Disease management experiences of parents of children with ADHD: a qualitative directed content analysis

Abstract

The long-term management of children with ADHD primarily relies on parents. As primary caregivers, parents bear the main responsibility for their children’s treatment coordination, daily behavior guidance, and school collaboration. However, the subjective experiences of these parents in navigating ADHD management, including their challenges, coping strategies, and emotional responses, remain insufficiently explored. Face-to-face, semi-structured in-depth interviews were conducted with 17 parents of children with ADHD. These caregivers were recruited from the psychiatric outpatient department of a Grade A tertiary general hospital in Yunnan, China, via a purposive sampling method. Guided by the ABC-X Model of Family Stress and Adaptation as the theoretical framework, the interview data were analyzed using directed content analysis, with NVivo 12.0 software employed for data management and analysis. The study identified four core categories corresponding to the ABC-X Model. (1) Multifaceted Challenges in Treatment Implementation: Medication Adherence Barriers, Time and Financial Pressures Faced. (2) Coping Resources: Positive Self-Regulation–Agentic Fatalism; Social Support: Gains and Gaps. (3) Differentiated Cognition of Disease Management: Evolution of ADHD Cognition, Perception and Cognitive Divergence in Disease Management Difficulty. (4) Duality of Management Results: Crisis Responses, Adaptive Outcomes. Other research findings included the impact of ADHD on siblings and social cognitive biases. The ABC-X Model is applicable to Chinese ADHD family management. The results of this study provide healthcare providers with a more detailed understanding of the disease management experiences of parents of children with ADHD.