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台湾儿童保护团队的医院式个案管理模式:一种行动研究方法。

Hospital-Based Case Management Model for Child Protection Teams in Taiwan: An Action Research Approach.

作者信息

Chen Chia-Jung, Chen Yi-Wen, Chang Hsin-Yi, Feng Jui-Ying

机构信息

PhD, RN, Supervisor, Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University.

PhD, RN, Head Nurse, Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University.

出版信息

J Nurs Res. 2022 Aug 1;30(4):e225. doi: 10.1097/jnr.0000000000000503.

Abstract

BACKGROUND

Hospital-based child protection teams play an important role in the multidisciplinary assessment, treatment, care, and rehabilitation of abused children and their families. However, the process by which these teams are built and promoted has not been explored adequately in the literature.

PURPOSE

This study was developed to examine the process used to promote child protection team case management and to evaluate the related results.

METHODS

An action research model was adopted in this study. The participants and the investigator were members of a child protection team at a medical center in southern Taiwan. Qualitative and quantitative assessments were used to identify problems related to organizational structure, intervention procedures, and evaluation effectiveness. Thereafter, the study program was implemented, and the results were evaluated. Content analysis of the qualitative data, including transcribed interviews with external benchmark members and members of the hospital's team and text entries from the investigator's reflective journal, was conducted. Quantitative data, including monitoring indicators for team case management, were analyzed using descriptive statistics.

RESULTS

Three important concepts emerged related to changes in the promotion of case management by hospital child protection teams. These included formulation of a team operation model through visits to benchmark hospitals, establishment of the case management and monitoring mechanism based on team consensus, and expansion of collaboration with external agencies through the establishment of a child and adolescent protection medical regional integration center. The results of the promotion process were affected by factors that included member willingness, teamwork, hospital support, and national policy.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Use of the hospital child protection team case management model developed in this study was shown to facilitate the provision of consultation services, integrate the opinions and resources of experts from various fields, and allow the timely provision of acute care, follow-up family environment support, and social resources required by children and their family members. These measures help prevent the reoccurrence of child abuse and enable children to grow up healthily and free from violence.

摘要

背景

医院儿童保护团队在受虐儿童及其家庭的多学科评估、治疗、护理和康复中发挥着重要作用。然而,这些团队的组建和推广过程在文献中尚未得到充分探讨。

目的

本研究旨在探讨促进儿童保护团队个案管理的过程,并评估相关结果。

方法

本研究采用行动研究模型。参与者和研究者均为台湾南部某医疗中心儿童保护团队的成员。采用定性和定量评估方法来识别与组织结构、干预程序和评估效果相关的问题。此后,实施研究方案并评估结果。对定性数据进行内容分析,包括对外部标杆成员和医院团队成员的访谈记录以及研究者反思日志中的文本记录。定量数据,包括团队个案管理的监测指标,采用描述性统计进行分析。

结果

出现了与医院儿童保护团队个案管理推广变化相关的三个重要概念。这些包括通过参观标杆医院制定团队运作模式,基于团队共识建立个案管理和监测机制,以及通过建立儿童和青少年保护医疗区域整合中心扩大与外部机构的合作。推广过程的结果受到成员意愿、团队合作、医院支持和国家政策等因素的影响。

结论/实践启示:本研究中开发的医院儿童保护团队个案管理模式的应用表明,它有助于提供咨询服务,整合各领域专家的意见和资源,并能及时提供急性护理、后续家庭环境支持以及儿童及其家庭成员所需的社会资源。这些措施有助于防止虐待儿童事件再次发生,使儿童能够健康成长且免受暴力侵害。

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