児童虐待と関連する障害を予防するための介入
Harriet L Macmillan1, C Nadine Wathen, Jane Barlow
1Departments of Psychiatry and Behavioural Neurosciences and of Pediatrics, and Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
Lancet (London, England)
|December 6, 2008
まとめ
効果的な児童虐待防止プログラムは限られているが,家庭訪問と親の訓練が有望である. 様々な種類の虐待に対する介入を評価し,児童福祉の成果を改善するために,さらなる研究が必要である.
科学分野:
- 子どもの発達 子供の発達 子供の発達
- 公衆衛生は公衆衛生である.
- ソーシャルワーク ソーシャルワーク
背景:
- 多くの児童虐待防止プログラムが存在するが,その有効性はほとんど証明されていない.
- 性的,感情的,または親密なパートナーによる暴力などの特定の形態の虐待を防ぐための証拠は依然として稀です.
研究 の 目的:
- 既存の児童虐待防止プログラムの有効性に関する証拠をレビューする.
- 成功が実証された介入と,さらなる研究を必要とする分野を特定する.
主な方法:
- 児童虐待防止プログラムの体系的なレビュー.
- 家庭訪問,親の訓練,治療アプローチを含む様々な介入タイプに関する証拠の分析.
主要な成果:
- 家庭訪問プログラムである看護師・家族パートナーシップ (Nurse-Family Partnership) やEarly Start (Early Start) は,子どもの虐待や怪我を予防する証拠を示しています.
- 親の訓練プログラムは,身体的虐待の再発を防止する利点を示していますが,無視の再発介入は不足しています.
- 認知行動療法 (Cognitive-behavioral therapy) は,性的虐待を受けたPTSDの子供に対して効果的であり,強化された養子家庭の介護は,虐待を受けた子供にとって有益であることが示されています.
結論:
- いくつかの介入が有望である一方で,あらゆる形態の児童虐待に関する証拠に基づいたプログラムには大きなギャップが存在します.
- 実際の虐待結果と健康対策を用いた制御試験は,将来の研究にとって極めて重要です.
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