MacElveen-Hoehn P, Eyres S J
Birth Defects Orig Artic Ser. 1984;20(5):11-43.
The purpose of this presentation is to review the concepts of social support and vulnerable families and children, propose a theoretical model on coping and adaptation, and ascertain any significant implications for the delivery of health care services and future research. The review of the literature indicates that major problems persist in the classification, conceptualization, empirical investigation, and clinical application of social support due to a lack of clarity regarding the definition of social support and how it works. Related perspectives such as bonding, child development, and child rearing also reaffirm the need for and the utilization of social support. High-risk factors, such as low maternal age, poverty, single parenthood, and long-term health problems, increase the vulnerability of families and children. This literature strongly suggests that the interactions of adults and children with supportive members of their social networks are important in the development of essential cognitive and social skills, as well as for the promotion of security and comfort. Supports from individuals, families, and groups also are associated with more successful adaptation and favorable outcomes. Despite numerous articles and research projects, however, questions concerning how social support works to assist vulnerable children and families remain. Seven factors are proposed as a theoretical model to identify threatening situations and coping difficulties so that appropriate support can be provided. These factors are surprise, experience, confusion, perceived effectiveness, perceived allies, perceived uniqueness of threat, and overload. Additional testing is required for this model so that a more meaningful investigation and utilization of social support can be established. Additional research also is indicated to determine the specific types of support needed in the presence of certain factors, network style preferences, the supply and demand for support over the life span, and cultural aspects of coping and support processes. The position that appropriate social support will promote mastery and self-determination has significant implications for health professionals.
本报告的目的是回顾社会支持以及弱势家庭和儿童的相关概念，提出一个关于应对和适应的理论模型，并确定其对医疗服务提供和未来研究的任何重大影响。文献综述表明，由于社会支持的定义及其作用方式缺乏明确性，社会支持在分类、概念化、实证研究和临床应用方面仍然存在主要问题。诸如联系、儿童发展和育儿等相关观点也重申了对社会支持的需求和利用。低龄母亲、贫困、单亲家庭和长期健康问题等高风险因素增加了家庭和儿童的脆弱性。这些文献有力地表明，成年人和儿童与社会网络中支持性成员的互动对于基本认知和社交技能的发展以及安全感和舒适度的提升非常重要。来自个人、家庭和群体的支持也与更成功的适应和良好结果相关。然而，尽管有大量文章和研究项目，但关于社会支持如何帮助弱势儿童和家庭的问题仍然存在。提出了七个因素作为理论模型，以识别威胁情况和应对困难，从而能够提供适当的支持。这些因素是意外、经验、困惑、感知有效性、感知盟友、感知威胁的独特性和负荷过重。需要对该模型进行更多测试，以便能够建立更有意义的社会支持调查和利用方式。还需要进行更多研究，以确定在某些因素存在时所需的具体支持类型、网络风格偏好、一生当中支持的供需情况以及应对和支持过程的文化方面。适当的社会支持将促进掌握能力和自我决定能力这一观点对健康专业人员具有重大影响。
