【作者】 陈丽；

【导师】 陆林；

【作者基本信息】 西南大学 ， 社会工作（专业学位）， 2022， 硕士

【摘要】 儿童意外伤害发生率高,对儿童造成的伤害大,意外伤害一旦发生不仅会导致儿童自身容貌或行为上的改变,更会影响到整个家庭。儿童遭受意外伤害后,对于整个家庭都是一种危机,尤其是对照顾者来说,照顾者会因为错误归因及面对儿童的长时间照护和治疗产生内疚感。一方面,形成错误归因,将儿童发生意外伤害归因于自身的疏忽,从而产生内疚感。另一方面,面对儿童受伤后的长时间治疗以及可能产生的后果,照顾者会感到压力和焦虑,加重内疚感程度。这样的变化不利于照顾者的身心健康,也不利于患儿的治疗和康复,因此需要得到关注和重视。许多学者在过往的研究中,都关注到了住院儿童照顾者,包括研究各类疾病领域下照顾者的心理状态、行为反应及应对方式等方面,涵盖护理学、康复学和心理学等领域。通过对文献的查阅及总结,发现以往的研究仅探究照顾者可能产生的心理或行为反应,并未对照顾者产生的负性情绪和不良行为反应提出相应的改善措施或介入干预。且儿童意外伤害发生后,仅分析意外伤害产生的原因,并未关注照顾者的心理状态。因此,本文将运用社会工作的专业理论及技巧,对“意外伤害儿童照顾者的内疚感”进行介入与干预,通过探究内疚感产生的原因,选择合适的介入方法,降低照顾者的内疚感,提升照顾者对患儿治疗的信心及生活质量。最后根据介入,对比和评估,总结降低意外伤害儿童照顾者内疚感的有效方式,并提出建议,以期为进一步研究提供参考。因此,本研究主要是基于两个背景展开研究:一是意外伤害已经成为威胁儿童生命安全的主要因素之一,作为负责看护儿童,保障儿童安全的照顾者需要得到关注和重视。二是意外伤害儿童照顾者会因为意外伤害事件产生内疚感等许多非合理情绪,其内疚感也会随着儿童的治疗过程发生变化,为了照顾者自身的心理健康及儿童的治疗及康复,降低照顾者的内疚感,改善照顾者的非合理情绪不容忽视。探索在当前背景下能够通过了解意外伤害儿童照顾者内疚感现状及如何运用社会工作方法较好的降低内疚感,发挥医务社会工作的作用,帮助照顾者构建积极健康的心理,拓宽个案工作的介入领域。首先,通过访谈及参与式观察法收集相关资料,并根据资料分析所得出的结论选择服务对象展开个案介入研究。本文通过初步了解,筛选出五位具有代表性的照顾者展开深度访谈,了解她们的内疚感程度及具体表现,并分析内疚感产生背后的深层次原因,为后文介入研究提供依据。其次,根据深度访谈资料,本文选取三个具有代表性,且适合展开个案介入的服务对象进行深度研究。三位服务对象分别处于内疚感的不同阶段,分别介入,充分分析后,得出不同的内疚感阶段应根据具体阶段的具体问题表现,选择不同的介入模式。通过运用社会工作方法和介入模式,降低照顾者的内疚感,探索介入过程中的问题,并积极分析,得出研究结论。最后,对整个介入过程进行反思和总结,通过对个案的介入和分析,总结医务社会工作介入降低意外伤害儿童内疚感的有效性,分析介入过程中可能会遇到的影响因素,并提出相关降低意外伤害儿童照顾者内疚感的建议。更多还原

【Abstract】 The incidence of accidental injuries among children is high,causing great harm to children.Once accidental injuries occur,they will not only lead to changes in children’s appearance or behavior,but also affect the whole family.An unintentional injury to a child can be a crisis for the whole family,especially for caregivers,who may feel guilty about misattribution and prolonged care and treatment.On the one hand,the formation of misattribution,children accident injuries due to their own negligence,so as to produce a sense of guilt.Caregivers,on the other hand,are stressed and anxious about the prolonged treatment and possible consequences of a child’s injury,exacerbating feelings of guilt.Such changes are not conducive to the physical and mental health of caregivers,nor to the treatment and rehabilitation of children,so attention and attention should be paid.In previous studies,many scholars have paid attention to inpatient child caregivers,including the psychological state,behavioral responses and coping styles of caregivers in various diseases,including nursing,rehabilitation and psychology.Through literature review and summary,it was found that previous studies only explored the possible psychological or behavioral reactions of caregivers,and did not propose corresponding improvement measures or intervention for negative emotions and adverse behavior reactions of caregivers.In addition,after the occurrence of accidental injuries,only the causes of accidental injuries were analyzed,without paying attention to the psychological state of caregivers.Therefore,this paper will use the professional theories and skills of social work to intervene and intervene on the "guilt of accidental injury of child caregivers".By exploring the causes of guilt and choosing appropriate intervention methods,it can reduce the guilt of caregivers and improve their confidence in the treatment of children and their quality of life.Finally,based on intervention,comparison and evaluation,the effective ways to reduce the guilt of child caregivers who accidentally hurt were summarized and suggestions were put forward to provide reference for further research.Therefore,this study is mainly carried out on the basis of two backgrounds: First,accidental injuries have become one of the main factors threatening children’s life safety,and caregivers responsible for children’s safety need to be paid attention to and paid attention to.Second,caregivers will because accident harm accident harm children events produce the reasonable number of emotions such as guilt,the guilt will change as the treatment process of children,to care for their own mental health and the treatment and rehabilitation of children,reduce the guilt of caregivers,improve caregivers not reasonable mood should not be ignored.Under the current background,this paper explores how to better reduce the guilt of child caregivers by understanding the current situation of accidental injury and how to use social work methods to play the role of medical social work,help caregivers build positive and healthy psychology,and broaden the intervention field of case work.Firstly,relevant data were collected through interviews and participatory observation,and the service objects were selected to carry out case intervention research according to the conclusions obtained from data analysis.Through preliminary understanding,this paper selected five representative caregivers to conduct in-depth interviews to understand their guilt degree and specific performance,and analyzed the deep reasons behind the guilt,so as to provide a basis for the subsequent intervention research.Secondly,based on in-depth interview data,this paper selects three representative service objects suitable for case intervention for in-depth research.Three service objects are in different stages of guilt,respectively,intervention.After full analysis,it is concluded that different stages of guilt should choose different intervention modes according to the performance of specific problems in specific stages.Through the application of social work methods and intervention models,caregivers’ guilt was reduced,problems in the intervention process were explored,and positive analysis was made to draw research conclusions.Finally,the whole intervention process was reflected and summarized.Through the intervention and analysis of individual cases,the effectiveness of medical social work intervention in reducing the guilt of children with accidental injury was summarized,the influencing factors that might be encountered in the intervention process were analyzed,and relevant suggestions to reduce the guilt of child caregivers with accidental injury were put forward.更多还原