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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 2024; 46:3849-3868. [PMID: 37737152 DOI: 10.1080/09638288.2023.2258792] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/09/2023] [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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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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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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Asikin AS, Aipipidely D, Kiling IY. Experience of dating violence’s victims in Indonesia: A photovoice study. INTERPERSONA: AN INTERNATIONAL JOURNAL ON PERSONAL RELATIONSHIPS 2021. [DOI: 10.5964/ijpr.4303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Dating violence is one of the major violence issues that is continuously threatening female youth in Indonesia. Dating violence can cause significant negative consequences to its victims, which are often underestimated in areas with strong patriarchal cultures. This study aims to identify the experience faced by dating violence victims, which could help expand the literature and provide insights for better violence prevention programs. Photovoice design was used and data were gathered through interviews and a focus group. Participants involved in this study are nine female youth victims of dating violence in Kupang, Indonesia. Analysis of interviews and focus group identified five main themes: 1) types of dating violence, 2) risk factors, 3) protective factors, 4) impacts of dating violence, and 5) withstanding and withdrawing from the relationship. Dating violence risk factors were patriarchal attitude, social and economic condition, lack of knowledge about dating violence, and exposure to violence. Factors that protect female youth from dating violence were positive self-concept, knowledge about dating violence, the role of parents, educational institutions, and health institutions. Reasons for victims to withstand their dating relationships were varied. Types and impacts of dating violence were also varied based on unique experiences. This study provides a deeper understanding of the experience of dating violence victims through photovoice methodology. These experiences were affected by religious and cultural beliefs distinctive to the Indonesian context, highlighting the need for more culture-fit interventions.
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Hepperlen RA, Rabaey P, Ament-Lemke A, Manley H. Caring for a child with a disability in a Zambian community: A study using photo-elicitation. Child Care Health Dev 2021; 47:422-434. [PMID: 33470454 DOI: 10.1111/cch.12851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 11/09/2020] [Accepted: 01/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Over the past 25 years, caregivers of children with disabilities (CWD) in low- and middle-income countries (LMIC) have received limited attention from researchers. Previous research identified the physical, emotional, and social challenges of caregiving in resource-limited areas. Researchers also identified protective factors, such as problem-focused coping and emotion-focused coping. This study seeks to explore experiences of caregivers of CWD through participant-driven photo-elicitation, in a low-income subdistrict of Lusaka, Zambia. METHODS Researchers considered the experiences of caregivers providing support to their children with disabilities (CWD). Ten parent participants completed this qualitative study using photo-elicitation. Parent participants completed an individual interview to describe their experiences reflected in the pictures they took. The research team used qualitative content analysis to identify the themes. RESULTS Five general themes emerged from the data. The last two themes, "Also, a human being," and "The community should learn," are unique in research of CWD caregivers in LMIC settings. It indicates ways that these parents sought to encourage more inclusion and acceptance of their CWD in the community and to speak to other parents who might be struggling with providing care for their CWD. CONCLUSIONS This study expanded disability research to include perspectives from a low-income area in Lusaka, Zambia. In doing so, we acquire a new viewpoint and enhanced understanding of their community experiences. Practice considerations include encouraging disability advocates to continue their work of educating the community about the inherent dignity and worth of people with disabilities and supporting CWD's rights.
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Affiliation(s)
- Renee A Hepperlen
- School of Social Work, University of St. Thomas, St. Paul, Minnesota, USA
| | - Paula Rabaey
- Occupational Therapy Program, St. Catherine University, St. Paul, Minnesota, USA
| | - Amanda Ament-Lemke
- School of Social Work, St. Catherine University - University of St. Thomas, St. Paul, Minnesota, USA
| | - Hayley Manley
- Occupational Therapy Program, St. Catherine University, St. Paul, Minnesota, USA
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Spiegel E, Nesbit KC, Altenor K, Nguyen HT, Tran L, Hermosa AQ, Martin H, Oettingen JV, Treleaven E, Partridge JC. Valuation of Life With Disability: An International Comparison Study in Vietnam, Peru, and Haiti. J Child Neurol 2021; 36:556-567. [PMID: 33432857 DOI: 10.1177/0883073820983262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors measured perceived quality of life for 4 disabilities among 450 adults in 3 resource-limited countries, measuring mean utilities using time trade-off, and surveying participants on 35 sociocultural characteristics to compare utilities for disabilities by country and examine associated sociocultural characteristics. Mean utilities were >0 for mild and moderate, but <0 for severe and profound. Utilities differed across countries (P = .007, .000, .017, .000 for mild, moderate, severe, profound, respectively). Vietnamese utilities correlated with residence (P = .03, moderate), education (P = .03, severe), and number of children (P = .03, moderate). Peruvian utilities correlated with education (P = .05, mild; P = .05, severe), experience with disability (P = .001, mild), gender (P = .04, moderate; P = .03, profound), number of hospitalizations (P = .04, severe). In Haiti, the only correlate was rejection (P = .02, moderate). Culture-specific variables differentially shape perceptions of disability in developing countries, thereby affecting cost-effectiveness calculations. Given substantially negative perceptions, reducing major disability would improve cost-effectiveness of health-policy decisions more than reducing mortality.
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Affiliation(s)
- Elizabeth Spiegel
- Department of Pediatrics, 8785University of California, San Francisco, San Francisco, CA, San Francisco, CA, USA
| | - Kathryn C Nesbit
- Graduate Program in Physical Therapy, 8785University of California, San Francisco/San Francisco State University, San Francisco, CA, USA
| | | | - Hoa Thi Nguyen
- Neonatology Department, Vietnam National Children's Hospital, Ha Noi, Viet Nam
| | - Ly Tran
- Neonatology Department, Vietnam National Children's Hospital, Ha Noi, Viet Nam
| | | | - Holly Martin
- Department of Pediatrics, 8785University of California, San Francisco, San Francisco, CA, San Francisco, CA, USA
| | - Julia von Oettingen
- Department of Pediatrics, 54473McGill University Health Centre, Montreal, Canada, USA
| | - Emily Treleaven
- Population Studies Center, University of Michigan, Ann Arbor, MI, USA
| | - John Colin Partridge
- Department of Pediatrics, 8785University of California, San Francisco, San Francisco, CA, San Francisco, CA, USA
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Asa GA, Fauk NK, Ward PR, Mwanri L. The psychosocial and economic impacts on female caregivers and families caring for children with a disability in Belu District, Indonesia. PLoS One 2020; 15:e0240921. [PMID: 33147246 PMCID: PMC7641436 DOI: 10.1371/journal.pone.0240921] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 10/05/2020] [Indexed: 11/22/2022] Open
Abstract
The current study aimed to understand psychosocial and economic impacts of female caregivers and families caring for children with a disability in Belu district, Indonesia. A qualitative inquiry employing one-on-one in-depth interviews was used to collect data from participants (n = 22). Data analysis was guided by a framework analysis for qualitative research. Social implications framework and the economic consequence of disease and injury framework were used to guide the conceptualisation, analysis and discussion of the findings. Findings indicated that female caregivers of children with a disability experienced significant psychosocial challenges. These included feeling frustrated, sad, angry, worried, inferior and insecure due to rejection of their children by other kids with no disability. Poor physical conditions of and negative labelling given to their children and the fear of what the future held for their children with a disability added yet another layer of psychosocial challenges experienced by these women. Separation or divorce and reduced social interaction and engagement in the community were expressed social impact loaded to these women resulting from poor acceptability of the children by their fathers, increased time spent caring and discriminatory and stigmatising attitudes against their children with a disability. The participants also experienced economic impacts, such as increased health and transport expenses, loss of jobs and productivity, and lack of savings. The findings indicate the need for programs and interventions addressing the needs of mothers or female caregivers and families with disabled children. Further studies with large number of participants covering mothers, fathers and caregivers to understand broader experiences and the need of caring for children with a disability are recommended.
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Affiliation(s)
- Gregorius Abanit Asa
- Sanggar Belajar Alternatif (SALT), Atambua, Nusa Tenggara Timur, Indonesia
- * E-mail:
| | - Nelsensius Klau Fauk
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Institute of Resource Governance and Social Change, Kupang, Nusa Tenggara Timur, Indonesia
| | - Paul Russell Ward
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Hashemi G, Wickenden M, Bright T, Kuper H. Barriers to accessing primary healthcare services for people with disabilities in low and middle-income countries, a Meta-synthesis of qualitative studies. Disabil Rehabil 2020; 44:1207-1220. [PMID: 32956610 DOI: 10.1080/09638288.2020.1817984] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
METHODS Six electronic databases were searched for relevant studies from 2000 to 2019. Forty-one eligible studies were identified. RESULTS Findings suggest that the people with disabilities' choice to seek healthcare services or not, as well as the quality of intervention provided by primary healthcare providers, are influenced by three types of barriers: cultural beliefs or attitudinal barriers, informational barriers, and practical or logistical barriers. CONCLUSION In order to achieve full health coverage at acceptable quality for people with disabilities, it is necessary not only to consider the different barriers, but also their combined effect on people with disabilities and their households. It is only then that more nuanced and effective interventions to improve access to primary healthcare, systematically addressing barriers, can be designed and implemented.IMPLICATIONS FOR REHABILITATIONPeople with disabilities in both high income and low- and middle-income country settings are more likely to experience poorer general health than people without disabilities.Barriers to accessing primary healthcare services for people with disabilities result from a complex and dynamic interacting system between attitudinal and belief system barriers, informational barriers, and practical and logistical barriers.Given primary healthcare is often the initial point of contact for referral to specialty care and rehabilitation services, it is crucial for people with disabilities to access primary healthcare services in order to get appropriate referrals for such services, specifically rehabilitation as appropriate.To achieve full health coverage at acceptable quality for people with disabilities, starting with primary healthcare, it is necessary for healthcare stakeholders, including rehabilitation professionals, to consider the combined and cumulative effects of the various barriers to healthcare on people with disabilities and their families and develop an understanding of how healthcare decisions are made by people with disabilities at the personal and the household level.
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Affiliation(s)
- Goli Hashemi
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK.,Department of Occupational Therapy, Samuel Merritt University, Oakland, CA, USA
| | - Mary Wickenden
- Institute of Development Studies, University of Sussex, Brighton, UK
| | - Tess Bright
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
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