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制定自闭症:移民家庭在实践中与疾病分类学的协商。

Enacting autism: Immigrant family negotiations with nosology in practice.

机构信息

Bahia School of Medicine and Public Health, Brazil.

Federal University of Recôncavo da Bahia, Brazil.

出版信息

Transcult Psychiatry. 2019 Apr;56(2):327-344. doi: 10.1177/1363461518818282. Epub 2018 Dec 13.

Abstract

This article describes how autism spectrum disorder is experienced in the context of immigrant families and how the meaning of this condition, proposed by professionals in the host country, is negotiated between families and healthcare providers. The study sample consists of 44 parents of different nationalities and their 35 children with autism spectrum disorder (ASD) living in a socioeconomically deprived neighborhood of Montreal, Canada. Individual parent interviews were audiotaped and transcribed for subsequent analysis. Results suggest that - although they may sometimes be a source of anxiety - the uncertainties regarding the etiology of ASD, as well as the gap between the explanatory models (EMs) proposed by host country professionals and the impressions of parents, seem to increase the capacity of families to resist the imposition of what they perceive as external categories. Parents perceived the day-to-day difficulties associated with their child's condition as a form of social exclusion that compromised their child's future and independence. These day-to-day difficulties were also described as directly affecting the parents' social life, constituting an important emotional and physical burden. When talking about their children, parents described the painfulness of their experiences, but also discussed how their autistic child had transformed and shaped their lives. Overall, these results show how the disease is "enacted" in the day-to-day life of parents; and suggest that such an embodied understanding of ASD may sometimes represent a form of re-appropriation of power by families faced with adversity.

摘要

这篇文章描述了自闭症谱系障碍在移民家庭背景下的体验,以及该病症在家庭和医疗保健提供者之间如何协商由东道国专业人员提出的意义。研究样本由来自不同国家的 44 名父母及其 35 名患有自闭症谱系障碍(ASD)的孩子组成,这些孩子生活在加拿大蒙特利尔一个社会经济贫困的社区。对家长的个人访谈进行了录音和转录,以备后续分析。结果表明,尽管自闭症谱系障碍的病因不确定性以及东道国专业人员提出的解释模型与家长的印象之间存在差距,这些情况有时可能会引起焦虑,但它们似乎增加了家庭抵制外部强加的分类的能力。家长们认为,他们孩子的日常困难是一种社会排斥的形式,这会影响他们孩子的未来和独立性。这些日常困难也被描述为直接影响父母的社会生活,给他们带来了重要的情感和身体负担。在谈论他们的孩子时,父母描述了他们经历的痛苦,但也讨论了他们患有自闭症的孩子如何改变和塑造了他们的生活。总的来说,这些结果表明了这种疾病是如何在父母的日常生活中“表现”出来的;并表明,这种对自闭症的身体理解有时可能代表了家庭面对逆境时重新获得权力的一种形式。

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