Human Development Research Foundation, Islamabad, Pakistan.
Int J Ment Health Syst. 2014 Feb 1;8(1):7. doi: 10.1186/1752-4458-8-7.
There are at least 50 million children with an intellectual or developmental disorder in South Asia. The vast majority of these children have no access to any service and there are no resources to develop such services. We aimed to explore a model of care-delivery for such children, whereby volunteer family members of affected individuals could be organized and trained to form an active, empowered group within the community that, a) using a task-sharing approach, are trained by specialists to provide evidence-based interventions to their children; b) support each other, with the more experienced FaNs i.e. family networks, providing peer-supervision and training to new family members who join the group; and c) works to reduce the stigma associated with the condition.
We used qualitative methods to explore carers' perspectives about such a care-delivery model.
The key findings of this research are that there is a huge gap between the needs of the carers and available services. Carers would welcome a volunteer-led service, and some community members would have time to volunteer. Raising community awareness in a culturally sensitive manner prior to launching such a service and linking it to the community health workers programme would increase the likelihood of success. Gender-matching would be important. It would be possible to form family networks around the more motivated volunteers, with support from local non-governmental organizations. The carers were receptive to the use of technology to assist the work of the volunteers as well as for networking.
We conclude that family volunteers delivering evidence-based packages of care after appropriate training is a feasible system that can help reduce the treatment gap for childhood intellectual and developmental disorders in under-served populations.
南亚地区至少有 5000 万儿童存在智力或发育障碍。这些儿童绝大多数无法获得任何服务,也没有资源来开发此类服务。我们旨在探索一种针对此类儿童的护理提供模式,即受影响个体的志愿家庭成员可以组织和培训,在社区内形成一个积极、有能力的群体,a)通过任务分担的方法,接受专家培训,为其子女提供循证干预措施;b)相互支持,经验更丰富的 FaNs 即家庭网络,为新加入小组的家庭成员提供同伴监督和培训;c)努力减少与病情相关的耻辱感。
我们使用定性方法来探讨护理人员对这种护理提供模式的看法。
这项研究的主要发现是,护理人员的需求与现有服务之间存在巨大差距。护理人员将欢迎志愿者主导的服务,并且一些社区成员有时间自愿参加。在推出此类服务之前,以对文化敏感的方式提高社区意识,并将其与社区卫生工作者计划联系起来,将增加成功的可能性。性别匹配将很重要。可以在更有积极性的志愿者周围形成家庭网络,并得到当地非政府组织的支持。护理人员愿意接受技术的使用,以协助志愿者的工作以及网络建设。
我们的结论是,经过适当培训后,由家庭志愿者提供循证护理包是一种可行的系统,可以帮助减少服务不足人群中儿童智力和发育障碍的治疗差距。