Bruskas Delilah
University of Washington, School of Nursing, and Executive Director, Pacific Northwest Alumni of Foster Care, Tacoma, Washington, USA.
J Child Adolesc Psychiatr Nurs. 2010 Nov;23(4):231-41. doi: 10.1111/j.1744-6171.2010.00249.x.
every day, the United States child welfare system is entrusted with the care of over 400,000 children through foster care. The majority of children entering this social setting are infants, the most developmentally vulnerable.
bronfenbrenner's human health ecology model and Bowlby's attachment theory are used to delineate the social setting of foster care and its impact on developmental health, and elucidates the relationship between childhood experiences and the overall continuum of health. Additionally, the notion of inherited genes and environmental influences or epigenetics toward gene expression will be explored.
research points out that what happens in childhood matters; the consequences of not addressing childhood adversity and the associated risk factors of foster care increase a child's risk for poor developmental health and other major illnesses noted later in life such as cardiac disease, depression, and even premature death. Healthcare providers and others charged with caring for this vulnerable population who understand the social setting of foster care and its impact on developmental health may help identify and treat developmental problems earlier, thus potentially reducing long-term effects of abuse and neglect.
improvement plans that promote best practice for child welfare must include those that directly address the unique developmental needs of all infants and children in foster care itself. Such plans will ensure that foster care as an intervention to protect vulnerable children at risk does not create more harm by reducing the associated risks and maximizing benefits while in foster care, and ensures that those born genetically vulnerable and disproportionately susceptible to poor outcomes in adversity are also protected and provided opportunities that promote optimal developmental health.
每天，美国儿童福利系统通过寄养服务负责照料超过40万名儿童。进入这种社会环境的大多数儿童是婴儿，他们在发育方面最为脆弱。
运用布朗芬布伦纳的人类健康生态模型和鲍尔比的依恋理论来描绘寄养服务的社会环境及其对发育健康的影响，并阐明童年经历与整体健康连续体之间的关系。此外，还将探讨遗传基因以及环境影响或表观遗传学对基因表达的作用。
研究指出童年时期所发生的事情至关重要；不解决童年逆境以及寄养服务相关风险因素所带来的后果会增加儿童发育健康不良以及日后出现诸如心脏病、抑郁症甚至过早死亡等其他重大疾病的风险。医疗服务提供者以及其他负责照料这一弱势群体的人员，若了解寄养服务的社会环境及其对发育健康的影响，可能有助于更早地识别和治疗发育问题，从而有可能减少虐待和忽视带来的长期影响。
促进儿童福利最佳实践的改进计划必须包括那些直接满足寄养服务中所有婴儿和儿童独特发育需求的计划。此类计划将确保作为保护处于危险中的弱势儿童的一种干预措施，寄养服务不会因降低相关风险并在寄养期间使利益最大化而造成更多伤害，同时确保那些天生基因脆弱且在逆境中极易出现不良后果的儿童也能得到保护，并获得促进最佳发育健康的机会。
