Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, UK.
Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK.
Health Expect. 2024 Jun;27(3):e14085. doi: 10.1111/hex.14085.
Parent carers of children with special educational needs or disabilities are at risk of poorer health and wellbeing outcomes because of the distinct and challenging circumstances they face. Evaluations of interventions promoting the health of parent carers should focus on measuring the aspects of health and wellbeing which are most relevant to this group. As part of a programme of research on parent carer-focused interventions, this study aimed to understand which aspects of health and wellbeing are perceived by parent carers as most meaningful and important.
A qualitative study using semistructured online interviews was conducted. A purposive sample of parent carers was interviewed about relevant health and wellbeing outcomes. Transcripts were analysed thematically.
Thirty parent carers were interviewed, 19 of whom had experienced a health-promoting intervention, either as participants (n = 14) or facilitators (n = 5). Three main themes were identified: 'self, identity and beliefs'; 'social connections and support' and 'health-promoting practices and outcomes.' Each theme encompassed the challenges participants faced, and the changes that helped them overcome these challenges. 'Self-identity' challenges focused on the overwhelming nature of the parental care role and the emotional impact of this. Changes were brought about by developing a positive mindset, increasing confidence, and reconnecting with aspects of their identity which were important to them before they became parent carers. Challenges related to 'social connections' reflected parent carers' isolation. Change was brought about through increased peer support and peer interactions. Parent carers experienced challenges in terms of 'health-promoting activities' because they lacked free time and experienced poor physical health. Changes were brought about by engagement in health-promoting activities of various kinds.
Parent carers view health and wellbeing in terms of overcoming the common challenges they face as a group. These challenges reflect the ways in which their physiological and psychological needs are often unmet. Researchers interested in measuring parent carer health and wellbeing should consider the specific challenges this group face, as well as theoretical frameworks which can make sense of these challenges, such as self-determination theory.
Our team carries out patient and public involvement (PPI) through a Family Faculty group facilitated by a Family Involvement Co-ordinator (A. McD.) who is herself a parent carer. A study-specific PPI working group was established which included members of the Family Faculty. The PPI group advised on various aspects of the research as reported in the paper. The manuscript was co-authored by the team's Family Involvement Co-ordinator (A. McD.).
由于面临独特而具有挑战性的环境,有特殊教育需求或残疾儿童的父母照顾者的健康和幸福结果可能会更差。评估促进父母照顾者健康的干预措施应侧重于衡量与该群体最相关的健康和幸福方面。作为针对父母照顾者为重点的干预措施的研究计划的一部分,本研究旨在了解父母照顾者认为哪些方面的健康和幸福最有意义和重要。
采用半结构式在线访谈进行定性研究。对父母照顾者进行了有关相关健康和幸福结果的有针对性的样本访谈。对转录本进行了主题分析。
对 30 名父母照顾者进行了访谈,其中 19 名父母照顾者经历过健康促进干预,无论是作为参与者(n=14)还是促进者(n=5)。确定了三个主要主题:“自我、身份和信念”、“社会联系和支持”以及“健康促进实践和结果”。每个主题都包含参与者面临的挑战,以及帮助他们克服这些挑战的变化。“自我认同”挑战主要集中在父母照顾角色的压倒性性质及其带来的情绪影响上。通过培养积极的心态、增强信心以及重新与成为父母照顾者之前对他们重要的身份方面联系起来,从而带来变化。与“社会联系”相关的挑战反映了父母照顾者的孤立。通过增加同伴支持和同伴互动来实现这种变化。父母照顾者在“促进健康的活动”方面遇到挑战,因为他们缺乏空闲时间并且身体健康状况不佳。通过参与各种健康促进活动带来了变化。
父母照顾者从克服他们作为一个群体面临的共同挑战的角度来看待健康和幸福。这些挑战反映了他们的生理和心理需求经常得不到满足的方式。对父母照顾者健康和幸福感兴趣的研究人员应该考虑该群体面临的具体挑战,以及可以理解这些挑战的理论框架,例如自我决定理论。
我们的团队通过由一名家庭参与协调员(A. McD.)主持的家庭学院小组进行患者和公众参与(PPI)。A. McD. 本身就是一名父母照顾者,她也是一名家庭照顾者。成立了一个特定于研究的 PPI 工作组,其中包括家庭学院的成员。PPI 小组就报告的论文中的各个方面提供了建议。该手稿由团队的家庭参与协调员(A. McD.)共同撰写。