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Li Y, Fuentes K, Hsu S, Ragunathan S, Lindsay S. Types and factors affecting and impact of ableism among Asian children and youth with disabilities and their caregivers: a systematic review of quantitative studies. Disabil Rehabil 2024:1-21. [PMID: 38339994 DOI: 10.1080/09638288.2024.2310755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/20/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE Asian children and youth with disabilities often experience multiple barriers and discrimination in education, healthcare, and social settings, which influence their well-being, especially the transition to adulthood. This review aims to explore the types, factors affecting and impact of ableism on Asian children and youth with disabilities and their caregivers. METHODS We conducted a systematic review and a narrative synthesis whereby we searched the literature from six international databases, including Healthstar, Ovid Medline, Embase, PsycInfo, Scopus, and Web of Science. RESULTS Twenty-nine studies were included in the review, and three themes were identified that related to ableism: (1) types and rates of ableism (i.e., stigma, bullying and victimization, and discrimination and inequalities); (2) factors affecting ableism (i.e. sociodemographic factors, familial factors, and societal factors); and (3) impacts of ableism (i.e. mental health, family impacts, and societal impacts). CONCLUSIONS Our review highlights that ableism has various types and can be influenced by multiple factors, influencing social and health outcomes of Asian families with children and youth with disabilities. This review also emphasizes the importance of increasing the public's awareness regarding disabilities to reduce ableism among Asian families with children with disabilities.
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Affiliation(s)
- Yiyan Li
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Kristina Fuentes
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Shaelynn Hsu
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
- Faculty of Science, York University, Toronto, Canada
| | - Sharmigaa Ragunathan
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Sally Lindsay
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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Li Y, Ragunathan S, Fuentes K, Hsu S, Lindsay S. Exploring the experiences of ableism among Asian children and youth with disabilities and their families: a systematic review of qualitative studies. Disabil Rehabil 2023:1-20. [PMID: 37737152 DOI: 10.1080/09638288.2023.2258792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/10/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Asian children and youth with disabilities often experience multiple barriers, stigmas and discrimination within and outside their families; yet less is understood about their lived experiences. This systematic review explored the experiences of ableism among Asian children and youth with disabilities and their families. METHODS We conducted a systematic review of qualitative studies and a qualitative meta-synthesis. We searched six databases including Ovid Medline, Embase, PsychInfo, Healthstar, Web of Science, and Scopus. RESULTS Forty-two articles met our inclusion criteria involving 17 countries and regions over a 22-year period. The findings were synthesized into four themes: (1) individual- and family-level ableism (i.e., stigma, fears, concerns, stress and anxieties, physical abuse, bullying, reduced engagement in community activities); (2) institutional-level ableism (i.e., barriers to accessing and navigating supports, ableist attitudes among service providers, unavailable services); (3) societal-level ableism (i.e., cultural and religious stigma, social rejection, discrimination, environmental and policy barriers); and (4) coping strategies (i.e., self-care activities, supports from family, friends and people with similar conditions, religious beliefs). CONCLUSIONS Our results highlight the ableist experiences that Asian children and youth with disabilities and their caregivers often encounter and the strong need for further supports to address ableism using culturally responsive strategies.
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Affiliation(s)
- Yiyan Li
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Sharmigaa Ragunathan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Kristina Fuentes
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Shaelynn Hsu
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Faculty of Science, York University, Toronto, Canada
| | - Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
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Coelho MLG, Campos TNC, Magalhães AG, Felix JB, Melo A, Tavares JS, Monteiro KS, Longo E. My child is growing and now? Exploring the environmental needs of children with congenital Zika syndrome according to their caregivers' perceptions. Health Expect 2022; 25:2828-2836. [DOI: 10.1111/hex.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/07/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Monique L. G. Coelho
- Faculty of Health Science of Trairi Federal University of Rio Grande do Norte Santa Cruz Brazil
| | - Taynah N. C. Campos
- Faculty of Health Science of Trairi Federal University of Rio Grande do Norte Santa Cruz Brazil
| | | | - Jean B. Felix
- Faculty of Health Science of Trairi Federal University of Rio Grande do Norte Santa Cruz Brazil
| | | | | | - Karolline S. Monteiro
- Faculty of Health Science of Trairi Federal University of Rio Grande do Norte Santa Cruz Brazil
| | - Egmar Longo
- Faculty of Health Science of Trairi Federal University of Rio Grande do Norte Santa Cruz Brazil
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Ozalp Akin E, Bingoler Pekcici EB, Ozturk Ertem I. Rates and Correlates of Stigmatization Expressed by Parents of Young Children with Developmental Difficulties in a Middle-Income Country. J Dev Behav Pediatr 2022; 43:e61-e69. [PMID: 34086634 DOI: 10.1097/dbp.0000000000000979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 04/20/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Information on stigmatization of young children with developmental difficulties (DDs) in low- and middle-income countries (LMICs), where most children reside, is crucial to combat stigma globally. We aimed to identify rates and correlates of stigmatization of young children with DDs in a middle-income country, Turkey. METHOD In this cross-sectional study, parents of children aged 0 to 42 months attending Ankara University School of Medicine, Department of Pediatrics, Developmental-Behavioral Pediatrics Division for their first visit were recruited consecutively. Parents responded to the written open-ended stigma questions of the Expanded Guide for Monitoring Child Development. Stepwise logistic regression analysis was used to determine factors associated with stigmatization. RESULTS The sample comprised 306 children (60.8% boys) with DDs (72.9% with chronic illness/disability and 27.1% with isolated language delay). Most of the mothers (61.1%) and fathers (60.7%) had less than high school education. Stigmatization was reported by 102 (33.3%) families. Child's sex, age, and health condition were not, but 5 of 9 environmental/contextual factors examined were statistically significantly associated with stigmatization. In the logistic regression model, not receiving support from relatives/friends (odds ratio [OR] = 4.97, 95% confidence interval [CI] = 2.16-11.48) and feelings of depression in the mother were independent factors associated with stigmatization (OR = 2.16, 95% CI = 1.04-4.50). CONCLUSION In a referred sample from Turkey and likely other LMICs, a large proportion of parents of young children with DDs report having experienced stigmatization at their first developmental assessment. Interventions that aim to address stigmatization in this early period must focus on support from family/friends and maternal mental health, which are independent strong correlates of stigma.
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Affiliation(s)
- Ezgi Ozalp Akin
- Department of Pediatrics, Developmental-Behavioral Pediatrics Division, Ankara University School of Medicine, Ankara, Turkey
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Nwankwo B, Joseph S, Usman N, Oyefabi A. Anemia in pregnancy: Prevalence among clients attending antenatal clinics in Chikun LGA, Kaduna, Nigeria. JOURNAL OF CLINICAL SCIENCES 2022. [DOI: 10.4103/jcls.jcls_42_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yanagisawa S, Swannimitr A, Singhala K, Rujkorakarn D, Aryamuang S, Hashimoto H, Sakamoto M. Needs assessment of caregivers of children with disabilities in resource-limited settings. J Rural Med 2022; 17:143-150. [PMID: 35847758 PMCID: PMC9263948 DOI: 10.2185/jrm.2021-062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/01/2022] [Indexed: 11/27/2022] Open
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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Affiliation(s)
| | | | | | | | | | - Hidemi Hashimoto
- Faculty of Nursing, Doshisha Women’s College of Liberal Arts, Japan
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Asa GA, Fauk NK, Mwanri L, Ward PR. Understanding Barriers to the Access to Healthcare and Rehabilitation Services: A Qualitative Study with Mothers or Female Caregivers of Children with a Disability in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111546. [PMID: 34770060 PMCID: PMC8583444 DOI: 10.3390/ijerph182111546] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 12/13/2022]
Abstract
Accessibility to healthcare and rehabilitation services for children with a disability (CWD) is essential to improving their health and wellbeing. However, access to the services, especially in many settings in developing countries with scarcity of resources, is still limited. As part of a qualitative study exploring impacts of caring for CWD on mothers or female caregivers and their coping strategies, this paper describes barriers for access to healthcare and rehabilitation services for CWD in Belu district, Indonesia. One-on-one, in-depth interviews were conducted with 22 mothers or female caregivers of CWD. Participants were recruited using a combination of purposive and snowball sampling techniques. These were supplemented with interviews with two staff of disability rehabilitation centers in Belu to understand any additional barriers. Data analysis was guided by a qualitative data analysis framework. Our analysis identified that lack of affordability of healthcare services (high costs and low financial capacity of mothers) was the key barrier for access to healthcare and rehabilitation services CWD. Religious or faith-based factors, such as being a non-Catholic (Belu is predominantly Catholic), converting from Catholic to other religions, and the belief in children’s disability condition as “God’s will”, were also influencing factors for lack of access to the services. Shortage of staff, distrust in the therapy skills of staff at rehabilitation centers, and unavailability of appropriately trained healthcare professionals were structural or system-related barriers. The findings indicate the need for government-owned and run disability rehabilitation centers (not faith-based), the provision of fully subsidised health insurance to provide free services, and the provision of qualified therapists and healthcare professionals (to build trust) in Belu and other similar settings in Indonesia.
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Affiliation(s)
| | - Nelsensius Klau Fauk
- College of Medicine and Public Health, Flinders University, P.O. Box 2100, Adelaide 5001, Australia; (L.M.); (P.R.W.)
- Institute of Resource Governance and Social Change, Kupang 85221, Indonesia
- Correspondence:
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, P.O. Box 2100, Adelaide 5001, Australia; (L.M.); (P.R.W.)
| | - Paul Russell Ward
- College of Medicine and Public Health, Flinders University, P.O. Box 2100, Adelaide 5001, Australia; (L.M.); (P.R.W.)
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Psychological, sociocultural and economic coping strategies of mothers or female caregivers of children with a disability in Belu district, Indonesia. PLoS One 2021; 16:e0251274. [PMID: 33956859 PMCID: PMC8101963 DOI: 10.1371/journal.pone.0251274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/22/2021] [Indexed: 11/19/2022] Open
Abstract
Caring for children with a disability can cause a range of psychological and socioeconomic challenges for parents and caregivers, such as anxiety, depression, inability to find affordable and appropriate childcare, loss of income and expenses related to disability specific treatment. As part of a study exploring the impacts of childhood disability on mothers or female caregivers and families, and the copy strategies they used, this paper describes strategies employed by mothers or female caregivers to cope with challenges associated with childhood disability within their family in Belu district, Indonesia. A qualitative approach using one-on-one in-depth interviews was used to collect data from participants (n = 22) who were recruited using a combination of purposive and snowball sampling techniques. Interviews were recorded, transcribed verbatim and imported to NVivo 12 for analysis. A qualitative framework analysis was used to guide data analysis. The conceptual framework of coping strategies guided the conceptualisation and discussion of the findings. The findings showed that active psychological coping strategies, including cognitive or acceptance strategies, knowledge of both health condition and socio-academic related development of children with a disability, and family relationship and support, were used by the participants to cope with psychological challenges facing them. Self-reliance and religious/spiritual coping strategies were also utilised. Sociocultural strategies, such as social withdrawal or disengagement, professional support and culture-based support, were used by the participants to cope with social impacts, stigma, and discrimination associated with childhood disability. Participants also reported using financial strategies such as selling of family assets to cope with the economic challenges. The findings indicate the need for programs and interventions that address the needs of mothers and female caregivers and their families, to assist with effectively managing the significant challenges they face when caring for a child with a disability. Further studies are needed, with a larger number of participants and the inclusion of fathers or male caregivers, in order to better understand the broader coping experience of childhood disability impacts within families.
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