تبیین چالش‌های ارائهٔ خدمات به افراد دارای معلولیت در مراکز نگهداری: یک مطالعهٔ کیفی

زمینه و هدف: افراد دارای معلولیت بخشی از جامعه به‌شمار می‌روند که به ‌لحاظ موقعیتشان نیاز بیشتری به حمایت اجتماعی و دریافت خدمات مطلوب دارند. باتوجه به ضرورت خدمت‌رسانی کارا و اثربخش به افراد معلول، هدف از مطالعهٔ کیفی حاضر تبیین چالش‌های ارائهٔ خدمات به افراد دارای معلولیت در مراکز نگهداری بود. روش‌بررسی: این مطالعه به‌صورت کیفی در سال 1399 انجام شد. جامعهٔ پژوهش را مدیران مراکز نگهداری افراد دارای معلولیت در تهران تشکیل دادند. در این پژوهش روش نمونه‌گیری هدف‌مند استفاده شد که پس از مصاحبه با نوزده نفر از مشارکت‌کنندگان اشباع اطلاعات به‌دست آمد. روش جمع‌آوری داده‌ها مصاحبهٔ نیمه‌ساختاریافته بود که با موافقت شرکت‌کنندگان ضبط، بازنویسی و تحلیل شد. برای تحلیل داده‌ها، روش تحلیل محتوای نهفته به‌کار رفت؛ همچنین برای بررسی توزیع فراوانی شرکت‌کنندگان در مطالعه برحسب متغیرهای دموگرافیک، از نرم‌افزار spss استفاده شد. یافته‌ها: یافته‌ها منجربه استخراج سه طبقهٔ اصلی و پانزده زیرطبقه شامل عوامل فرهنگی-‌آموزشی (نبود فرهنگ‌سازی و ارتقای دانش عمومی، فقدان آموزش فردی و همگانی، معرفی‌نشدن منابع در زمینهٔ معلولیت، باورنداشتن توان‌مندی افراد دارای معلولیت، نبود آموزش و تربیت نیروی انسانی)، برنامه‌ریزی (فقدان بانک اطلاعاتی، فقدان برنامه‌های مدون ارائهٔ خدمات، نبود برنامهٔ افزایش پوشش خدمات، فقدان گایدلاین، فقدان برنامهٔ مشخص بهره‌گیری از ظرفیت افراد دارای معلولیت) و منابع، امکانات و زیرساخت‌های لازم (نبود کفایت تجهیزات و اقلام، کمبود‌‌های دارویی، منابع انسانی و مالی، فقدان حمایت‌های بین‌بخشی) شد. نتیجه‌گیری: براساس یافته‌ها، سه عامل فرهنگی-آموزشی، برنامه‌ریزی و منابع، امکانات و زیرساخت‌های لازم به‌عنوان چالش‌های مهم‌تر ارائهٔ خدمات به افراد دارای معلولیت در مراکز نگهداری هستند.

challenges of providing services to individuals with disabilities: a qualitative study

background & objectives: individuals with disabilities (iwds) are part of the society that, respecting their situation, have the greatest need for social support and the provision of desirable services. however, in underdeveloped and developing countries, the existence of a negative and incorrect view towards iwds is effective in providing services to them, especially in care centers; accordingly, this condition makes this part of society encounter numerous challenges in receiving the necessary services. factors, such as the number of iwds in care centers, their age, their ratio to the number of caregivers, and the characteristics of caregivers, such as their professional skills and experience, are influential in the occurrence of abusive behaviors. due to the necessity of providing efficient and effective service to iwds, the present study aimed to identify the challenges of providing services in care centers for iwds.methods: this qualitative study was conducted in 2020. the research setting consisted of all care centers for iwds in tehran city, iran. moreover, the study population included the managers of care centers for iwds in tehran. using the purposive sampling method, 19 managers of the centers were selected and interviewed according to the objectives of the study. the interviews continued until reaching data saturation. for data collection, we used semi–structured interviews; the interviews were recorded, then transcribed, and analyzed with the consent of the study participants. for data confirmation, each interview was provided to the study participants after analysis, and their opinions were re–obtained concerning their interviews. the latent content analysis method was also used to analyze the collected data. for this purpose, after listening to each interview several times and reading the transcripts line by line, important phrases in the content of the data were identified; consequently, the appropriate concepts were determined and placed in the same categories. to observe ethical issues, verbal informed consent was obtained from all study participants before conducting the interviews. spss was used to investigate the frequency distribution of study participants respecting the demographic variables.results: the mean age of study participants was 41.13 years. the majority of the study participants (57.89%) were in the age group of 41–46 years. their average work experience equaled 14.51 years and the majority (68.42%) were in the group of 13–20 years. additionally, most of the respondents had a ba degree (68 .42%). after analyzing the interviews with 19 managers of the centers, the first 321 separate codes were obtained; after analyzing, they were grouped under 15 sub–categories. finally, after reviewing and analyzing these subcategories, 3 main categories, including cultural–educational factors, planning, and necessary resources, as well as facilities and infrastructures were developed. cultural–educational characteristics, included the lack of culture creating, the lack of promotion of public knowledge, the lack of individual and public education, not introducing resources about disability, no belief in the ability of iwds, and the lack of education and training of human resources. planning consisted of the lack of a database, no codified service delivery programs, no plan to increase service coverage, guidelines, and specific program for use by iwds. necessary resources, facilities, and infrastructures included the lack of adequate equipment and items, drug shortages, human and financial resources, the lack of interdepartmental supports to support iwds.conclusion: according to the current research findings, factors related to culture–education, planning, and the necessary resources, facilities and infrastructures were the main challenges and obstacles in providing services to iwds.