Liabo K, McKenna C, Ingold A, Roberts H
University of Exeter Medical School, Exeter, UK.
Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK.
Child Care Health Dev. 2017 Mar;43(2):182-191. doi: 10.1111/cch.12426. Epub 2016 Nov 29.
Young people in residential or foster care experience multiple transitions around their 18 birthday without the long term and consistent support from their family of origin that most of their peers can expect. We report a mixed methods qualitative study of transitions across health and social care services for children leaving care, providing narratives of what young people described as positive, and what they and professionals think might be improved.
Data were collected in participatory meetings and individual interviews between young people and researchers (n = 24) and individual interviews with practitioners (n = 11). In addition to discussion and interview techniques, we used pictorial and other participatory methods. Interviews were coded by three members of the team and differences resolved with a fourth. Our analysis draws on thematic and framework approaches.
Health was rarely at the top of any young person's agenda, although gaps in health care and exceptional care were both described. Housing, financial support and education took priority. Young people and professionals alike emphasized the importance of workers prepared to go the extra mile; of young people being able to contact professionals; and professionals being able to contact one another.
Policy and practice aspirations for care leavers recommend gradual change but transfer rather than transition continues to be described by care leavers. Our data support the need for transition as a long-term process, with children and young people having early opportunities to prepare for citizenship.
进入寄宿或寄养机构的年轻人在18岁生日前后会经历多次转变,却得不到大多数同龄人所能期待的来自原生家庭的长期且持续的支持。我们报告了一项针对离开寄养机构的儿童在健康和社会护理服务方面转变的混合方法定性研究,呈现了年轻人所描述的积极方面,以及他们和专业人士认为可能需要改进之处。
数据收集于年轻人与研究人员的参与式会议及个人访谈(n = 24),以及与从业者的个人访谈(n = 11)。除讨论和访谈技巧外,我们还使用了图片及其他参与式方法。访谈由团队的三名成员进行编码,分歧由第四名成员解决。我们的分析采用了主题和框架方法。
健康很少处于任何年轻人议程的首位,尽管医疗保健差距和特殊护理都被提及。住房、经济支持和教育更为优先。年轻人和专业人士都强调了工作人员愿意付出额外努力的重要性;年轻人能够联系专业人士;以及专业人士能够相互联系。
针对离开寄养机构者的政策和实践期望建议逐步改变,但离开寄养机构者仍将其描述为转移而非转变。我们的数据支持将转变作为一个长期过程的必要性,让儿童和年轻人有早期机会为成为公民做准备。