Conectar
by Archana Bagale, Anil Raj Ojha, Machhindra Lamichhane
BackgroundThe neurodevelopmental disorder known as autism spectrum disorder (ASD) affects people of all racial, ethnic, and socioeconomic backgrounds. Although the study of autism is burgeoning with important implications both for public health and society, there is little research exploring the experiences of raising a child with autism spectrum disorder (ASD) from the Parent’s perspectives. The aim of this study was to explore experiences and coping strategies of parents of children with ASD in Nepal.
MethodologyA descriptive phenomenological design explored the lived experiences of nine parents raising children with ASD in Nepal. Participants were purposively selected from the Pediatric OPD of Patan Academy of Health Sciences. Data were collected through in-depth, semi-structured interviews in Nepali and analyzed using Colaizzi’s method. The interview guide, adapted from Batchelor (2017) and the Chronic Sorrow Instrument, explored emotional, social, financial, and caregiving experiences. Researcher bias was minimized through bracketing and reflexive journaling, and trustworthiness ensured via member checking, audit trails, and peer debriefing. Ethical approval was obtained from the PAHS Ethical Review Board, with informed consent and confidentiality maintained.
ResultsFive major themes emerged: psychological impact (emotional burden, hope and uncertainty, guilt), physical impact (fatigue, sleep deprivation, safety concerns), social impact (isolation, stigma, family sacrifices), career impact (job loss, reduced opportunities), and financial impact (high costs, limited resources). Coping strategies included crying, listening to religious music (bhajans), meditation, and practicing positive thinking. Some parents reframed their experience as an opportunity to help others.
ConclusionParents raising children with autism in Nepal face profound emotional strain, physical fatigue, social isolation, career disruption, and financial pressure. These challenges were especially evident among mothers, who formed the majority of caregivers. Despite early diagnosis and continued care, families reported limited resources and persistent social stigma. Yet, many parents showed determination and resilience in supporting their children’s development. These findings emphasize the need to strengthen family-centered support, accessible services, and community awareness to better address the lived realities of caregivers.
Coronary revascularisation practices have evolved over the last three decades. This study sought to examine the variations in percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) rates, alongside mortality from acute myocardial infarction (AMI) across a group of 16 high-income countries between 2006 and 2020.
Retrospective observational analysis using data from the Organisation for Economic Co-operation and Development (OECD) database between 2006 and 2020. Estimated annual percent change in revascularisation was analysed using Joinpoint regression model, and mortality rates were evaluated using the locally weighted scatterplot smoothing model.
Publicly available data on PCI and CABG procedure rates alongside AMI mortality rate from 2006 to 2020.
16 countries from the OECD database.
Not applicable.
Standardised PCI and CABG procedure rates and AMI age-standardised mortality rate (ASMR) from 2006 to 2020.
Over the 15 year period, 14.0 million PCI and 2.8 million CABG procedures were collectively recorded across 16 countries. PCI rates varied among nations, but from 2006 to 2020 increased in 11 of the 16 nations overall, led by Finland (+36.0%), Ireland (+34.5%) and France (+31.5%). Meanwhile, CABG rates declined in 14 out of the 16 countries, with Luxembourg (–71.3%), the UK (–62.6%) and Finland (–60.6%) experiencing the most substantial decreases. Throughout the study period, the PCI-to-CABG ratio increased, while AMI ASMR decreased consistently across all countries.
Despite evidence supporting CABG over PCI in specific scenarios, CABG rates have declined, and PCI rates have increased. Possible factors for this trend may include patient preference and advancement in interventional techniques. The varied use of PCI among these nations, alongside a sustained decline in AMI mortality rates, may be expected given the importance of optimal medical therapy in the management of ischaemic heart disease. The results further suggest the significance of factors beyond revascularisation in driving improved outcomes.
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