Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Disabil Rehabil. 2011;33(12):989-98. doi: 10.3109/09638288.2010.520811. Epub 2010 Sep 28.
Previous literature has highlighted marginalisation and stigma of children with disabilities in developing countries, but few studies have explored the central care-giving environment and the relationship of the mother and her child with disabilities in this context. A group of women caring for children with disabilities in a low income community in Karachi, Pakistan was identified for the study. The aims were: (1) to explore the influence children with disabilities have on the daily lives of their mothers, (2) to describe the factors which influence the care-giving capacity of mothers.
A participatory qualitative research design was implemented. A women's group of caregivers of children with disabilities was formed. Several different tools were used during the course of the group meetings to facilitate discussion including social mapping. A thematic analysis of issues around care-giving and the relationship between the mother and her child with disabilities was conducted.
In a society where women may experience restrictions in freedom of movement and decision making, caring for a child with disabilities enabled women to move beyond traditional boundaries in seeking health and education services for their children. However, the gain in empowerment was counter-acted by a lack of care-giving support, a lack of appropriate services for health, rehabilitation and education of children with disabilities and stigma creating anxiety and stress for women.
While children with disabilities do have some positive effects on the lives of their mothers, there are many more factors which create anxiety for this group of mothers (including a lack of care-giving support and stigma). Community-based rehabilitation strategies should consider the care-giving environment of children with disabilities and shift from a child only to family focus. Interventions which support, empower and strengthen the capacity of mothers are essential for the well being of their children with disabilities.
先前的文献强调了发展中国家残疾儿童的边缘化和耻辱感,但很少有研究探讨过在这种背景下残疾儿童的核心照顾环境以及母亲与其残疾儿童的关系。在巴基斯坦卡拉奇的一个低收入社区中,确定了一群照顾残疾儿童的妇女进行这项研究。目的是:(1)探讨残疾儿童对其母亲日常生活的影响,(2)描述影响母亲照顾能力的因素。
采用参与式定性研究设计。成立了一个残疾儿童照顾者妇女小组。在小组会议期间,使用了几种不同的工具来促进讨论,包括社会绘图。对照顾问题和残疾儿童与母亲之间关系的主题进行了分析。
在一个妇女可能在行动和决策自由方面受到限制的社会中,照顾残疾儿童使妇女能够超越传统界限,为子女寻求健康和教育服务。然而,赋权的增加被缺乏照顾支持、缺乏残疾儿童健康、康复和教育的适当服务以及对妇女造成焦虑和压力的耻辱感所抵消。
虽然残疾儿童确实对其母亲的生活有一些积极影响,但也有更多因素给这群母亲带来焦虑(包括缺乏照顾支持和耻辱感)。基于社区的康复策略应考虑残疾儿童的照顾环境,从以儿童为中心转变为以家庭为中心。支持、赋权和加强母亲能力的干预措施对于残疾儿童的福祉至关重要。