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神经发育障碍和医疗复杂性儿童的需求:照顾者的观点。

Needs of children with neurodevelopmental disorders and medical complexity: Caregiver perspectives.

机构信息

School of Public Policy, University of Calgary, Calgary, Alberta, Canada.

School of Public Policy, University of Calgary, Calgary, Alberta, Canada; School of Nursing and Midwifery, Mount Royal University, Calgary, Alberta, Canada.

出版信息

Res Dev Disabil. 2024 Oct;153:104815. doi: 10.1016/j.ridd.2024.104815. Epub 2024 Aug 13.

DOI:10.1016/j.ridd.2024.104815
PMID:39142086
Abstract

BACKGROUND

Caregivers of children with neurodevelopmental disorders and medical complexities (NDD-MC) coordinate care across complex multisectoral systems. Often NDD-MC children have complex behaviors, however there is limited information on coordination needs for families.

AIM

The objective of this mixed methods study was to understand the needs of families with NDD-MC children.

METHODS AND PROCEDURES

This sequential exploratory study obtained the perspectives of 67 caregivers of NDD-MC children using semi-structured interviews and validated questionnaires to measure family quality of life, care integration, and resource use. An adapted model using Maslow's hierarchy of needs was integrated, to understand the impacts of caregiving on quality of life.

OUTCOMES AND RESULTS

Lack of support in caring for NDD-MC children negatively impacted family quality of life, resulting in various unmet needs, including caregiver burden, behavioural challenges, financial losses, and mental health issues. Caregivers dealt with a fragmented healthcare system that offered limited support to address coordination challenges.

CONCLUSIONS AND IMPLICATIONS

The implementation of a needs-based care coordination program is recommended to consider the health, educational, and social needs of NDD-MC children and their families. Effective care for children with complex needs should tailor support for families using Maslow's hierarchy to enhance quality of life.

摘要

背景

儿童神经发育障碍和医疗复杂(NDD-MC)的照顾者在复杂的多部门系统中协调护理。通常,NDD-MC 儿童有复杂的行为,但关于家庭协调需求的信息有限。

目的

本混合方法研究的目的是了解 NDD-MC 儿童家庭的需求。

方法和程序

这项顺序探索性研究使用半结构化访谈和经过验证的问卷获得了 67 名 NDD-MC 儿童照顾者的观点,以衡量家庭的生活质量、护理整合和资源利用。采用适应的马斯洛需求层次模型,了解护理对生活质量的影响。

结果

缺乏照顾 NDD-MC 儿童的支持对家庭生活质量产生负面影响,导致各种未满足的需求,包括照顾者负担、行为挑战、经济损失和心理健康问题。照顾者面临着零碎的医疗保健系统,该系统提供的支持有限,无法解决协调挑战。

结论和影响

建议实施基于需求的护理协调计划,以考虑 NDD-MC 儿童及其家庭的健康、教育和社会需求。对有复杂需求的儿童的有效护理应根据马斯洛需求层次为家庭提供定制支持,以提高生活质量。

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