Yanagisawa Satoko, Swannimitr Amorn, Singhala Kocharporn, Rujkorakarn Darunee, Aryamuang Supaporn, Hashimoto Hidemi, Sakamoto Mariko
School of Nursing and Health, Aichi Prefectural University, Japan.
Faculty of Nursing, Mahasarakham University, Thailand.
J Rural Med. 2022 Jul;17(3):143-150. doi: 10.2185/jrm.2021-062. Epub 2022 Jul 1.
This study aimed to identify and classify the needs of caregivers of children with disabilities living in resource-limited settings and develop a framework for need assessment. This study was conducted in the Maha Sarakham Province, Thailand, with 15 caregivers caring for children with disabilities recruited from hospitals, the Association for the Disabled, and primary health centers. Semi-structured interviews were conducted in local dialects, recorded, transcribed, converted into standard Thai, and then into English for thematic analysis. Meaning units corresponding to caregivers' needs were extracted, interpreted, coded, and hierarchically organized into subcategories by comparing similarities and differences among the extracted codes. The subcategories were further grouped and abstracted into categories, and then domains of caregivers' needs were formed. Nineteen categories were identified across five domains of caregivers' needs: health and medical, welfare, educational, social, and informational. Although basic medical treatment was covered, specific support, such as referral to a specialist, rehabilitation, or psychological support, was limited. Financial support and relief from the care burden are the main welfare needs. Educational needs were identified to provide knowledge to children and to offer respite to their caregivers. Social needs revealed ethical problems that arose because of strong rural community ties, making it difficult to maintain privacy. Informational needs were intertwined with the other four domains. In rural areas, where parents of children with disabilities migrate to cities to find work, the special needs of grandparents who were primary caregivers of the children needed to be addressed. This study provides a conceptual framework for comprehensive needs assessment and policy development for caregivers of children with disabilities living in resource-limited settings.
本研究旨在识别和分类生活在资源有限环境中的残疾儿童照料者的需求,并制定一个需求评估框架。这项研究在泰国玛哈沙拉堪府进行,从医院、残疾人协会和初级卫生中心招募了15名照料残疾儿童的照料者。采用当地方言进行半结构化访谈,进行录音、转录,先转换成标准泰语,再转换成英语进行主题分析。通过比较提取代码之间的异同,提取与照料者需求相对应的意义单元,进行解释、编码,并按层次组织成子类别。子类别进一步分组并抽象成类别,进而形成照料者需求的领域。在照料者需求的五个领域中识别出了19个类别:健康与医疗、福利、教育、社会和信息。虽然基本医疗得到了保障,但诸如转诊至专科医生、康复或心理支持等具体支持却很有限。经济支持和减轻照料负担是主要的福利需求。确定教育需求是为了向儿童传授知识,并为其照料者提供喘息机会。社会需求揭示了由于农村社区关系紧密而产生的伦理问题,使得难以保持隐私。信息需求与其他四个领域相互交织。在农村地区,残疾儿童的父母会迁移到城市找工作,需要关注作为儿童主要照料者的祖父母的特殊需求。本研究为生活在资源有限环境中的残疾儿童照料者的综合需求评估和政策制定提供了一个概念框架。