Rossiter Chris, Fowler Cathrine, Hopwood Nick, Lee Alison, Dunston Roger
Centre for Research in Learning and Change, University of Technology Sydney, Broadway, NSW 2007, Australia.
Aust J Prim Health. 2011;17(4):378-83. doi: 10.1071/PY11056.
Family circumstances in infancy are persistent and powerful determinants of children's physical and mental health, influencing inequalities that trace from childhood through to adulthood. While the social factors that perpetuate patterns of inequality are more complex than can be addressed through single interventions, child and family health (CFH) services represent crucial sites where trajectories of inequality can be disrupted. In particular, approaches that foster opportunities for practitioner-parent engagement that challenge traditional hierarchical health care practice, such as the Family Partnership Model (FPM), are recommended as ways of addressing disadvantage. Little is known about how practitioners implement models of working in partnership with families and, consequently, there is a gap in understanding how best to develop and sustain these new CFH practices. This paper reports a research project that investigated the experiences of 25 health professionals working within a FPM framework with vulnerable families. Through discussion of four key themes - redefining expertise, changing practices, establishing new relationships with parents and the complexities of partnership practice - the paper offers first-hand accounts of reframing practices that recognise the needs, skills and expertise of parents and thus contribute to empowerment of families.
婴儿期的家庭环境是儿童身心健康的长期且有力的决定因素，影响着从童年到成年的不平等状况。虽然使不平等模式持续存在的社会因素比单一干预措施所能解决的更为复杂，但儿童与家庭健康（CFH）服务是可以打破不平等轨迹的关键场所。特别是，诸如家庭伙伴关系模式（FPM）等促进从业者与家长互动机会、挑战传统等级制医疗实践的方法，被推荐为解决不利状况的途径。对于从业者如何实施与家庭合作的模式知之甚少，因此，在理解如何最好地发展和维持这些新的CFH实践方面存在差距。本文报告了一个研究项目，该项目调查了25名在FPM框架内与弱势家庭合作的卫生专业人员的经历。通过对四个关键主题——重新定义专业知识、改变实践、与家长建立新关系以及伙伴关系实践的复杂性——的讨论，本文提供了重新构建实践的第一手描述，这些实践认识到家长的需求、技能和专业知识，从而有助于增强家庭权能。
