamese SMEs: The Fuzzy VIKOR Approach, 2023, 11, 2079-8954, 121, 10.3390/systems11030121
    4. Yung-Fu Huang, Abbott Po-Shun Chen, Manh-Hoang Do, Jen-Chieh Chung, Assessing the Barriers of Green Innovation Implementation: Evidence from the Vietnamese Manufacturing Sector, 2022, 14, 2071-1050, 4662, 10.3390/su14084662
    5. Manh-Hoang Do, Yung-Fu Huang, Barriers to university social responsibility implementation in the Vietnamese higher education, 2023, 0951-354X, 10.1108/IJEM-11-2021-0432
    6. Manh-Hoang Do, Yung-Fu Huang, Vu-Dung-Van Phan, Analyzing the barriers to green supply chain management implementation: a case study of the Vietnamese agriculture sector, 2023, 1741-0398, 10.1108/JEIM-10-2021-0459
    7. Muhamad Rusliyadi, Yu Hua Chen, 2025, chapter 8, 9798369353509, 133, 10.4018/979-8-3693-5350-9.ch008
    8. Imadeddine Oubrahim, 2025, Chapter 18, 978-3-031-81377-1, 204, 10.1007/978-3-031-81378-8_18
    9. Damian Dubisz, Arkadiusz Kawa, Correlation Between Key Parameters of Wood Biomass Reverse Supply Chains and Their Impact on Total Biomass Acquisition Levels, 2023, 66, 2956-9141, 1, 10.12841/wood.1644-3985.449.06
  • Reader Comments
  • © 2019 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(8784) PDF downloads(2474) Cited by(4)

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog