Child and Community Wellbeing Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.
Colorectal and Pelvic Reconstruction Service, The Royal Children's Hospital, Parkville, VIC, Australia.
Health Soc Care Community. 2021 Nov;29(6):e269-e278. doi: 10.1111/hsc.13350. Epub 2021 Mar 24.
The delivery of family-centred practice (FCP) within Early Childhood Intervention Services (ECISs) for young children with a disability or development delay conceptualises that children's learning environments, parenting, family and community supports intersect to have the greatest impact on the developing child. The transdisciplinary key worker model is considered a best-practice approach within ECISs whereby staff work collaboratively across disciplinary boundaries to plan and implement services for children and their families. Research suggests families who have a key worker have better relationships with services, fewer unmet needs, better morale, more information about services, higher parental satisfaction and more parental involvement than those not receiving this service. Using a phenomenological qualitative design this study sought to understand transdisciplinary key workers' perspectives regarding the strengths and challenges to undertaking their role in providing services to children and families accessing an ECIS at a major disability service organisation, in light of the changing policy reform during the roll out of the National Disability Insurance Scheme in Australia. Purposive sampling was used to recruit key workers (n = 13) to participate in semi-structured interviews during 2015. Data were analysed using an inductive, thematic approach. Results revealed four main themes that impact on the effectiveness of key workers' service provision. These are broadly categorised as (a) Engagement with the workplace, (b) Engagement with clients, (c) Professional capacity and (d) Staff Wellbeing. The findings aligned with previous studies identifying sources of support and stress for disability services staff. They also provided new insights into key workers' lack of confidence in addressing parental mental health issues, despite operating under a family-centred approach. These findings informed the development of an intervention trial and evaluation to improve support for parent and staff wellbeing within a Victorian Disability Service with the aim of building their capacity to support children with a disability.
家庭为中心的实践（FCP）在幼儿残疾或发育迟缓早期干预服务（ECIS）中的实施，将儿童的学习环境、育儿、家庭和社区支持概念化，认为这些因素的交集对发育中的儿童影响最大。跨学科关键工作人员模式被认为是 ECIS 中的最佳实践方法，即工作人员跨越学科界限合作，为儿童及其家庭规划和实施服务。研究表明，与没有接受这项服务的家庭相比，拥有关键工作人员的家庭与服务机构的关系更好，未满足的需求更少，士气更高，对服务的了解更多，父母满意度更高，参与度更高。本研究采用现象学定性设计，旨在了解跨学科关键工作人员在澳大利亚国家残疾保险计划实施过程中，针对不断变化的政策改革，在为残疾服务组织的 ECIS 中接受服务的儿童和家庭提供服务时，对其角色的优势和挑战的看法。通过目的抽样，招募了 13 名关键工作人员参与 2015 年的半结构化访谈。使用归纳、主题方法进行数据分析。结果揭示了影响关键工作人员服务提供有效性的四个主要主题。这些主题大致可分为：（a）与工作场所的互动，（b）与客户的互动，（c）专业能力和（d）员工福祉。研究结果与先前的研究一致，这些研究确定了残疾服务人员的支持和压力来源。它们还为关键工作人员在家庭为中心的方法下，缺乏解决父母心理健康问题的信心提供了新的见解。这些发现为在维多利亚州残疾服务机构内开展一项改善父母和员工福祉的支持干预试验和评估提供了信息，旨在建立他们支持残疾儿童的能力。
