住院医师通过与残疾儿童的家庭会面了解到什么?:体验式学习模块的定性分析。

Niraj Sharma, Paula S Lalinde, Jeffrey P Brosco
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引用次数: 25

摘要

目的:医疗服务提供者对残疾人的态度会影响患者获得的护理质量。作者评估了一个体验式学习模块,以调查迈阿密大学/杰克逊纪念医院的儿科和医学/儿科住院医生从访问有残疾儿童的家庭中学到了什么。方法:通过社区家长组织招募家庭。这些家庭被要求讨论有一个残疾孩子是什么感觉,并考虑在1-2小时的家访中向居民传达的主要信息。自1998年以来,住院医生参与了必要的发育儿科轮转。他们被要求写一页关于这次访问的叙述性描述。作者利用定性研究和内容分析的扎根理论来计算居民描述中确定的关键主题。结果:24个家庭和63名居民参与了学习模块。驻地观察员提出了四个主要主题。24%的人表示家庭需要更多的信息;79%的人指出,家庭面临各种障碍,包括经济(33%)、医疗服务提供者的悲观情绪(29%)、家庭内部矛盾(27%)和医疗系统问题(22%);49%的居民认为家庭会调整和应对孩子的残疾;27%的居民表示,这一经历改变了他们对残疾儿童的看法。结论:作者的研究表明,对残疾儿童的家庭进行一次家访,可以使儿科和医学/儿科住院医师深入了解家庭对残疾的看法,否则在以医院为基础的培训方案中是无法实现的。
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What do residents learn by meeting with families of children with disabilities?: A qualitative analysis of an experiential learning module.

Purpose: Attitudes of medical providers towards persons with disabilities can affect the quality of care their patients receive. The authors evaluated an experiential learning module to investigate what Paediatric and Medicine/Paediatric residents at the University of Miami/Jackson Memorial Hospital learn from visiting the homes of families with children who have disabilities.

Methods: Families were recruited through a community-based parent organization. The families were instructed to discuss what it is like to have a child with a disability and to think about a primary message to give to residents during a 1-2 hour home visit. Since 1998, residents participated as part of the required Developmental Paediatrics rotation. They were instructed to write a one-page narrative description of their visit. The authors utilized the grounded theory of qualitative research and content analysis to count the key themes identified in the residents' descriptions.

Results: Twenty-four families and 63 residents participated in the learning module. The resident observations yielded four major themes. Twenty-four per cent stated families needed more information; 79% noted that families face various obstacles, including financial (33%), medical providers' pessimism (29%), inter-personal family conflicts (27%) and medical system problems (22%); 49% of residents commented that families adjust and cope with their child's disability; and 27% of residents stated that the experience changed their insight about children with disabilities.

Conclusion: The authors' study suggests that a single home visit with the family of a child with a disability provides paediatrics and medicine/paediatrics residents with insights into the family's perspective on disability otherwise unattainable in a hospital-based training programme.

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