Alignment of Canada's COVID-19 policy response with barriers and facilitators for coping reported by caregivers of youth with developmental delays, disorders, and disabilities

Anna Katalifos, M. Elsabbagh, A. Yusuf, Sakiko Yamaguchi, Julie Scorah, Nicola Wright, M. Steiman, Andy Shih, K. Shikako
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Abstract

The UNICEF-WHO Global Report on Developmental Delays, Disorders, and Disabilities is an ongoing initiative aimed at increasing awareness, compiling data, providing guidance on strengthening health systems, and engaging country-level partners. Data from its caregiver survey assessing impacts of the COVID-19 pandemic showed that half of youths with developmental delays and disabilities (DDDs) and their caregivers struggled to cope, with a significant portion reporting a lack of supports and difficulty managing the worsening of the child's symptoms in isolation. Governments created service strategies supporting vulnerable groups. Little is known about the alignment between COVID-19 policies for persons with disabilities and their lived experiences. Contextualizing caregivers’ experiences can promote the development of tailored public supports for these families following a public health crisis.Online survey data were collected from June-July 2020, leading to a convenience sample of caregivers of youth with DDDs across Canada. Respondents answered two open-ended questions regarding challenges and coping strategies during the pandemic. We conducted a thematic analysis of responses using inductive coding on NVivo software. Overarching codes derived from the dataset were contextualized using an analysis of provincial policies published during the pandemic. Parallels with these policies supported the exploration of families’ and youths’ experiences during the same period.Five hundred and seventy-six (N = 576) participants answered open-ended questions. Barriers to coping included family mental health issues, concerns about the youths’ regression, challenges in online schooling, limited play spaces, and managing physical health during quarantine. Environmental barriers encompassed deteriorating family finances, loss of public services, and a lack of accessible information and supports. In contrast, caregivers reported coping facilitators, such as family time, outdoor activities, and their child's resilience. Environmental facilitators included community resources, public financial supports, and access to telehealth services. Few COVID-19 policies effectively addressed caregiver-identified barriers, while some restrictions hindered access to facilitators.Prioritizing needs of families of youths with DDDs during public health emergencies can significantly impact their experiences and mental health. Enhancing financial benefits, providing telehealth services, and creating inclusive public play spaces are priority areas as we navigate the post-pandemic landscape.
加拿大 COVID-19 政策应对措施与发育迟缓、失调和残疾青少年的照顾者所报告的应对障碍和促进因素相一致
联合国儿童基金会-世界卫生组织关于发育迟缓、发育障碍和残疾的全球报告》是一项持续开展的活动,旨在提高认识、汇编数据、为加强卫生系统提供指导,并吸引国家级合作伙伴的参与。该报告对 COVID-19 大流行的影响进行了评估,其护理人员调查的数据显示,半数发育迟缓和残疾(DDDs)青少年及其护理人员难以应对,其中很大一部分人表示缺乏支持,难以单独应对儿童症状的恶化。各国政府制定了支持弱势群体的服务战略。人们对 COVID-19 残疾人政策与他们的生活经历之间的一致性知之甚少。将照顾者的经历背景化,可以促进在公共卫生危机发生后为这些家庭制定量身定制的公共支持。在线调查数据于 2020 年 6 月至 7 月收集,方便地抽取了加拿大各地患有残疾与发展障碍青少年的照顾者。受访者回答了两个开放式问题,内容涉及大流行期间的挑战和应对策略。我们使用 NVivo 软件对回答进行了归纳编码的主题分析。通过分析大流行期间发布的省级政策,我们对从数据集中得出的总体代码进行了背景分析。五百七十六名(N = 576)参与者回答了开放式问题。应对障碍包括家庭心理健康问题、对青少年退步的担忧、在线教育的挑战、有限的游戏空间以及隔离期间的身体健康管理。环境方面的障碍包括家庭经济状况恶化、公共服务缺失以及缺乏可获取的信息和支持。与此相反,照顾者报告了应对障碍的促进因素,如家庭时间、户外活动和孩子的适应能力。环境促进因素包括社区资源、公共财政支持和远程医疗服务。很少有 COVID-19 政策能有效解决照顾者发现的障碍,而一些限制则阻碍了他们获得促进因素。在公共卫生突发事件中,优先考虑有残疾的青少年家庭的需求会极大地影响他们的经历和心理健康。提高经济福利、提供远程医疗服务和创建包容性的公共游戏空间是我们在大流行后的优先领域。
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