Nilsson David
Social Work Department, Western Hospital, Footscray, Victoria 3011, Australia.
Soc Work Health Care. 2007;45(2):1-20. doi: 10.1300/J010v45n02_01.
This article describes the development of a proposed unifying theoretical framework for the concept of adjustment as understood by health social workers. This arose from an exploratory study (Nilsson, 2002) aimed at elucidating social workers' understanding of Adjustment to Health Condition and Adjustment to Hospitalisation as Indicators for Intervention. The findings of that study demonstrated that adjustment was conceptualised as a complex, multi-dimensional process including the key inter-related themes of coping, emotion, subjective meaning, integration, adaptation, support, family focus, and process orientation. Participants were, however, unable to identify a unifying meta-theory to explain the described critical inter-relationships between these concepts. The proposed explanatory framework is based substantially on Folkman's (1997) revision of Lazarus and Folkman's (1984) theory of 'coping as a mediator of emotion' and also incorporates important aspects of family systems theory as described by McCubbin and McCubbin (1996). This framework has the potential to assist social workers to better understand and assess the crucial contributory aspects of adjustment-related issues and thus improve client-focused clinical practice.
本文描述了一个拟议的统一理论框架的发展,该框架用于阐释健康社会工作者所理解的调适概念。这一框架源自一项探索性研究(尼尔森,2002年),该研究旨在阐明社会工作者对“调适健康状况”和“调适住院情况作为干预指标”的理解。该研究的结果表明,调适被概念化为一个复杂的、多维度的过程,包括应对、情绪、主观意义、整合、适应、支持、家庭关注和过程导向等关键的相互关联主题。然而,参与者未能确定一个统一的元理论来解释这些概念之间所描述的关键相互关系。拟议的解释框架在很大程度上基于福克曼(1997年)对拉扎勒斯和福克曼(1984年)的“应对作为情绪调节变量”理论的修订,同时还纳入了麦库宾和麦库宾(1996年)所描述的家庭系统理论的重要方面。该框架有可能帮助社会工作者更好地理解和评估与调适相关问题的关键促成因素,从而改善以客户为中心的临床实践。