Needs assessment of caregivers of children with disabilities in resource-limited settings.

Satoko Yanagisawa, Amorn Swannimitr, Kocharporn Singhala, Darunee Rujkorakarn, Supaporn Aryamuang, Hidemi Hashimoto, Mariko Sakamoto
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Abstract

Objective: This study aimed to identify and classify the needs of caregivers of children with disabilities living in resource-limited settings and develop a framework for need assessment. Participants and Methods: This study was conducted in the Maha Sarakham Province, Thailand, with 15 caregivers caring for children with disabilities recruited from hospitals, the Association for the Disabled, and primary health centers. Semi-structured interviews were conducted in local dialects, recorded, transcribed, converted into standard Thai, and then into English for thematic analysis. Meaning units corresponding to caregivers' needs were extracted, interpreted, coded, and hierarchically organized into subcategories by comparing similarities and differences among the extracted codes. The subcategories were further grouped and abstracted into categories, and then domains of caregivers' needs were formed. Results: Nineteen categories were identified across five domains of caregivers' needs: health and medical, welfare, educational, social, and informational. Although basic medical treatment was covered, specific support, such as referral to a specialist, rehabilitation, or psychological support, was limited. Financial support and relief from the care burden are the main welfare needs. Educational needs were identified to provide knowledge to children and to offer respite to their caregivers. Social needs revealed ethical problems that arose because of strong rural community ties, making it difficult to maintain privacy. Informational needs were intertwined with the other four domains. In rural areas, where parents of children with disabilities migrate to cities to find work, the special needs of grandparents who were primary caregivers of the children needed to be addressed. Conclusion: This study provides a conceptual framework for comprehensive needs assessment and policy development for caregivers of children with disabilities living in resource-limited settings.

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资源有限环境中残疾儿童照料者的需求评估。
目的:本研究旨在识别和分类生活在资源有限环境中的残疾儿童照顾者的需求,并建立一个需求评估框架。参与者和方法:本研究在泰国Maha Sarakham省进行,从医院、残疾人协会和初级卫生中心招募了15名照顾残疾儿童的护理人员。半结构化访谈用当地方言进行,录音,转录,转换成标准泰语,然后转换成英语进行主题分析。通过比较所提取的代码的异同,提取、解释、编码并分层组织成子类别。在此基础上,对各子类别进行分组和抽象,形成照顾者需求域。结果:在照顾者需求的五个领域中确定了19个类别:健康和医疗,福利,教育,社会和信息。虽然提供基本医疗,但具体支助,如转诊专家、康复或心理支助,是有限的。经济支持和减轻照顾负担是主要的福利需求。确定了教育需要,以便向儿童提供知识,并为他们的照顾者提供喘息的机会。社会需求揭示了由于农村社区关系紧密而产生的伦理问题,这使得保持隐私变得困难。信息需求与其他四个领域交织在一起。在农村地区,残疾儿童的父母迁移到城市找工作,作为儿童主要照顾者的祖父母的特殊需要需要得到解决。结论:本研究为资源有限环境下残疾儿童照料者的综合需求评估和政策制定提供了一个概念性框架。
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