Abeasi Doreen Asantewa, Nkosi Nokuthula Gloria, Badoe Ebenezer, Adjeman Josephine
Department of Nursing Science Education, University of Witwatersrand, Johannesburg, South Africa.
Department of Nursing and Midwifery, Presbyterian University, Abetifi, Ghana.
BMC Nurs. 2024 Jul 15;23(1):482. doi: 10.1186/s12912-024-02142-1.
Caring for a child with developmental disabilities (DD) is associated with significant stress and burden. Caregivers' experiences are influenced by factors such as poverty, stigma, and the lack of accessibility to services, equipment, and assistive devices. These factors are prevalent in a low-resource setting like Ghana which ultimately influences the experiences of caregivers. The aim of the study was to explore the experiences of caregivers of children with DD in the context of the Stress Process Model.
The study employed a descriptive phenomenological design Caregivers of children with DD attending the Neurodevelopmental Clinic of a Teaching Hospital were purposively sampled. Data collection involved semi-structured interviews, reaching saturation with 14 participants. The interviews were audio-recorded transcribed verbatim and analysed using thematic analysis.
Four main themes emerged: perception of caregiving, stressors faced by caregivers, negative health outcomes and coping strategies. Perception of caregiving had two sub-themes as stressful nature of caregiving and time-consuming. Six sub-themes were linked to stressors faced by caregivers: the child's ADL needs, communication barrier, managing challenging behaviour, child's health needs, unmet educational needs, and economic burden. Negative health outcomes had three sub-themes: decline in physical, mental and social well-being. While some caregivers used maladaptive coping strategies like blaming, others employed adaptive coping strategies like religious coping through prayer, self-encouragement and support from other family members.
The study highlights the complex interaction between caregivers' perception of their caregiving situation, the stressors they experience, their coping resources, and the negative health outcomes associated with caregiving. These findings underscore the need for context-specific caregiver programmes to mitigate the negative impacts of caregiving.
照顾发育障碍(DD)儿童会带来巨大压力和负担。照顾者的经历受到贫困、耻辱感以及服务、设备和辅助装置获取不便等因素的影响。这些因素在加纳这样的资源匮乏环境中普遍存在,最终影响着照顾者的经历。本研究的目的是在压力过程模型的背景下探讨发育障碍儿童照顾者的经历。
本研究采用描述性现象学设计,对在一家教学医院神经发育诊所就诊的发育障碍儿童的照顾者进行了有目的抽样。数据收集包括半结构化访谈,14名参与者达到饱和。访谈进行了录音,逐字转录,并采用主题分析法进行分析。
出现了四个主要主题:照顾的认知、照顾者面临的压力源、负面健康结果和应对策略。照顾的认知有两个子主题,即照顾的压力性质和耗时性。六个子主题与照顾者面临的压力源相关:儿童的日常生活活动需求、沟通障碍、管理具有挑战性的行为、儿童的健康需求、未满足的教育需求和经济负担。负面健康结果有三个子主题:身体、心理和社会幸福感下降。一些照顾者采用了责备等适应不良的应对策略,而另一些则采用了祈祷、自我鼓励和其他家庭成员支持等宗教应对等适应性应对策略。
该研究强调了照顾者对其照顾状况的认知、他们所经历的压力源、他们的应对资源以及与照顾相关的负面健康结果之间的复杂相互作用。这些发现强调了需要制定针对具体情况的照顾者计划,以减轻照顾的负面影响。