Parenting individuals with intellectual and developmental disabilities in South India

Qualitative analysis of social support for caregivers of children with neurodevelopmental disorders in South India

BACKGROUND

Despite its importance, limited formal social supports are available for caregivers of children with neurodevelopmental disorders (NDDs) navigating rehabilitation and caregiving in low-resource contexts. The current study investigates the social support sources and coping processes of caregivers of children with NDD at a rural rehabilitation center in South India. An emphasis is placed on interactions between the study participants and families of other children with NDD receiving services at the center.

METHODS AND PROCEDURE

A constructivist grounded theory methodology was adopted. Data analysis was based on data obtained from twenty-two parents obtaining rehabilitation services in the center over two phases.

OUTCOMES AND RESULTS

Constant comparative analysis of caregivers' perceptions and experiences generated a theoretical framework of the long-term emergence of social support and coping, comprising three subcategories: accessing service, gaining acceptance and experiencing support at a grassroots level, and coping at a grassroots level.

CONCLUSIONS AND IMPLICATIONS

Findings illustrate the need for and benefit of supporting caregivers of children with NDD to find informal social support. Critical considerations for rehabilitation providers, researchers, and policymakers to facilitate caregivers' formal and informal social support and coping skills are discussed.

Unmet and under-met needs among Indian parents of children with neurological disorders

BACKGROUND

Parents of children with neurological disorders commonly report having unmet needs related to their child's care. Mixed methods research is needed with parents of children with neurological disorders in India in order to: 1) quantify which needs are unmet and under-met, and 2) qualitatively explore how parents perceive their unmet and under-met needs.

METHODS

This concurrent mixed-methods study used a convergence model of triangulation design. Parents of children with neurological disorders receiving treatment in a children's hospital in Hyderabad, India completed questionnaires (n = 205) on unmet/under-met needs. Twenty-five of these parents then completed in-depth interviews exploring experiential aspects of unmet needs.

RESULTS

Quantitative analysis suggested that education about the child's illness and medical needs were the most frequent unmet needs. Parents needed their child's condition explained to them (91.7%) and greater continuity of their child's care (85.4%). Qualitative analysis suggested that parents reported struggling to find a specialist who was knowledgeable about their child's condition. Though parents living in rural areas quantitatively reported fewer unmet needs (child's medical care, care coordination, and communication) than parents living in the city (B = 0.92 [95%CI = 0.64,1.20] for medical care needs), the qualitative data showed this may be due to lower expectations from the health system.

CONCLUSION

Parents of children with neurological disorders in India frequently report unmet and under-met needs.

PRACTICE IMPLICATIONS

Community-based interventions coupled with training nurses on information provision could help bridge the gap between what is offered by hospital systems, and what is needed by parents, in terms of information and support.