Chiu Irish Mae C, Sy Michael P, Oruga Myra D P, Bonito Sheila R
Faculty of Management and Development Studies University of the Philippines Open University Los Baños Laguna Philippines.
National Teacher Training Center for the Health Professions University of the Philippines Manila Philippines.
Public Health Chall. 2023 Apr 4;2(2):e79. doi: 10.1002/puh2.79. eCollection 2023 Jun.
Childhood disability remains a lowly prioritized and funded international health concern in the world today. Exacerbated by poverty, a lack of bureaucratic support, and societal discrimination, rehabilitation services are not readily accessible for Filipino families who happen to have a child with disability. This article intends to determine the perceived barriers of Filipino service users when it comes to accessing rehabilitation services for children with special needs in Cagayan de Oro City and to propose suggestions to improve the access to rehabilitation services from an international health perspective.
The study utilized the four-phased Q methodology, a mixed-method research design with an exploratory sequential approach: (1) creating and validating the Q-sort statements, (2) Q-sorting administration, (3) factor analysis, and (4) interpreting factors.
After going through the four phases of Q methodology, the following factors, called "viewpoints" emerged: systemic discrimination based on differences in culture and ethnicity (Viewpoint 1), socioeconomic factors such as affordability and accessibility (Viewpoint 2), and predisposed health beliefs and lack of trust to health professionals (Viewpoint 3).
Barriers to accessing rehabilitation services in the Philippines go beyond the lack of individual resources. These perceived barriers can be mitigated by employing participatory and collaborative approaches in developing rehabilitation programs for children and their families, viable strategies such as integrating telehealth in the rehabilitation process, and cultural competence in recognizing folkloric beliefs as a way to build trust toward health-care professionals.
This article determined contextualized barriers when accessing health and rehabilitation services based on service users themselves, which in turn hopes to promote inclusive, justice-oriented, and culturally focused rehabilitation services underpinned by international health principles.
儿童残疾问题在当今世界仍是国际卫生领域中未得到足够重视且资金投入不足的问题。由于贫困、缺乏官方支持以及社会歧视等因素的加剧，菲律宾那些有残疾儿童的家庭难以获得康复服务。本文旨在确定菲律宾服务使用者在获取卡加延德奥罗市有特殊需求儿童的康复服务时所感受到的障碍，并从国际卫生视角提出改善康复服务获取途径的建议。
本研究采用了四阶段Q方法，这是一种具有探索性序列方法的混合方法研究设计：（1）创建并验证Q分类陈述，（2）进行Q分类管理，（3）进行因素分析，以及（4）解释因素。
在经历了Q方法的四个阶段后，出现了以下被称为“观点”的因素：基于文化和种族差异的系统性歧视（观点1）、诸如可承受性和可及性等社会经济因素（观点2），以及预先存在的健康观念和对卫生专业人员缺乏信任（观点3）。
菲律宾在获取康复服务方面的障碍不仅仅是个人资源的缺乏。通过在为儿童及其家庭制定康复计划时采用参与式和协作式方法、在康复过程中整合远程医疗等可行策略，以及在认识民俗信仰方面具备文化能力以建立对医护专业人员的信任等方式，可以减轻这些所感受到的障碍。
本文确定了基于服务使用者自身在获取健康和康复服务时的背景性障碍，进而希望促进以国际卫生原则为基础的包容性、注重公正且以文化为重点的康复服务。
