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倡导和赋权在制定服务计划以满足发育障碍儿童家庭需求中的作用。

The role of advocacy and empowerment in shaping service development for families raising children with developmental disabilities.

机构信息

Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Department of Health Services and Population Research, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

出版信息

Health Expect. 2022 Aug;25(4):1882-1891. doi: 10.1111/hex.13539. Epub 2022 May 29.

Abstract

INTRODUCTION

Empowerment of families raising children with developmental disabilities (DDs) is essential to achieving rights-based service development.

METHODS

In this qualitative study, we investigated stakeholder perceptions on the role of advocacy and empowerment in developing caregiver interventions for families of children with DDs in a global context. Participants had experience with at least one intervention, namely the Caregiver Skills Training developed by the World Health Organization (WHO). Participants were clinicians, caregivers and researchers representing five continents, and representatives of WHO and Autism Speaks. Two focus group discussions and 25 individual interviews were conducted. Data were analysed thematically.

RESULTS

Three themes were developed: empowerment as independence and as a right; the role and practices of advocacy; and using evidence to drive advocacy. Many professional participants defined empowerment within the realms of their expertise, focusing on caregivers' individual skills and self-confidence. Caregivers expressed that this expert-oriented view fails to acknowledge their intuitive knowledge and the need for community-level empowerment. Participants discussed the challenges of advocacy in light of competing health priorities. The gap between the rights of caregivers and the availability of services, for example, evidence-based interventions, was highlighted as problematic. Scientific evidence was identified as a key for advocacy.

CONCLUSION

Rights-orientated empowerment of caregivers and advocacy may make vital contributions to service development for children with DDs in contexts worldwide.

PATIENT AND PUBLIC CONTRIBUTION

Research questions were revised based on views presented during focus group discussions. Participant feedback on preliminary themes informed the development of the interview guides.

摘要

简介

赋予养育发育障碍(DD)儿童的家庭权力对于实现基于权利的服务发展至关重要。

方法

在这项定性研究中,我们调查了利益相关者对倡导和赋权在制定针对发育障碍儿童家庭的护理人员干预措施方面的作用的看法,该干预措施是在全球范围内进行的。参与者至少有一项干预措施的经验,即世界卫生组织(WHO)制定的《照顾者技能培训》。参与者是代表五大洲的临床医生、照顾者和研究人员,以及世界卫生组织和“自闭症代言人”的代表。进行了两次焦点小组讨论和 25 次个人访谈。对数据进行了主题分析。

结果

确定了三个主题:赋权是独立和权利;倡导的作用和实践;以及利用证据推动倡导。许多专业参与者在其专业领域内定义了赋权,重点关注照顾者的个人技能和自信。照顾者表示,这种以专家为导向的观点未能承认他们的直觉知识和社区层面赋权的必要性。参与者根据竞争的健康优先事项讨论了倡导的挑战。例如,将照顾者的权利与基于证据的干预措施等可用服务之间的差距视为存在问题。科学证据被确定为倡导的关键。

结论

以权利为导向的照顾者赋权和倡导可能会对全球范围内发育障碍儿童的服务发展做出重要贡献。

患者和公众的贡献

根据焦点小组讨论中提出的观点修改了研究问题。参与者对初步主题的反馈意见为访谈指南的制定提供了信息。

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