تجربیات مادران کودکان ADHD در مواجهه با سیستم‌های آموزش، سلامت و جامعه: مدل پارادایمی پارادوکس مراقبت

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد، گروه روانشناسی و آموزش کودکان استثنایی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران

2 دانشجوی کارشناسی ارشد، گروه روانشناسی، مشاوره و جامعه شناسی ، دانشگاه خیام، مشهد، ایران

3 دانشجوی کارشناسی ارشد، گروه روانشناسی بالینی، دانشگاه علوم پزشکی آزاد اسلامی تهران، تهران، ایران

4 دانشجوی کارشناسی ارشد، گروه روانشناسی تربیتی و شخصیت، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران

5 دپارتمان مشاوره و روانشناسی، کلینیک شهید دادمان، وزارت راه و شهرسازی، تهران، ایران

چکیده

هدف: پژوهش حاضر با هدف تبیین فرآیند تجربیات زیسته مادران ایرانی دارای کودکان مبتلا به اختلال نقص توجه/بیش‌فعالی (ADHD) در مواجهه با سیستم‌های سلامت، آموزش، خانواده و جامعه و نیز تدوین نظریه‌ای بومی در این زمینه انجام شد.
روش: این مطالعه با رویکرد کیفی و با استفاده از راهبرد نظریه داده‌بنیاد (رویکرد ساخت‌گرایانه) انجام گرفت. مشارکت‌کنندگان شامل 20 نفر از مادران دارای کودک مبتلا به ADHD بودند که به روش نمونه‌گیری هدفمند و سپس نظری انتخاب شدند. داده‌ها از طریق مصاحبه‌های نیمه‌ساختاریافته گردآوری و تا رسیدن به اشباع نظری ادامه یافت. تحلیل داده‌ها همزمان با جمع‌آوری و در سه مرحله کدگذاری اولیه، متمرکز و نظری با استفاده از نرم‌افزار MAXQDA انجام شد. برای افزایش اعتبار یافته‌ها از معیارهای اعتمادپذیری شامل بازبینی مشارکت‌کنندگان و هم‌کدگذاری استفاده گردید.
یافته‌ها: تحلیل داده‌ها به استخراج 65 کد باز و 17 مقوله در قالب یک مدل پارادایمی انجامید. پدیده محوری با عنوان «پارادوکس مراقبت چندبعدی» شناسایی شد که بیانگر زیست معلق مادران میان «ایثار عاشقانه» و «فرسودگی ناشی از تضادهای سیستمی» است. شرایط علی شامل ابهام در تشخیص و فشارهای آموزشی، در بستر خلأهای ساختاری و تحت تأثیر شرایط مداخله‌گر مانند قضاوت‌های اجتماعی و تنش‌های خانوادگی، به اتخاذ راهبردهایی همچون نقش معلم‌سایه، پنهان‌کاری و میانجی‌گری میان‌سیستمی منجر شده است.
نتیجه‌گیری: پیامد نهایی این فرآیند، استحاله هویتی و بازتعریف مفهوم موفقیت در مادران است. یافته‌ها ضرورت گذار از رویکرد کودک‌محور به خانواده‌محور و ارتقای آگاهی اجتماعی در مواجهه با تنوع عصبی را برجسته می‌سازد.

کلیدواژه‌ها

عنوان مقاله [English]

Experiences of Mothers of Children with ADHD in Encountering Education, Health, and Social Systems: A Paradigmatic Model of the Care Paradox

نویسندگان [English]

  • Fatemeh Nesa Ghanbari 1
  • Elaheh Shokouhi Far 2
  • Sahel Kazemian 3
  • Leila Aslani 4
  • Kourosh Ghanbari 5
1 M.A. student, Department of Psychology and Education of Exceptional Children, SR.C., Islamic Azad University, Tehran, Iran
2 M.A. Student, Department of Psychology, Counseling and Sociology, Khayyam University, Mashhad, Iran
3 M.A. Student, Department of Clinical Psychology, Islamic Azad University of Medical Sciences, Tehran, Iran
4 M.A. Student, Department of Educational Psychology and Personality, SR.C., Islamic Azad University, Tehran, Iran
5 Department of Counseling and Psychology, Shahid Dadman Clinic, Ministry of Roads and Urban Development, Tehran, Iran
چکیده [English]

Objective: The present study aimed to explain the lived experiences of Iranian mothers of children with attention deficit/hyperactivity disorder (ADHD) in their encounters with health, education, family, and community systems, and to develop a local theory in this field.
Method: a qualitative approach using a data-based theory strategy (constructivist approach). Participants included 20 mothers of children with ADHD who were selected through purposive and then theoretical sampling. Data were collected through semi-structured interviews and continued until theoretical saturation was reached. Data analysis was performed simultaneously with collection and in three stages of initial, focused, and theoretical coding using MAXQDA software. Reliability criteria including participant review and co-coding were used to increase the validity of the findings.
Findings: Data analysis led to the extraction of 65 open codes and 17 categories in the form of a paradigmatic model. A central phenomenon titled “multidimensional caregiving paradox” was identified, which expresses the suspended life of mothers between “romantic sacrifice” and “burnout due to systemic conflicts.” Causal conditions, including ambiguity in diagnosis and educational pressures, in the context of structural gaps and under the influence of intervening conditions such as social judgments and family tensions, have led to the adoption of strategies such as the role of shadow teacher, concealment, and intersystem mediation.
Conclusion: this process is identity transformation and a redefinition of the concept of success in mothers. The findings highlight the necessity of transitioning from a child-centered to a family-centered approach and promoting social awareness in the face of neurodiversity.

کلیدواژه‌ها [English]

  • Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Grounded Theory
  • Care Paradox
  • Support Systems
  • Paradigmatic Model

مراجع

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 69، شماره 1
فروردین1405
فروردین 1405
صفحه 66-92

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