PURPOSE:The aim of this integrative review is to synthesize quantitative and qualitative research evidence on challenges in caring for a child with a disability among immigrant parents and to understand their coping strategies and resiliency factors associated with their coping. METHODS:A comprehensive literature search was conducted to identify relevant studies from the following databases: MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, PsycINFO, Social work abstract, Cochrane library, and EMBASE. FINDINGS:This review included 25 studies: 1 quantitative, 23 qualitative, and 1 narrative review. The main challenges that parents faced were language barriers, financial hardships, service utilization challenges, poor adaptation to new culture, stigma related to mental illness, discrimination, and social isolation. This review found poor communication and lack of cultural awareness among some healthcare professionals. Immigrant parents used problem-focused coping, avoidance coping, spiritual coping, and social support to manage their challenges. Parents who received social, emotional, and instrumental support were more resilient. Personality traits and faith were protective factors that enhanced resilience. CONCLUSIONS:When immigration and disability are considered concurrently, the burden of care multiplies. Immigrant parents with children who have disabilities faced extra challenges related to adaptation, finance, service utilization, and stigma. Healthcare providers can play an important role in aiding these parents in service utilization and adaptation. SIGNIFICANCE:This review adds new knowledge on immigrant parents' challenges in caring for their children with disabilities. Such knowledge could help health professionals to develop supportive interventions to enhance parental coping and resilience. CLINICAL RELEVANCE:Culturally appropriate and sensitive communication and care provided by healthcare providers can facilitate service utilization and reduce perceived stigma. Special training provided to healthcare providers regarding the challenges of these families may enhance awareness. Information support and parental support groups may help to enhance parental coping and reduce isolation. An interpreting service should be provided in all aspects of care.

译文

目的:本综合综述的目的是综合定量和定性研究证据,说明在移民父母中照料残疾儿童所面临的挑战,并了解他们的应对策略和与应对相关的适应力因素。
方法:进行了全面的文献检索,从以下数据库中检索了相关研究:MEDLINE,护理和相关健康文献累积索引(CINAHL),Scopus,PsycINFO,社会工作摘要,Cochrane库和EMBASE。
结果:该评价包括25项研究:1项定量,23项定性和1项叙述性评价。父母面临的主要挑战是语言障碍,经济困难,服务使用挑战,对新文化的适应性差,与精神疾病,歧视和社会孤立有关的污名化。这篇评论发现一些医疗保健专业人员之间沟通不畅,缺乏文化意识。移民父母使用以问题为中心的应对,逃避应对,精神应对和社会支持来应对挑战。受到社会,情感和工具支持的父母更具韧性。人格特质和信仰是增强韧性的保护因素。
结论:同时考虑移民和残疾时,护理负担成倍增加。有残疾儿童的移民父母面临着与适应,经济,服务利用和污名化相关的额外挑战。医疗保健提供者可以在帮助这些父母进行服务利用和适应方面发挥重要作用。
重要性:该评论为移民父母在照顾残疾儿童方面面临的挑战增加了新的知识。这些知识可以帮助卫生专业人员制定支持性干预措施,以增强父母的应对能力和应变能力。
临床相关性:医疗保健提供者提供的文化上适当且敏感的沟通和护理可以促进服务利用并减少可耻的污名。向医疗服务提供者提供有关这些家庭面临的挑战的特殊培训可能会增强意识。信息支持和父母支持小组可能有助于增强父母的应对能力并减少孤立感。应在护理的各个方面提供口译服务。

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