López Stewart C, Lara M G, Amighetti L D, Wissow L S, Gutierrez M I, Levav I, Maddaleno M
República de Chile, Ministerio de Salud, Unidad de Salud Mental, Santiago, Chile.
Rev Panam Salud Publica. 2000 Oct;8(4):257-67. doi: 10.1590/s1020-49892000000900005.
Physical punishment is a form of intrafamilial violence associated with short- and long-term adverse mental health outcomes. Despite these possible consequences, it is among the most common forms of violent interpersonal behavior. For many children it begins within the first year of life. The goal of this study was to determine the feasibility of involving public sector primary health care providers to inform parents about alternatives to physical punishment. The study used a qualitative design utilizing focus groups and survey questionnaires with parents and providers at six clinic sites chosen to be representative of public sector practice settings in Costa Rica and in metropolitan Santiago, Chile. The data were collected during 1998 and 1999. In the focus groups and surveys the parents voiced a range of opinions about physical punishment. Most acknowledged its common use but listed it among their least preferred means of discipline. Frequency of its use correlated positively with the parents' belief in its effectiveness and inversely with their satisfaction with their children's behavior. Some parents wanted to learn more about discipline; others wanted help with life stresses they felt led them to use physical punishment. Parents reported they chose other family members more frequently as a source of parenting information than they did health care providers. Some parents saw providers as too rushed and not knowledgeable enough to give good advice. Providers, in turn, felt ill equipped to handle parents' questions, but many of the health professionals expressed interest in more training. Parents and providers agreed that problems of time, space, and resources were barriers to talking about child discipline in the clinics. Many parents and providers would welcome a primary-care-based program on physical punishment. Such a program would need to be customized to accommodate local differences in parent and provider attitudes and in clinic organization. Health care professionals need more training in child discipline and in the skills required to interact with parents on issues relating to child behavior.
体罚是一种家庭内部暴力形式，与短期和长期的不良心理健康后果相关。尽管存在这些可能的后果，但它却是人际暴力行为中最常见的形式之一。对许多儿童来说，体罚在其生命的第一年就开始了。本研究的目的是确定让公共部门的初级卫生保健提供者参与进来，向家长宣传体罚替代方法的可行性。该研究采用定性设计，利用焦点小组以及对家长和提供者进行调查问卷的方式，这些家长和提供者来自哥斯达黎加以及智利首都圣地亚哥六个被选为代表公共部门实践环境的诊所。数据收集于1998年和1999年。在焦点小组和调查中，家长们对体罚表达了一系列看法。大多数人承认体罚很常见，但将其列为最不喜欢的管教方式之一。体罚的使用频率与家长对其有效性的信念呈正相关，与他们对孩子行为的满意度呈负相关。一些家长想更多地了解管教方法；另一些家长则希望在他们认为导致自己使用体罚的生活压力方面得到帮助。家长们报告说，比起卫生保健提供者，他们更频繁地选择其他家庭成员作为育儿信息的来源。一些家长认为提供者太忙，而且知识不够丰富，无法给出好的建议。反过来，提供者觉得自己没有足够的能力处理家长的问题，但许多卫生专业人员表示对更多培训感兴趣。家长和提供者一致认为，时间、空间和资源问题是在诊所讨论儿童管教问题的障碍。许多家长和提供者会欢迎一个基于初级保健的体罚项目。这样一个项目需要根据家长和提供者态度以及诊所组织方面的当地差异进行定制。卫生保健专业人员需要在儿童管教以及就与儿童行为相关问题与家长互动所需技能方面接受更多培训。
