PDF(Pubmed)
Abstract：
BACKGROUND: There are many dimensions regarding autism that are closely connected to social structures, policies, and power dynamics, silently impacting the well-being of individuals within the autism spectrum. This research aims to explore these overlooked aspects using a theoretical framework called \"structural violence.\"
METHODS: The study was conducted in Kurdistan, Iran, and a qualitative longitudinal approach was chosen. A purposive sampling method was employed to select the participants, with 11 parents taking part. The study data comprised 29 interviews using a topic guide conducted over a span of 2 years. Thematic analysis and a matrix-based approach were utilized for data analysis. To enhance the scientific rigor of this research, four criteria, including Guba and Lincoln\'s principles, were implemented to ensure methodological accuracy.
RESULTS: The research findings highlight four primary forms through which structural violence impacts children on the autism spectrum and their families: access to healthcare, geographic disparities, awareness and stigma, and poverty and financial burden. Additionally, the study identified 11 subthemes related to structural violence in the context of autism and families.
CONCLUSIONS: We illustrated how structural forces create barriers to accessing adequate healthcare services, exacerbate discrimination based on ethnicity and geography, perpetuate stigma, and contribute to poverty and the inability to meet basic needs. These factors not only worsen health issues but also deepen existing disparities in healthcare access and outcomes for children on the autism spectrum and families. We emphasize the urgent need for systemic changes to address these issues. It is essential to promote public awareness, provide better access to health and support services, and address economic and political factors that contribute to these inequalities.
METHODS: The study was conducted in Kurdistan, Iran, and a qualitative longitudinal approach was chosen. A purposive sampling method was employed to select the participants, with 11 parents taking part. The study data comprised 29 interviews using a topic guide conducted over a span of 2 years. Thematic analysis and a matrix-based approach were utilized for data analysis. To enhance the scientific rigor of this research, four criteria, including Guba and Lincoln\'s principles, were implemented to ensure methodological accuracy.
RESULTS: The research findings highlight four primary forms through which structural violence impacts children on the autism spectrum and their families: access to healthcare, geographic disparities, awareness and stigma, and poverty and financial burden. Additionally, the study identified 11 subthemes related to structural violence in the context of autism and families.
CONCLUSIONS: We illustrated how structural forces create barriers to accessing adequate healthcare services, exacerbate discrimination based on ethnicity and geography, perpetuate stigma, and contribute to poverty and the inability to meet basic needs. These factors not only worsen health issues but also deepen existing disparities in healthcare access and outcomes for children on the autism spectrum and families. We emphasize the urgent need for systemic changes to address these issues. It is essential to promote public awareness, provide better access to health and support services, and address economic and political factors that contribute to these inequalities.
摘要：
背景：关于自闭症的许多方面与社会结构密切相关，政策,和动力动态，默默地影响自闭症谱系内个体的福祉。这项研究的目的是探索这些被忽视的方面使用一个理论框架称为“结构性暴力。\"
方法：这项研究是在库尔德斯坦进行的，伊朗,并选择了定性纵向方法。采用目的抽样方法选择参与者，有11位家长参加。研究数据包括29次访谈，使用主题指南进行了2年。利用主题分析和基于矩阵的方法进行数据分析。为了加强这项研究的科学严谨性，四个标准，包括古巴和林肯的原则,实施以确保方法的准确性。
结果：研究结果强调了结构性暴力影响自闭症儿童及其家庭的四种主要形式：获得医疗保健，地理差异,意识和耻辱，贫困和财政负担。此外,该研究确定了11个与自闭症和家庭背景下的结构性暴力相关的子主题。
结论：我们说明了结构性力量如何为获得适当的医疗保健服务造成障碍，加剧基于种族和地理的歧视，永久的污名，并导致贫困和无法满足基本需求。这些因素不仅加剧了健康问题，而且加深了自闭症儿童和家庭在医疗保健获取和结果方面的现有差距。我们强调迫切需要进行系统性变革以解决这些问题。提高公众意识至关重要，提供更好的健康和支持服务，并解决导致这些不平等的经济和政治因素。
方法：这项研究是在库尔德斯坦进行的，伊朗,并选择了定性纵向方法。采用目的抽样方法选择参与者，有11位家长参加。研究数据包括29次访谈，使用主题指南进行了2年。利用主题分析和基于矩阵的方法进行数据分析。为了加强这项研究的科学严谨性，四个标准，包括古巴和林肯的原则,实施以确保方法的准确性。
结果：研究结果强调了结构性暴力影响自闭症儿童及其家庭的四种主要形式：获得医疗保健，地理差异,意识和耻辱，贫困和财政负担。此外,该研究确定了11个与自闭症和家庭背景下的结构性暴力相关的子主题。
结论：我们说明了结构性力量如何为获得适当的医疗保健服务造成障碍，加剧基于种族和地理的歧视，永久的污名，并导致贫困和无法满足基本需求。这些因素不仅加剧了健康问题，而且加深了自闭症儿童和家庭在医疗保健获取和结果方面的现有差距。我们强调迫切需要进行系统性变革以解决这些问题。提高公众意识至关重要，提供更好的健康和支持服务，并解决导致这些不平等的经济和政治因素。
