Table 2A.

Barriers to optimal and empowering interactions and parent–professional relationships between fathers of children with disabilities and HCPs.

Theme n = number of utterances % of Barriers	Subtheme	Description	Father's utterances n (% of total)	HCPs' utterances n (% of total)	Total utterances n (% of Theme)
Factors related to fathers N = 34 39.1%	Uninvolved or disengaged	Fathers who are uninvolved and/or disengaged in the healthcare of their child (e.g., during medical visits)	0 (0)	7 (100)	7 (20.5)
	Rigid working schedule and stress level	Fathers' working schedule and stress levels that limit the possibility of interactions and involvement in the healthcare of their child.	2 (28.5)	5 (71.4)	7 (20.5)
	Unhelpful personality traits	Fathers' personality traits impeding communication and parent-professional relationship building (e.g., too demanding, dismissive, imposing).	0 (0)	6 (100)	6 (17.6)
	Denial	Fathers who are in denial about their child's challenges or who have difficulty accepting the situation.	1 (16.7)	5 (83.3)	6 (17.6)
	Lack of understanding	Fathers who lack understanding or knowledge about their child and/or about the condition of their child.	1 (25.0)	3 (75.0)	4 (11.7)
	Previous experiences	Fathers with previous negative experiences with HCPs and/or the healthcare system and who are “carrying the baggage” into a new conversation/interaction.	0 (0)	2 (100)	2 (5.8)
	Difficulty opening up	Fathers who have difficulty opening up about certain issues and/or share their feelings and concerns for fear of being perceived “weak.”	0 (0)	1 (100)	1 (2.9)
	Difficulty understanding HCPs	Fathers who have difficulty understanding HCPs for various reasons (e.g., communication barrier, low education level)	0 (0)	1 (100)	1 (2.9)
	Total		4 (11.7)	30 (88.2)	34 (100)
Cultural beliefs N = 18 20.7%	Father's role	The cultural beliefs about father's role in the family and the healthcare of the child.	2 (28.5)	5 (71.4)	7 (38.8)
	HCP who are female	Father's cultural beliefs toward HCPs who are female.	0 (0)	4 (100)	4 (22.2)
	Culture-general	Ethnicity or general cultural factors that can affect interactions.	0 (0)	3 (100)	3 (16.6)
	Disability	Fathers' cultural beliefs about their child's disability.	0 (0)	2 (100)	2 (11.1)
	HCP discipline	Fathers' cultural beliefs about HCP discipline (e.g., physicians vs. therapists).	0 (0)	1 (100)	1 (5.5)
	HCP age/experience level	Fathers' cultural beliefs about HCP of young age and/or possible low level of experience in childhood disability.	0 (0)	1 (100)	1 (5.5)
	Total		2 (11.1)	16 (88.8)	18 (100)
Stereotypical thinking or assumptions N = 9 10.3%	-	Refers to preconceived or stereotypical beliefs (e.g., “father is present at the medical visit because of lack of trust or unsatisfaction with services”).	3 (33.3)	6 (66.7)	9 (100)
	Total		3 (33.3)	6 (66.7)	9 (100)
Family dynamics N = 8 9.1%	-	Refers to various limiting family dynamics (e.g., overpowering partner).	0 (0)	8 (100)	8 (100)
	Total		0 (0)	8 (100)	8 (100)
Factors related to the healthcare and child-care systems N = 7 8.0%	Accessibility to information, services, or contacts	Challenges related to accessing information, services or contact within the electronic record system/scheduling system.	3 (60.0)	2 (40.0)	5 (71.4)
	Delays in appointments - long waiting times	Long waiting lists for medical appointments.	1 (100)	0 (0)	1 (14.2)
	Maternity vs. paternity leaves	Refers to a longer vs. shorter maternity vs. paternity leave, possibly affecting father's involvement in child's healthcare, general care, knowledge about child and condition.	0 (0)	1 (100)	1 (14.2)
	Total		4 (57.1)	3 (42.8)	7 (100)
Factors related to HCPs N = 6 6.8%	Focus on negative aspects	HCP focusing on negative aspects, disability.	2 (100)	0 (0)	2 (33.3)
	Lack of attention to fathers	HCP not directing attention specifically to fathers in interactions.	1 (50.0)	1 (50.0)	2 (33.3)
	Lack of knowledge about cultural factors and how to bridge them	HCP who lacks awareness about certain cultural factors that can be at play and how to bridge them during interactions.	0 (0)	1 (100)	1 (16.7)
	Early career, confidence level	HCP who is early in their career and have a low confidence level when interacting with fathers.	0 (0)	1 (100)	1 (16.7)
	Total		3 (50.0)	3 (50.0)	6(100)
Time limitation N = 5 5.7%	-	Refers to time limitations during interactions (e.g., feeling of being rushed through medical visit or limited appointment time because of ongoing case load of the HCP).	3 (60.0)	2 (40.0)	5 (100)
	Total		3 (60.0)	2 (40.0)	5 (100)
	Grand Total		19 (21.8)	68 (78.2)	87 (100)