Sharma Niraj, Lalinde Paula S, Brosco Jeffrey P
University of Miami Leonard M. Miller School of Medicine, Miami, FL 33101, USA.
Pediatr Rehabil. 2006 Jul-Sep;9(3):185-9. doi: 10.1080/13638490600570606.
Attitudes of medical providers towards persons with disabilities can affect the quality of care their patients receive. The authors evaluated an experiential learning module to investigate what Paediatric and Medicine/Paediatric residents at the University of Miami/Jackson Memorial Hospital learn from visiting the homes of families with children who have disabilities.
Families were recruited through a community-based parent organization. The families were instructed to discuss what it is like to have a child with a disability and to think about a primary message to give to residents during a 1-2 hour home visit. Since 1998, residents participated as part of the required Developmental Paediatrics rotation. They were instructed to write a one-page narrative description of their visit. The authors utilized the grounded theory of qualitative research and content analysis to count the key themes identified in the residents' descriptions.
Twenty-four families and 63 residents participated in the learning module. The resident observations yielded four major themes. Twenty-four per cent stated families needed more information; 79% noted that families face various obstacles, including financial (33%), medical providers' pessimism (29%), inter-personal family conflicts (27%) and medical system problems (22%); 49% of residents commented that families adjust and cope with their child's disability; and 27% of residents stated that the experience changed their insight about children with disabilities.
The authors' study suggests that a single home visit with the family of a child with a disability provides paediatrics and medicine/paediatrics residents with insights into the family's perspective on disability otherwise unattainable in a hospital-based training programme.
医疗服务提供者对残疾人的态度会影响其患者所接受的护理质量。作者评估了一个体验式学习模块，以调查迈阿密大学/杰克逊纪念医院的儿科及内科/儿科住院医师在走访有残疾儿童的家庭中学到了什么。
通过一个社区家长组织招募家庭。这些家庭被要求讨论养育一个残疾孩子是什么样的，并思考在1至2小时的家访中要传达给住院医师的主要信息。自1998年以来，住院医师作为发育儿科必修轮转课程的一部分参与其中。他们被要求写一页关于此次家访的叙述性描述。作者运用定性研究的扎根理论和内容分析法来统计住院医师描述中确定的关键主题。
24个家庭和63名住院医师参与了该学习模块。住院医师的观察得出了四个主要主题。24%的人表示家庭需要更多信息；79%的人指出家庭面临各种障碍，包括经济方面（33%）、医疗服务提供者的悲观态度（29%）、家庭内部人际冲突（27%）和医疗系统问题（22%）；49%的住院医师评论说家庭会适应并应对孩子的残疾状况；27%的住院医师表示这次经历改变了他们对残疾儿童的看法。
作者的研究表明，与有残疾孩子的家庭进行一次家访，能让儿科及内科/儿科住院医师了解到在基于医院的培训项目中无法获得的家庭对残疾问题的看法。
