Teoh Yvonne, Garg Pankaj, Karyadiguna Nugroho, Vivekanandarajah Sinthu, So Lydia, Hurwitz Romy, Raman Shanti
Department of Community Paediatrics, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
UNSW Medicine, University of New South Wales, Kensington, New South Wales, Australia.
BMJ Paediatr Open. 2025 Mar 28;9(1):e003003. doi: 10.1136/bmjpo-2024-003003.
While there is a high level of concern among parents about waiting for child developmental services, there is limited research on caregiver perspectives on accessing public developmental diagnostic services, especially for families from culturally diverse backgrounds. We aimed to explore caregiver perspectives and satisfaction after attending a Child Developmental Assessment Service (CDAS) appointment for their child in South Western Sydney, as part of a large quality improvement project.
Over a 6-month period between June and December 2022, we surveyed caregivers after their child's first CDAS appointment, using an adapted caregiver questionnaire that contained Likert scale and free-text responses. We analysed the data using simple descriptive and thematic data analysis.
Of 107 caregiver satisfaction questionnaires completed, almost two-thirds (63%) were from culturally and linguistically diverse backgrounds. Over 90% caregivers reported a satisfaction response of 'Agree' to 'Strongly Agree', 88% felt that the assessment was suitable to their child's needs and 85% considered waiting times reasonable. The mean overall caregiver satisfaction score was 4.5 (SD 1.1). About 30% of families had doubts about their child's neurodevelopmental diagnosis. The themes identified from free-text responses were (1) positive caregiver experience; (2) clinician attributes; (3) quality of the service delivery; (4) information received. Caregivers expressed very high levels of satisfaction with the quality of service and clinicians' skills, appreciated enhanced understanding of their child's development and found the assessment helpful.
Our study showed surprisingly high levels of caregiver satisfaction in attending a neurodevelopmental assessment service, in a culturally diverse metropolitan setting. Our findings support the importance of providing interpersonal sensitivity and family-centred practice for children with neurodevelopmental difficulties. We need to respond to the families who disagreed with the diagnostic formulation or were dissatisfied with the service, to improve the service quality, using longitudinal evaluation and more in-depth qualitative analysis.
虽然家长们对等待儿童发育服务高度关注，但关于照顾者对获得公共发育诊断服务的看法的研究有限，尤其是对于来自文化背景多样的家庭。作为一个大型质量改进项目的一部分，我们旨在探讨悉尼西南部的照顾者在带孩子参加儿童发育评估服务（CDAS）预约后的看法和满意度。
在2022年6月至12月的6个月期间，我们在照顾者孩子首次进行CDAS预约后对其进行了调查，使用了一份经过改编的照顾者问卷，其中包含李克特量表和自由文本回答。我们使用简单描述性和主题数据分析来分析数据。
在完成的107份照顾者满意度问卷中，近三分之二（63%）来自文化和语言背景多样的群体。超过90%的照顾者对“同意”到“强烈同意”的满意度回答表示满意，88%的人认为评估符合孩子的需求，85%的人认为等待时间合理。照顾者的总体平均满意度得分为4.5（标准差1.1）。约30%的家庭对孩子的神经发育诊断存在疑虑。从自由文本回答中确定的主题包括：（1）照顾者的积极体验；（2）临床医生的特质；（3）服务提供的质量；（4）收到的信息。照顾者对服务质量和临床医生的技能表示非常高的满意度，对增进对孩子发育的理解表示赞赏，并认为评估很有帮助。
我们的研究表明，在一个文化多元的大都市环境中，照顾者对参加神经发育评估服务的满意度出奇地高。我们的研究结果支持了为有神经发育困难的儿童提供人际敏感性和以家庭为中心的实践的重要性。我们需要回应那些不同意诊断结果或对服务不满意的家庭，通过纵向评估和更深入的定性分析来提高服务质量。
