Wissow L S, Roter D
Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.
Pediatrics. 1994 Oct;94(4 Pt 2):587-93.
Corporal punishment is widely practiced despite evidence of its harm to children. Clinicians can more effectively counsel alternatives if they: are clear in their own minds about the risks of corporal punishment and its boundaries with reportable child maltreatment; appreciate parents' justifications for corporal punishment and offer corresponding alternatives; demonstrate their interest and expertise in matters of child behavior and family dynamics; practice communication techniques that elicit discussion of psychosocial topics and facilitate mutual problem solving; let parents take the lead in tailoring alternative disciplinary strategies to the family's unique needs; start early helping parents understand child behavior in general and their child's temperament and development in particular. Clinicians as a group should demonstrate a united stand against the use of violence within families. Both undergraduate and continuing medical education should involve training in communication skills in general and problem-solving techniques in particular. Pediatricians need more time during their training to learn about child behavior and family dynamics.
尽管有证据表明体罚对儿童有害,但体罚仍被广泛实施。如果临床医生能够做到以下几点,就能更有效地提供替代体罚的建议:清楚认识到体罚的风险以及与可报告的儿童虐待行为的界限;理解父母实施体罚的理由并提供相应的替代方法;展示他们在儿童行为和家庭动态方面的兴趣和专业知识;运用能够引发心理社会话题讨论并促进共同解决问题的沟通技巧;让父母主导根据家庭的独特需求调整替代纪律策略;尽早开始帮助父母全面了解儿童行为,尤其了解他们孩子的气质和发育情况。作为一个群体,临床医生应表明坚决反对家庭内暴力行为的立场。本科医学教育和继续医学教育都应包括一般沟通技巧特别是问题解决技巧的培训。儿科医生在培训期间需要更多时间来学习儿童行为和家庭动态。