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对加纳农村地区未接受康复服务的脑瘫患儿照料者的经历:一项定性研究。

The experience of carers of children with cerebral palsy living in rural areas of Ghana who have received no rehabilitation services: A qualitative study.

作者信息

Nyante Gifty Gyamah, Carpenter Christine

机构信息

College of Health Sciences, University of Ghana, Accra, Ghana.

The University of British Columbia, Vancouver, Canada.

出版信息

Child Care Health Dev. 2019 Nov;45(6):815-822. doi: 10.1111/cch.12706. Epub 2019 Aug 16.

Abstract

AIM

This study aims to explore the experiences of carers of children with cerebral palsy living in rural areas of Ghana who have received no rehabilitation services.

BACKGROUND

Cerebral palsy is the most common chronic disability from childhood, which needs lifelong rehabilitation. Most of the population living in rural communities in Ghana have virtually no form of rehabilitation services for their chronic disabling conditions. Caring for children with disability are known to be challenging especially when coupled with environmental challenges in rural communities.

RESULTS

Purposive and snowball techniques were used to recruit 12 carers, age 22 to 68 years, of children with cerebral palsy aged 7 to 15 years. Two main themes, developing personal beliefs to support the caregiving role and the demands that shape the experience of caring, emerged from six subthemes and 25 theme clusters of the narratives of the carers. The essential structure of the phenomenon demonstrated the complex interaction of personal and environmental factors in harmony with the actual demands to influence the experiences of participants positively or negatively. Positively, carers achieved coping, committed to caring, hoped for the future, and accepted the condition. However, negatively, carers described the triggering factors of feeling of despair and sorrow as frustration and lack of understanding of the condition, felt stigmatized, and perceived the child was going through pain and suffering.

CONCLUSIONS

Carers derived strength from their religious and spiritual beliefs to balance the demands of caregiving. Findings could be used as basis for developing interventions to support carers and inform new strategies for rehabilitation service and sensitization of community members about inclusion of children with disabilities.

摘要

目的

本研究旨在探索加纳农村地区未接受康复服务的脑瘫患儿照料者的经历。

背景

脑瘫是儿童期最常见的慢性残疾,需要终身康复。加纳农村社区的大多数人口实际上没有针对其慢性致残状况的任何形式的康复服务。众所周知,照料残疾儿童具有挑战性,尤其是在农村社区面临环境挑战的情况下。

结果

采用目的抽样和滚雪球技术招募了12名年龄在22至68岁之间、照料7至15岁脑瘫患儿的照料者。照料者叙述中的六个子主题和25个主题簇中出现了两个主要主题,即形成支持照料角色的个人信念以及塑造照料经历的需求。该现象的基本结构表明,个人因素和环境因素与实际需求之间的复杂相互作用,对参与者的经历产生积极或消极影响。积极方面,照料者实现了应对、致力于照料、对未来抱有希望并接受了现状。然而,消极方面,照料者将绝望和悲伤情绪的触发因素描述为挫折感和对病情的不理解,感到受到污名化,并认为孩子正在经历痛苦。

结论

照料者从他们的宗教和精神信仰中汲取力量,以平衡照料的需求。研究结果可作为制定支持照料者的干预措施的基础,并为康复服务的新策略以及提高社区成员对残疾儿童融入的认识提供参考。

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