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“应对等待”:父母为被诊断患有自闭症谱系障碍的儿童和青少年获取诊断及治疗服务的经历

"Managing the Wait": Parents' Experiences in Accessing Diagnostic and Treatment Services for Children and Adolescents Diagnosed With Autism Spectrum Disorder.

作者信息

Smith-Young Joanne, Chafe Roger, Audas Rick

机构信息

Division of Clinical Epidemiology, Memorial University of Newfoundland, St. John's, NL, Canada.

Division of Pediatrics, Memorial University of Newfoundland, St. John's, NL, Canada.

出版信息

Health Serv Insights. 2020 Jan 27;13:1178632920902141. doi: 10.1177/1178632920902141. eCollection 2020.

Abstract

BACKGROUND

Parents of children and adolescents diagnosed with autism spectrum disorder (ASD) report delays in accessing timely diagnostic and treatment services for their children. Research has generally focused on parents' experiences in caring for a child diagnosed with ASD. This study describes the process of how parents access ASD services for their children and adolescents.

METHOD

This study used a qualitative research design that was informed by grounded theory methodology. We used constant comparative analysis to develop a process model and a core concept.

RESULTS

Seventeen parents of children and adolescents diagnosed with ASD were interviewed. Our process model included 3 main phases: Watchful waiting (noticing suspected behaviors, and searching for assessment and diagnosis); Informed waiting (receiving the diagnosis, facing challenges in accessing treatment services, and realizing the impact of an ASD diagnosis); and Contemplative waiting (pondering the future, reflecting on the past, and making recommendations). "Managing the Wait" was identified as the core category central to parents' experience of this process. This process was found to be impacted by socioeconomic status, parents' skills and capacity to advocate on their child's behalf, and severity of their child's ASD.

CONCLUSIONS

Our findings illustrate the many barriers families face during their journey in accessing ASD services. Our results illustrate the need to address wait times for services, and provide education and support services for parents as a means of improving their self-advocacy skills, especially for parents of children and adolescents with severe disability.

摘要

背景

被诊断患有自闭症谱系障碍(ASD)的儿童和青少年的家长表示,他们在为孩子及时获得诊断和治疗服务方面存在延迟。研究通常集中在家长照顾被诊断患有ASD的孩子的经历上。本研究描述了家长为其孩子和青少年获取ASD服务的过程。

方法

本研究采用了基于扎根理论方法的定性研究设计。我们使用持续比较分析来开发一个过程模型和一个核心概念。

结果

对17位被诊断患有ASD的儿童和青少年的家长进行了访谈。我们的过程模型包括3个主要阶段:警惕等待(注意到疑似行为,并寻求评估和诊断);知情等待(收到诊断结果,在获取治疗服务方面面临挑战,并意识到ASD诊断的影响);以及沉思等待(思考未来,反思过去,并提出建议)。“管理等待”被确定为家长在此过程中的核心类别。发现这个过程受到社会经济地位、家长代表孩子进行维权的技能和能力以及孩子ASD的严重程度的影响。

结论

我们的研究结果说明了家庭在获取ASD服务的过程中面临的许多障碍。我们的结果表明需要解决服务等待时间的问题,并为家长提供教育和支持服务,作为提高他们自我维权技能的一种手段,特别是对于重度残疾儿童和青少年的家长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24a6/6987484/38fa33be5dd3/10.1177_1178632920902141-fig1.jpg

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