Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.
Sheffield Young Carers, Sheaf Bank Business Park, Unit R7b, Sheffield, UK.
Health Soc Care Deliv Res. 2024 Sep;12(36):1-108. doi: 10.3310/ABAT6761.
Many children and young people in England provide support to family members who are disabled, have mental or physical ill health, or misuse drugs or alcohol. Providing care can negatively impact children and young people's education, employment, health and social participation, with associated costs. Support is needed to prevent and reduce these negative impacts. The study sought to provide new knowledge and address prior research gaps regarding how best to support young carers from their perspective and that of the people they care for.
To address the following questions: What types, components or features of services and other support are seen as helpful, valued, and acceptable to young people who look after someone at home and the people they support? Conversely, what is found to be less or unhelpful? What additional support is perceived as needed? What are the barriers experienced by young and young adult carers in seeking and accessing services for themselves or the person they support? What are the barriers and facilitators for practitioners in providing support and services perceived as valued, helpful and needed by young and young adult carers and the people they support?
In-depth qualitative methodology using focus groups, in-depth semistructured interviews and workshops in four localities in England.
One hundred and thirty-three carers aged 9-25 years with a range of caring and life circumstances and sociodemographic characteristics. Seventeen adult care recipients (parents) with a range of physical and/or mental healthcare and support needs. Nineteen practitioners from schools, colleges, young carers organisations, voluntary sector services, mental health services, the National Health Service, adult social care and local authority adult and children's social care commissioners.
The types and aspects of support that young carers and their families need, and value when received, include: support that reduces or removes their practical and emotional caring responsibilities; support to mitigate the negative impacts of care and help with other life issues; information and advice about services and wider resources and support; someone trusted available to talk to; greater awareness, recognition and understanding; and choice, flexibility, and co-development of plans and solutions. We found a great deal of unmet need for support, and variation in type and quality of support received, including geographically.
Potential limitations are that we were not able to engage with, or recruit, young carers from some intended subgroups, meaning some perspectives are missing. Partly because of COVID-19 measures during the study, we mainly recruited through young carers organisations and their family projects, although this was balanced by recruitment through schools and extensive outreach and engagement by the collaborating organisations prior to the project starting.
Action is now needed to consistently and sustainably implement the types of support that young carers and the people they care for say they need and value.
Future work should include more research from the perspectives of young carers and the people they care for, especially from particularly marginalised groups; and research to understand what works and how to improve implementation of the support needed and valued.
This study is registered as Current Controlled Trials ISRCTN13478876. https://doi.org/10.1186/ISRCTN13478876.
This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129645) and is published in full in ; Vol. 12, No. 36. See the NIHR Funding and Awards website for further award information.
在英格兰,许多儿童和年轻人为残疾、身体或精神健康状况不佳、药物或酒精滥用的家庭成员提供支持。提供护理会对儿童和年轻人的教育、就业、健康和社会参与产生负面影响,并带来相关成本。需要提供支持以预防和减少这些负面影响。该研究旨在提供新知识,并解决先前研究中的空白,即如何最好地从年轻人自身和他们所照顾的人的角度来支持年轻的照顾者。
回答以下问题:对于在家中照顾他人的年轻人和他们所照顾的人来说,什么样的服务类型、组成部分或特征被认为是有帮助、有价值和可接受的?相反,哪些被认为是无益的?还需要哪些额外的支持?年轻和成年照顾者在为自己或他们所照顾的人寻求和获得服务方面面临哪些障碍?在为年轻和成年照顾者以及他们所照顾的人提供有价值、有帮助和他们需要的支持和服务方面,实践者面临哪些障碍和促进因素?
在英格兰的四个地点使用深入的定性方法,包括焦点小组、深入的半结构化访谈和研讨会。
133 名年龄在 9-25 岁之间的照顾者,他们有各种各样的照顾和生活情况以及社会人口特征。17 名成年护理接受者(父母),他们有各种身体和/或心理健康保健和支持需求。19 名来自学校、学院、年轻照顾者组织、志愿部门服务、心理健康服务、国民保健服务、成人社会护理和地方当局成人和儿童社会护理专员的从业者。
年轻照顾者及其家人需要并在收到时重视的支持类型和方面包括:减少或消除他们实际和情感照顾责任的支持;减轻照顾负面影响并帮助处理其他生活问题的支持;有关服务和更广泛资源和支持的信息和建议;可信赖的人可随时交谈;更多的认识、认可和理解;以及选择、灵活性以及计划和解决方案的共同制定。我们发现,对支持的需求存在很大的未满足感,而且收到的支持的类型和质量存在差异,包括地域差异。
潜在的局限性是我们无法接触或招募某些预期的年轻照顾者群体,因此一些观点缺失。部分由于 COVID-19 研究期间的措施,我们主要通过年轻照顾者组织及其家庭项目进行招募,尽管这通过学校以及在项目开始之前合作组织的广泛外展和参与得到了平衡。
现在需要采取行动,持续和可持续地实施年轻照顾者及其所照顾的人表示需要和重视的支持类型。
未来的工作应该包括更多来自年轻照顾者和他们所照顾的人视角的研究,特别是来自特别边缘化群体的研究;以及研究了解什么有效以及如何改进所需和重视的支持的实施。
本研究在 Current Controlled Trials ISRCTN13478876 注册。https://doi.org/10.1186/ISRCTN13478876。
该奖项由英国国家健康与保健研究所(NIHR)健康与社会保健交付研究计划(NIHR 奖号:NIHR129645)资助,并在全文中发布;第 12 卷,第 36 期。有关该奖项的更多信息,请访问 NIHR 资助和奖项网站。