Heaton Janet, Noyes Jane, Sloper Patricia, Shah Robina
Social Policy Research Unit, University of York, UK.
Health Soc Care Community. 2005 Sep;13(5):441-50. doi: 10.1111/j.1365-2524.2005.00571.x.
In the present study, families' experiences of caring for a technology-dependent child were examined from a temporal perspective. This involved exploring the multiple 'technological', 'social' and 'natural' rhythms and routines around which the families' lives were variously structured. A purposive sample of 36 families with technology-dependent children who used one or more medical devices on a daily basis was recruited. Devices included feeding pumps, suction machines, dialysis machines and ventilators. Using mainly qualitative methods, children, parents and siblings were interviewed to establish what the care routines involved and how these impacted on family members. The authors found that the rhythms and routines of care varied across the sample, depending on the type and number of devices used, the individual child's needs, and who provided technical care during the day and/or at night at home and in other settings. While the children's health and quality of life benefited from the technology, the time demands of the care routines and lack of compatibility with other social and institutional timeframes had some negative implications for the children and their families, limiting their participation in school, employment and social life in general. The need to use and oversee the use of some medical technologies at night also meant that many parents suffered regular disruption to their sleep. In conclusion, the authors argue that the care of technology-dependent children at home places considerable time demands on families. Families have little or no access to suitably trained carers who can provide technical care required in the home or away from the home to give parents and the whole family a break from caring where required. More trained carers and short-term care provision, better coordination of services and improvements in the design of devices would all help to reduce the negative effects of the care routines on families.
在本研究中,从时间角度审视了家庭照顾技术依赖型儿童的经历。这涉及探索围绕家庭生活构建的多种“技术”“社会”和“自然”节奏与日常安排。招募了36个有技术依赖型儿童的家庭作为目的抽样,这些家庭每天使用一种或多种医疗设备。设备包括喂养泵、吸痰机、透析机和呼吸机。主要采用定性方法,对儿童、父母和兄弟姐妹进行访谈,以确定护理日常安排的内容以及这些安排如何影响家庭成员。作者发现,护理的节奏和日常安排因样本不同而有所差异,这取决于所使用设备的类型和数量、个别儿童的需求,以及白天和/或晚上在家中和其他场所提供技术护理的人员。虽然技术使儿童的健康和生活质量受益,但护理日常安排的时间需求以及与其他社会和机构时间框架的不兼容性对儿童及其家庭产生了一些负面影响,限制了他们总体上参与学校、就业和社会生活。夜间使用和监督某些医疗技术的需求也意味着许多父母的睡眠经常受到干扰。总之,作者认为在家照顾技术依赖型儿童给家庭带来了相当大的时间需求。家庭几乎无法获得经过适当培训的护理人员,这些人员无法在家庭内外提供所需的技术护理,以便在需要时让父母和整个家庭从照顾中解脱出来。更多经过培训的护理人员和短期护理服务、更好的服务协调以及设备设计的改进都将有助于减少护理日常安排对家庭的负面影响。