College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
School of Nursing, University of Manchester, Manchester, UK.
Health Expect. 2024 Feb;27(1):e13831. doi: 10.1111/hex.13831. Epub 2023 Sep 13.
Caring for children and youth with special health care needs (CYSHCN) is a significant undertaking for families. While respite care is intended to address this burden, demand continues to exceed supply. Exploring the perspectives of respite service providers (SPs) and stakeholders (SKs) provides unique insight into families' needs and respite care systems.
We conducted semistructured interviews with 41 respite care SPs and SKs across four Canadian provinces to ascertain perspectives on current and ideal respite care for families of CYSHCN. The analysis included delineating units of meaning from the data, clustering units of meaning to form thematic statements and extracting themes. The second-level analysis involved applying themes and subthemes to cross-functional process maps.
Participants noted the critical, but sometimes absent role of Community Service Workers, who have the ability to support families accessing and navigating respite care systems. SPs and SKs identified current respite systems as operating in crisis mode. New findings suggest an ideal respite care system would incorporate advocacy for families, empower families and value CYSHCN, their families and respite workers.
The evidence of unmet respite care needs of families of CYSHCN across Canada has long been available. Our findings identifying respite system challenges and solutions can be used by funders and policymakers for planning and enhancing resources, and by healthcare professionals, respite care providers and SKs to understand barriers and take action to improve respite outcomes to meet the respite needs of all families and CYSHCN.
The research team is composed of patients, researchers, clinicians and decision-makers along with our Family Advisory Committee (FAC) composed of members of families of CYSHNC. The FAC was formed and met regularly with research team members, knowledge users and collaborators throughout the study to provide input on design, review themes and ensure findings are translated and disseminated in a meaningful way.
照顾有特殊健康需求的儿童和青少年(CYSHCN)是家庭的一项重要任务。虽然临时护理旨在缓解这种负担,但需求仍然超过供应。探索临时护理服务提供者(SP)和利益相关者(SK)的观点,为家庭的需求和临时护理系统提供了独特的见解。
我们在加拿大四个省进行了半结构化访谈,共有 41 名临时护理 SP 和 SK,以了解他们对当前和理想的 CYSHCN 家庭临时护理的看法。分析包括从数据中划定意义单位,将意义单位聚类形成主题陈述,并提取主题。二级分析涉及将主题和子主题应用于跨职能流程图。
参与者注意到社区服务工作者的关键但有时缺失的角色,他们有能力支持家庭获得和驾驭临时护理系统。SP 和 SK 确定当前的临时护理系统处于危机模式。新发现表明,理想的临时护理系统将包括为家庭提供宣传、赋权家庭和重视 CYSHCN、他们的家庭和临时护理人员。
加拿大各地 CYSHCN 家庭对临时护理需求未得到满足的证据早已存在。我们发现的临时护理系统挑战和解决方案可以供资助者和政策制定者用于规划和增强资源,以及医疗保健专业人员、临时护理提供者和 SK 了解障碍并采取行动改善临时护理结果,以满足所有家庭和 CYSHCN 的临时护理需求。
研究团队由患者、研究人员、临床医生和决策者以及我们的家庭咨询委员会(FAC)组成,成员是 CYSHNC 的家庭成员。FAC 在研究过程中与研究团队成员、知识用户和合作者一起定期组建和会面,为设计提供投入,审查主题,并确保研究结果以有意义的方式进行翻译和传播。