Thompson Melanie, Elliott Catherine, Willis Claire, Ward Roslyn, Falkmer Marita, Falkmer Torbjӧrn, Gubbay Anna, Girdler Sonya
School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia.
School of Sport Science, Exercise and Health, University of Western Australia, Perth, Western Australia, Australia.
PLoS One. 2016 Jul 1;11(7):e0157951. doi: 10.1371/journal.pone.0157951. eCollection 2016.
Acquired brain injury (ABI) is a leading cause of permanent disability, currently affecting 20,000 Australian children. Community participation is essential for childhood development and enjoyment, yet children with ABI can often experience barriers to participation. The factors which act as barriers and facilitators to community participation for children with an ABI are not well understood.
To identify the viewpoints of parents of children with an ABI, regarding the barriers and facilitators most pertinent to community participation for their child.
Using Q-method, 41 parents of children with moderate/severe ABI sorted 37 statements regarding barriers and facilitators to community participation. Factor analysis identified three viewpoints.
This study identified three distinct viewpoints, with the perceived ability to participate decreasing with a stepwise trend from parents who felt their child and family "can" participate in viewpoint one, to "want" in viewpoint two and "try" in viewpoint three.
Findings indicated good participation outcomes for most children and families, however some families who were motivated to participate experienced significant barriers. The most significant facilitators included child motivation, supportive relationships from immediate family and friends, and supportive community attitudes. The lack of supportive relationships and attitudes was perceived as a fundamental barrier to community participation.
This research begins to address the paucity of information regarding those factors that impact upon the participation of children with an ABI in Australia. Findings have implications for therapists, service providers and community organisations.
获得性脑损伤（ABI）是导致永久性残疾的主要原因，目前影响着20000名澳大利亚儿童。社区参与对于儿童的发展和快乐至关重要，然而患有ABI的儿童在参与方面常常会遇到障碍。对于患有ABI的儿童而言，阻碍和促进其社区参与的因素尚未得到充分了解。
确定患有ABI的儿童的家长对于与其孩子社区参与最为相关的阻碍和促进因素的看法。
采用Q方法，41位中重度ABI儿童的家长对37条关于社区参与的阻碍和促进因素的陈述进行了分类。因子分析确定了三种观点。
本研究确定了三种不同的观点，从认为孩子和家庭“能够”参与的观点一的家长，到观点二中的“想要”参与以及观点三中的“尝试”参与，感知到的参与能力呈逐步下降趋势。
研究结果表明，大多数儿童和家庭的参与结果良好，然而一些有参与意愿的家庭却遇到了重大障碍。最重要的促进因素包括孩子的积极性、直系亲属和朋友的支持关系以及社区的支持态度。缺乏支持性的关系和态度被视为社区参与的根本障碍。
本研究开始解决澳大利亚关于影响ABI儿童参与的因素的信息匮乏问题。研究结果对治疗师、服务提供者和社区组织具有启示意义。
