Quality Of Care For Children Research Articles

Malaysian occupational therapists’ perspectives on sensory-based intervention for children with autism spectrum disorder: A focus group discussion

ABSTRACT This study explores Malaysian occupational therapists’ perspectives on implementing sensory-based intervention for children with autism spectrum disorder, addressing the high prevalence of sensory processing disorder in this population. Despite sensory-based intervention’s common usage globally, its implementation and associated challenges remain inadequately documented. The research employed a qualitative approach, conducting two focus group discussions with 14 experienced occupational therapists. Thematic analysis using ATLAS.ti software revealed eight themes: intervention approaches, implementation references, common activities, implementation structure, strategies, intervention types, evaluation methods, and challenges encountered. The findings emphasize the importance of personalized intervention strategies to meet the diverse sensory needs of children with autism spectrum disorder. The study highlights the necessity for developing comprehensive guidelines for effective sensory-based intervention implementation and underscores the need for individualized approaches. The study’s findings provide a contextual overview of sensory-based intervention in addressing sensory processing disorder among children with autism spectrum disorder. This research may inform the development of evidence-based guidelines and protocols for sensory interventions in occupational therapy practice, ultimately improving the quality of care for children with autism spectrum disorder.

7991 A Quality Improvement Initiative to Increase Documentation of Carbohydrate Ratios and Correction Factors on Insulin Sliding Scales

Abstract Disclosure: R.J. Vitale: None. C. Lu: None. A. Sonawalla: None. T.K. Maxwell: None. S. Nanavati: None. N.E. Renthal: None. E.T. Rhodes: None. C.E. Cherella: None. Background: In the management of insulin-dependent diabetes mellitus, sliding scale (SS) tables - which contain precalculated insulin doses for ranges of blood glucose and carbohydrate intake, usually based on a carbohydrate ratio (CR) and correction factor (CF) - provide a safer alternative for families with limited health literacy and numeracy. However, as insulin needs change, adjusting SS tables can be more difficult than adjusting CRs and CFs, which can cause less frequent or non-standard adjustments in SS tables, result in potential errors, and lead to disparities in the quality of care for these patients. We identified challenges to standardized SS documentation and adjustment at our institution and conducted a quality improvement (QI) initiative to address this problem. We aimed to increase the use of CR/CF to generate and adjust SS to improve the ease and accuracy of SS adjustments and ultimately improve care for this vulnerable patient population. Methods: Our goal was to increase the proportion of patients with diabetes mellitus discharged with CR/CF documented on the most recent SS in the medical record (the primary outcome measure) by 20% over 12 months. The process measure was clinician-reported utilization of CR/CF when generating or adjusting SS. To achieve our goal, we made two process improvements and used Plan-Do-Study-Act cycles to evaluate them. First, we standardized the template for documentation of the SS which also prompted inclusion of the CR/CF to preserve it for future adjustments. Second, we developed a Microsoft Excel SS generator based on clinician input of CR/CF. Clinicians were educated about the importance of CR/CF documentation and were taught to use the new process. SS documentation of CR/CF in the medical record was evaluated through monthly chart review and tracked on a run chart. Clinicians were periodically surveyed on the frequency of use of CR/CF in the creation of SS. Results: The median value of SS that included CR/CF documentation in medical records increased from 0% at baseline to 58% after the interventions. Reported use of CR/CF to make and adjust SS increased from 6/15 (40%) to 6/7 (86%). Provider qualitative feedback on the new process was positive. Conclusion: In this QI project, the implementation of a template that promoted documentation of CR/CF, and a standardized and automated SS calculator that generated SS based on CR/CF, led to both increased documentation of CR/CF for SS, and increased clinician-reported use of CR/CF to adjust SS. The latter may indicate a decrease in barriers to adjusting SS regimens. By facilitating adjustment, this low-cost, reproducible system could increase frequency of changes to SS and may help to improve the quality of care for children with diabetes mellitus using SS. Presentation: 6/2/2024

Cost-Effectiveness And Health Impact Of Increasing Emergency Department Pediatric Readiness In The US.

The quality of emergency department (ED) care for children in the US is highly variable. The National Pediatric Readiness Project aims to improve survival for children receiving emergency services. We conducted a cost-effectiveness analysis of increasing ED pediatric readiness, using a decision-analytic simulation model. Previously published primary analyses of a nationally representative, population-based cohort of children receiving emergency services at 747 EDs in eleven states provided clinical and cost parameters. From a health care sector perspective, we used a 3percent annual discount rate and quantified lifetime costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). We performed probabilistic, one-way, and subgroup sensitivity analyses. Increasing ED pediatric readiness yields 69,100 QALYs for the eleven-state cohort, costing $9,300 per QALY gained. Achieving high readiness nationally yields 179,000 QALYs at the same ICER (with implementation costs of approximately $260million). Implementing high ED pediatric readiness for all EDs in the US is highly cost-effective.

Learning Effects of Mechanical Ventilator/Tracheal Suctioning XR Simulators and Extracting Decision Making Criteria to Introduce a Novel Simulator

Researchers have developed Simmar+ESTE-SIM, a XR simulator that can train the multitask of “endotracheal suctioning for a patient with a mechanical-ventilator’’ as part of support for Technology-dependent children in the community. In this study, we conducted a questionnaire after using the simulator with the aim of extracting the learning effects of the simulator and judgment indicators when introducing a new simulator, based on feedback from 4th grade university students and the faculty members. As a result, both groups tended to score low on the question of whether the content was appropriate for learning in the third year, but the scores were generally high, at 3.0 or higher. The training task “endotracheal suctioning for a patient with mechanical respirator” was slightly early in 3rd grade students, and the appropriate timing was shown to be for 4th grade students. Principal component analysis extracts two principal components: “Balance between learning content difficulty and motivation (Achievability)” and “Balance between learning time, cost, and learning effect (Feasibility)”. These two factors were thought to be the promoting and inhibiting factors when introducing a simulator. The future challenge is to popularize the simulator education program which is both achievable and feasible to improve the quality of care for children with home-ventilators and their families.

Medicaid Accountable Care Organizations and Disparities in Pediatric Asthma Care.

Nearly 6 million children in the US have asthma, and over one-third of US children are insured by Medicaid. Although 23 state Medicaid programs have experimented with accountable care organizations (ACOs), little is known about ACOs' effects on longstanding insurance-based disparities in pediatric asthma care and outcomes. To determine associations between Massachusetts Medicaid ACO implementation in March 2018 and changes in care quality and use for children with asthma. Using data from the Massachusetts All Payer Claims Database from January 1, 2014, to December 31, 2020, we determined child-years with asthma and used difference-in-differences (DiD) estimates to compare asthma quality of care and emergency department (ED) or hospital use for child-years with Medicaid vs private insurance for 3 year periods before and after ACO implementation for children aged 2 to 17 years. Regression models accounted for demographic and community characteristics and health status. Data analysis was conducted between January 2022 and June 2024. Massachusetts Medicaid ACO implementation. Primary outcomes were binary measures in a calendar year of (1) any routine outpatient asthma visit, (2) asthma medication ratio (AMR) greater than 0.5, and (3) any ED or hospital use with asthma. To determine the statistical significance of differences in descriptive statistics between groups, χ2 and t tests were used. Among 376 509 child-year observations, 268 338 (71.27%) were insured by Medicaid and 73 633 (19.56%) had persistent asthma. There was no significant change in rates of routine asthma visits for Medicaid-insured child-years vs privately insured child-years post-ACO implementation (DiD, -0.4 percentage points [pp]; 95% CI, -1.4 to 0.6 pp). There was an increase in the proportion with AMR greater than 0.5 for Medicaid-insured child-years vs privately insured in the postimplementation period (DiD, 3.7 pp; 95% CI, 2.0-5.4 pp), with absolute declines in both groups postimplementation. There was an increase in any ED or hospital use for Medicaid-insured child-years vs privately insured postimplementation (DiD, 2.1 pp; 95% CI, 1.2-3.0 pp), an 8% increase from the preperiod Medicaid use rate. Introduction of Massachusetts Medicaid ACOs was associated with persistent insurance-based disparities in routine asthma visit rates; a narrowing in disparities in appropriate AMR rates due to reductions in appropriate rates among those with private insurance; and worsening disparities in any ED or hospital use for Medicaid-insured children with asthma compared to children with private insurance. Continued study of changes in pediatric asthma care delivery is warranted in relation to major Medicaid financing and delivery system reforms.

Beyond babysitting: an analysis of the quality of childcare service in Ethiopia

ABSTRACT Empirical evidence underscores the importance of investing in early childhood care to ensure its quality. This study examined the quality of child care in day-care centers in Bahir Dar and Gondar cities, Amhara region, Ethiopia, employing an embedded mixed-methods approach. Utilizing descriptive and inferential statistics, including t-tests, regression analysis, and thematic analysis, the research assessed both distal quality – encompassing environmental and staffing conditions – and proximal quality – focusing on caregiver–child interactions. The findings revealed significant deficiencies in distal quality, including inadequate space, activities, and staff qualifications. Proximal quality was also found to be lacking, with government centers exhibiting higher levels of harshness in caregiver interactions compared to private centers. Key factors influencing interaction quality were staff education, experience, and child-to-worker ratios. Despite existing regulatory standards, their enforcement was found to be inadequate. The study recommends that policymakers enhance and enforce regulations, improve staff training and invest in professional development. Further research should explore regulatory enforcement challenges and assess the long-term impacts of training improvements on care quality.

Rural-Urban Disparities in Hospital Services and Outcomes for Children With Medical Complexity

Limited availability of inpatient pediatric services in rural regions has raised concerns about access, safety, and quality of hospital-based care for children. This may be particularly important for children with medical complexity (CMC). To describe differences in the availability of pediatric services at acute care hospitals where rural- and urban-residing CMC presented for hospitalization; identify rural-urban disparities in health care quality and in-hospital mortality; and determine whether the availability of pediatric services at index hospitals or the experience of interfacility transfer modified rural-urban differences in outcomes. This retrospective cohort study examined all-payer claims data from Colorado, Massachusetts, and New Hampshire from 2012 to 2017. Analysis was conducted from May 2023 to July 2024. Participants included CMC younger than 18 years residing in these states and hospitalized during the study period. Rural or urban residence was determined using Rural-Urban Commuting Area codes. Hospitals were categorized as children's hospitals or general hospitals with comprehensive, limited, or no dedicated pediatric services using American Hospital Association survey data. Interfacility transfers between index and definitive care hospitals were identified using health care claims. In-hospital mortality, all-cause 30-day readmission, medical-surgical safety events, and surgical safety events were operationalized using Agency for Healthcare Research and Quality measure specifications. Among 36 943 CMC who experienced 79 906 hospitalizations, 16 525 (44.7%) were female, 26 034 (70.5%) were Medicaid-insured, and 34 008 (92.1%) were urban-residing. Rural-residing CMC were 6.55 times more likely to present to hospitals without dedicated pediatric services (rate ratio [RR], 6.55 [95% CI, 5.86-7.33]) and 2.03 times more likely to present to hospitals without pediatric beds (RR, 2.03 [95% CI, 1.88-2.21]) than urban-residing CMC, with no significant differences in interfacility transfer rates. In unadjusted analysis, rural-residing CMC had a 44% increased risk of in-hospital mortality (RR, 1.44 [95% CI, 1.03-2.02]) with no significant differences in other outcomes. Adjusting for clinical characteristics, the difference in in-hospital mortality was no longer significant. Index hospital type was not a significant modifier of observed rural-urban outcomes, but interfacility transfer was a significant modifier of rural-urban differences in surgical safety events. In this cohort study, rural-residing CMC were significantly more likely to present to hospitals without dedicated pediatric services. These findings suggest that efforts are justified to ensure that all hospital types are prepared to care for CMC.

Construction of indicators for evaluating the quality of extended care for children with asthma

Background and aims To construct a set of scientific and effective quality evaluation indicators of continuing care for children with asthma, and to promote the development of continuing care for children with asthma toward a more specialized and standardized direction. Methods Through literature research and semi-structured interview, the item pool of evaluation index was drawn up, and the first draft of expert inquiry questionnaire was formed based on the three-dimensional quality theoretical model of structure-process-result, and the construction of quality evaluation index was completed through two rounds of expert inquiry and analytic hierarchy process. Results The effective recovery rate was 94.44% in the first round and 100.00% in the second round, the expert authority coefficient was 0.852 and 0.863, and the Kendal coordination coefficient was 0.129 and 0.126, respectively (p < 0.01). Finally, the evaluation index of continuing care quality for children with asthma was formed, including 3 first-level indicators, 9 s-level indicators and 36 third-level indicators, and then the weight and combination weight of each index were obtained by AHP. Conclusions The evaluation index of continuing care quality for children with asthma is scientific and specific, which is of great significance to the improvement of continuing care quality for children with asthma.

Addressing workforce distribution and improving care: insights from trainees

Introduction: Plastic surgeons are maldistributed in New Zealand. Regional centres have fewer surgeons and lower surgeon to population ratios than larger metropolitan areas. There is no published data on the future work intentions of plastic surgical trainees in New Zealand. This study examines the career preferences and intentions of plastic surgery trainees in New Zealand as well as perceived barriers to working in a regional centre. Methods: An anonymous online survey was sent to 31 current plastic surgery trainees and recent graduates. Data collected included demographic information, rural background, previous experience in regional centres, family responsibilities, preferred work locations, aspirations for private practice and work–life balance preferences. Results: A total of 25 trainees completed the questionnaire, with a response rate of 81 per cent. A significant proportion of trainees have prior experience in smaller regional centres. Family-friendly work environments and employment for partners were identified as important considerations. The top-ranked regional centres to work in included Queenstown/Wānaka, Hawkes Bay, Nelson and Whangārei. Factors such as the presence of other plastic surgeons, leave policies, after-hours call arrangements and access to a private operating facility were considered essential. Financial considerations, access to quality schooling or childcare, employment opportunities for partners, opportunities for teaching and unit expansion were also important factors. Conclusion: The results of this survey provide insight into the personal and professional factors influencing the career decisions of plastic surgery trainees in New Zealand. The findings highlight the need for strategic workforce planning and engaging relevant stakeholders to address the maldistribution of plastic surgeons, ultimately improving access to specialised care and reducing healthcare disparities for New Zealanders.

Simulation Education in Pediatric Surgery

Simulation education in pediatric surgery using laparoscopic simulators and virtual reality glasses Kyalio VR surgical training increases the efficiency of surgeon training, reduces the time of adaptation to real operations and improves the quality of medical care for children.

Harnessing Natural Language Processing to Assess Quality of End-of-Life Care for Children With Cancer.

Data on end-of-life care (EOLC) quality, assessed through evidence-based quality measures (QMs), are difficult to obtain. Natural language processing (NLP) enables efficient quality measurement and is not yet used for children with serious illness. We sought to validate a pediatric-specific EOLC-QM keyword library and evaluate EOLC-QM attainment among childhood cancer decedents. In a single-center cohort of children with cancer who died between 2014 and 2022, we piloted a rule-based NLP approach to examine the content of clinical notes in the last 6 months of life. We identified documented discussions of five EOLC-QMs: goals of care, limitations to life-sustaining treatments (LLST), hospice, palliative care consultation, and preferred location of death. We assessed performance of NLP methods, compared with gold standard manual chart review. We then used NLP to characterize proportions of decedents with documented EOLC-QM discussions and timing of first documentation relative to death. Among 101 decedents, nearly half were minorities (Hispanic/Latinx [24%], non-Hispanic Black/African American [20%]), female (48%), or diagnosed with solid tumors (43%). Through iterative refinement, our keyword library achieved robust performance statistics (for all EOLC-QMs, F1 score = 1.0). Most decedents had documented discussions regarding goals of care (83%), LLST (83%), and hospice (74%). Fewer decedents had documented discussions regarding palliative care consultation (49%) or preferred location of death (36%). For all five EOLC-QMs, first documentation occurred, on average, >30 days before death. A high proportion of decedents attained specified EOLC-QMs more than 30 days before death. Our findings indicate that NLP is a feasible approach to measuring quality of care for children with cancer at the end of life and is ripe for multi-center research and quality improvement.

Bias, Prejudice, Discrimination, Racism, and Social Determinants: The Impact on the Health and Well-Being of Latino Children and Youth

This narrative review focuses on the impact of bias, prejudice, discrimination, racism (BPDR), social determinants of health, and structural racism on Latino children’s health and well-being. The race/ethnicity, country of origin, immigrant/generational status, limited English proficiency (LEP), acculturation level, and social class of Latino children and their parents can heighten or modify the impact of BPDR. These differences have been shown to affect BPDR among Latino adults and presumably for their children. Surveys of Latino adolescents reveal that 60% have experienced discrimination, with first- and second-generation teens having a higher prevalence. These experiences are magnified by adverse social determinants/structural racism. BPDR can impact Latino children prenatally through adolescence. Bias involving neonatal, primary, and inpatient pediatric services has been reported. In 2021, Latino children were 19% less likely to complete preventive care, and 32% of LEP children had no medical home. School-age Latino children experience system inequities associated with chronic physical and mental health conditions. BPDR is also seen in educational performance but can be buffered by a strong racial/ethnic self-identity. To address BPDR/structural racism for Latino children, we suggest pediatricians: 1) increase the Latino child-health workforce to address BPDR internally and externally, 2) advocate for data collection on and monitoring of Latino children’s disparities and racism metrics in pediatric services, to improve quality of care for Latino children and their families, and 3) advocate for child health equity. Together, these steps will help eliminate BPDR for Latino children and ensure they obtain their full potential.

Evaluation of the WHO standards to assess quality of care for children with acute respiratory infections: findings of a baseline multicentre assessment (CHOICE) in Italy

BackgroundExperience is lacking on the implementation of the WHO standards for improving the quality of care (QOC) for children at facility level. We describe the use of 10 prioritised WHO...

Implementation of the WHO standards to assess quality of care for children with acute pain in EDs: findings of a multicentre study (CHOICE) in Italy

BackgroundThere is little experience on the use of the WHO Standards for improving the quality of care (QOC) for children. We describe the use of four prioritised WHO Standard-based Quality...

Implementation of the WHO standards to assess the quality of care for children with acute diarrhoea: findings of a multicentre study (CHOICE) in Italy

BackgroundThere is no documented experience in the use of the WHO standards for improving the quality of care (QOC) for children at the facility level. We describe the use of...

A Case Series of Children With Medulloblastoma Depicting the Disparities in Care and the Challenges in the Detection and Treatment of Pediatric Central Nervous System Tumors in Low-Resource Settings: A Case Study of Uganda

BackgroundPrimary central nervous system tumors are the second most common cancer among children in high-income countries (HICs). These tumors are also the leading cause of cancer-related deaths in children in this setting. Studies from HICs report gliomas as the most common pediatric cancer. However, there is paucity of data from low- and middle-income countries as not many publications have been made in this field. MethodsThe objective was to describe the disparities in detection, treatment, and survival of children with central nervous system tumors in low-income countries (LICs) when compared with HICs, using a case series. A retrospective chart review of three children treated for medulloblastoma in Uganda was done. In addition, a review of the literature about management of pediatric central nervous system tumors in both LICs and HICs was conducted. ResultsThere are no quantifiable results for this case series. ConclusionThere are notable differences in the quality of care for children with pediatric central nervous system tumors in LICs when compared with HICs. In Uganda, the challenges in management of these children include few multidisciplinary specialists, long distance from the neurosurgery centers, and difficulties in making a correct pathologic diagnosis, among others.

Identifying pregnant and postpartum women’s priorities for enhancing nutrition support through social needs programmes in a resource-constrained urban community in South Africa

BackgroundMalnutrition remains a pressing public health concern for mothers and children in South Africa. Despite the government’s multisectoral response, unaddressed social needs prevent some mothers getting full benefit from interventions, spanning financial planning, income stability, housing, access to government services, social support, and provision of affordable, nutritious foods. Engaging with mothers and prioritising their concerns is important if we wish to overcome obstacles to women benefiting from government nutrition interventions. This study aimed to identify the programmes that women perceived as a priority in addressing the social needs of mothers of young infants and pregnant women to enhance nutrition in a resource-constrained urban township in South Africa.MethodsA cross-sectional study employed a quantitative preference elicitation survey, administered to 210 mothers and pregnant women from five primary healthcare facilities in Soweto. The survey tool was developed with the community to identify unmet social needs and potential solutions, which were synthesised with findings from the literature. The survey described 15 programmes, grouped into three delivery levels: clinics, community, and government. Participants were required to rank programme options in two stages. First, they selected their top two programmes within each delivery level. Subsequently, they allocated stickers to indicate the strength of their preference among the top programmes across the levels. Rankings were analysed using descriptive statistics.ResultsThe highest priority was given to five programmes. Two delivered at the community level: Women’s economic empowerment groups and Job search assistance, two at the clinic level: Social needs assessment and referral, and Prescription-based food, and one at the government level: Free quality childcare. The lowest-ranked programmes were two clinic-based programmes, specifically Maternal nutrition groups and Couple antenatal education.ConclusionWomen expressed strong views about which programmes should be prioritised to support mothers and pregnant women in addressing their social needs and improving nutrition. Key areas included providing support with job searching and entrepreneurship, accessing childcare and the healthy foods recommended at clinics, as well as finding information on available community and government services. Leveraging multisectoral collaboration, aligned policy objectives, efficient public financing, and strengthened implementation capacity will be pivotal in delivering these programmes.

Hospitalization Patterns for Rural-Residing Children from 2002 to 2017

ObjectiveThe closure of inpatient pediatric units within general hospitals has contributed to the regionalization of pediatric care. For children in rural areas, the distance traveled for hospitalization impacts the quality of care for children, the impact upon families, and the preparedness for disaster planning within rural communities. We assessed trends in location of hospitalization over time for rural-residing children. MethodsUsing the Healthcare Cost and Utilization Project’s State Inpatient Databases, we studied 256,947 hospitalizations for rural-residing children 0–17 years of age within eight states (CO, FL, KY, NC, NJ, NY, OR, WA) from 2002 to 2017. Level of rurality was defined by Rural-Urban Commuting Area Codes: micropolitan, small rural, and isolated rural. Birth, psychiatric, and surgical hospitalizations were excluded. Trends in number of hospitalizations by hospital location, interfacility transfer (IFT), and whether the hospital location was the same level of rurality as the patient’s home residence were assessed with the Cochran-Armitage trend test. ResultsFrom 2002 to 2017, hospitalizations for rural-residing children decreased by 52.7% (56,168 to 26,548) and IFTs increased from 6.7% to 26.5% (P < .001). The proportion of total hospitalizations within metropolitan areas for rural-residing children increased from 32.2% to 72.8% (P < .001). Local-area agreement between the patient’s residence and hospital utilized decreased from 53.6% to 21.5% (P < .001). ConclusionsAlthough overall hospitalizations for rural-residing children decreased, IFTs increased, and the proportion hospitalized in metropolitan areas increased. The impact of this shift in inpatient health services on efficiency and quality of care for rural-residing children needs further exploration.

Management of Paediatric Cardiac Arrest due to Shockable Rhythm-A Simulation-Based Study at Children's Hospitals in a German Federal State.

(1) Background: To improve the quality of emergency care for children, the Hessian Ministry for Social Affairs and Integration offered paediatric simulation-based training (SBT) for all children's hospitals in Hesse. We investigated the quality of paediatric life support (PLS) in simulated paediatric resuscitations before and after SBT. (2) Methods: In 2017, a standardised, high-fidelity, two-day in-house SBT was conducted in 11 children's hospitals. Before and after SBT, interprofessional teams participated in two study scenarios (PRE and POST) that followed the same clinical course of apnoea and cardiac arrest with a shockable rhythm. The quality of PLS was assessed using a performance evaluation checklist. (3) Results: 179 nurses and physicians participated, forming 47 PRE and 46 POST interprofessional teams. Ventilation was always initiated. Before SBT, chest compressions (CC) were initiated by 87%, and defibrillation by 60% of teams. After SBT, all teams initiated CC (p = 0.012), and 80% defibrillated the patient (p = 0.028). The time to initiate CC decreased significantly (PRE 123 ± 11 s, POST 76 ± 85 s, p = 0.030). (4) Conclusions: The quality of PLS in simulated paediatric cardiac arrests with shockable rhythm was poor in Hessian children's hospitals and improved significantly after SBT. To improve children's outcomes, SBT should be mandatory for paediatric staff and concentrate on the management of shockable rhythms.

Psychometric Properties of the Chinese Version of the Core Symptom Index: A Study among Chinese Parents of Children with Autistic Spectrum Disorders.

(1) Background: Parents of children with autism spectrum disorders often experience psychological distress, which can affect the quality of childcare they provide. It is crucial to screen for psychiatric symptoms among these parents. The core symptom index (CSI) is a widely recognized tool used to assess general symptoms, including depression, anxiety, and somatic issues. It has proven validity and reliability across diverse Thai populations. Given the cultural similarities between Thai and Chinese populations, the CSI has been successfully implemented within the Chinese population. Nevertheless, it is crucial to research its validity and reliability in the general Chinese population. This study aimed to investigate the psychometric properties of the Chinese version of the CSI among parents of children with autism spectrum disorders using confirmatory factor analysis (CFA). (2) Methods: A total of 794 Chinese parents raising children with autism participated in this study. All completed the CSI, along with the social inhibition subscale of the Interpersonal Problems Inventory and the Couple Satisfaction Index. Factorial validity was assessed using CFA to determine how well the bifactor three-factor model fits the data. Various structural models were compared using model fit indices. Convergent and discriminant validity were examined by exploring correlations with the social inhibition subscale and the Couple Satisfaction Index. Invariance testing of the CSI was conducted across multiple groups based on gender, age, and education using CFA. The reliability of the CSI was evaluated using McDonald's omega coefficients. (3) Results: The bifactor model emerged as the best-fitting model for the data, suggesting that the total score of the CSI adequately represents overall psychiatric symptoms. The CSI exhibited significant correlations with the social inhibition subscale (r = 0.41, p < 0.01) and smaller correlation coefficients with the Couple Satisfaction Index (r = -0.16, p < 0.05), indicating both convergent and discriminant validity. The invariant test results support scalar invariance levels based on gender and age but only partial invariance for education. The Chinese version of the CSI demonstrated high consistency, with McDonald's omega coefficients ranging between 0.86 and 0.95. (4) Conclusions: The bifactor model of the Chinese version of the CSI is validated, making it a suitable tool for measuring depression, anxiety, and somatization symptoms among parent(s) of children with autism spectrum disorders. Further research on other Chinese populations is encouraged.