Parental Challenges in Raising Preschoolers With Attention-Deficit/Hyperactivity Disorder in Mainland China’s First-Tier Cities: Qualitative Study Using Framework Analysis
Notice bibliographique
Résumé
BACKGROUND: First-tier cities in mainland China present unique challenges for raising children with attention-deficit/hyperactivity disorder (ADHD) due to rapid urbanization, intense academic pressure, and distinct sociocultural dynamics. While existing research has documented ADHD parenting challenges across various contexts, limited attention has been paid to the preschool period in Chinese metropolitan settings, where early intervention is crucial yet complicated by traditional values and evolving health care systems. OBJECTIVE: This study aimed to explore the comprehensive challenges faced by parents raising preschoolers with ADHD in these metropolitan contexts. METHODS: We conducted web-based semistructured focus group interviews with 13 parents (n=12, 92% mothers and n=1, 8% fathers; aged between 32 and 44 years) of preschool children with ADHD (n=10, 77% boys and n=3, 23% girls; aged between 5 and 7 years) in first-tier cities in mainland China between March and July 2024. Participants were purposively recruited through the ADHD Mutual Support Alliance's platform if they had a preschool child with a formal ADHD diagnosis and lived in first-tier cities. Four interviews were conducted (3 focus groups with 4 participants each and 1 pilot individual interview). All interviews were moderated by a practitioner working with populations with ADHD following a semistructured interview guide developed through expert panel consultation. Interviews were audio-recorded and transcribed verbatim. Qualitative data were analyzed using framework analysis, using a theoretical framework approach, with dual-researcher coding and participant verification to ensure methodological rigor. Data were coded and organized manually using Microsoft Word, supported by NVivo software. RESULTS: Challenges emerged across six major themes: (1) individual psychological and behavioral challenges, including parental emotional burden, self-blame, and difficulties managing ADHD symptoms; (2) microsystem challenges in family and school environment challenges, particularly regarding behavioral management and teacher understanding; (3) mesosystem difficulties in family-school-hospital coordination, highlighted by recurring teacher complaints and inconsistent diagnostic standards; (4) exosystem barriers in work-family balance and health care access, including limited availability of specialized services and financial burdens; (5) macrosystem challenges from societal stigma and traditional educational values, manifesting as discrimination fears and academic pressure; and (6) chronosystem impacts from historical and social changes, notably the COVID-19 pandemic's influence and gaps in support systems compared to countries with comprehensive health care infrastructure. CONCLUSIONS: Parents face multilayered challenges in raising preschoolers with ADHD, particularly regarding access to specialized health care services, navigation of educational systems, and use of culturally adapted interventions. These challenges are intensified by the unique urban context of intense academic pressure and rapid modernization. Future initiatives should focus on enhancing health care resource accessibility, developing culturally sensitive support programs, implementing systematic educational accommodations, and promoting broader societal awareness of ADHD in mainland China. These findings underscore the necessity for comprehensive ecological interventions that address challenges across all systemic levels while considering the unique characteristics of Chinese metropolitan environments.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,006 | 0,004 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».