Factors that influence the utilization of primary care for children with special health care needs.

摘要

This study explored the relationships among the factors that influence the utilization of primary care providers by families for their child with special health care needs (CSHCN). Healthy People 2010 established a focus area to improve access to health care services. Primary care is significant in accomplishing this goal. Families of CSHCN must adapt to the challenges presented by their child's physical, cognitive, psychosocial or developmental special needs and primary care is essential to assist these families in meeting these challenges.;The Health Promotion Model was used as the theoretical framework to explain the relationships among chronic sorrow, communication, parental satisfaction with primary care providers, and perceived barriers and facilitators to the utilization of primary care by families of CSHCN. The unique contributions of this study to the literature included the use of the Health Promotion Model to explore these factors and the examination of chronic sorrow as a potentially contributing factor.;The research design was a cross-sectional quantitative survey. The questionnaire was developed to explore the latent constructs of parent satisfaction, barriers and facilitators to care, communication, depression, chronic sorrow and utilization of primary care. Pre-existing instruments were used to measure parent satisfaction, barriers and facilitators to care, as well as depression which were used to investigate these constructs. The instrument to measure the construct of chronic sorrow was newly developed. Two hundred and fifteen parents and guardians of CSHCN completed a survey questionnaire. Confirmatory factor analysis, a form of structural equation modeling, was used to analyze the data. Perceived good communication and parental satisfaction with primary care services were found to have the most significant relationship with the utilization of primary of primary care by families of CSHCN.