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| 社会工作介入农村双老智障家庭老年照顾者减压研究 摘 要 21世纪以来全球老龄化趋势下，老年人口增加，残疾人群亦然。智力障碍人士由于其特殊的残疾问题需要给予长期的照顾，且因身体机能退化相比其他残疾人群率先进入老龄阶段。受到传统家庭观念、经济条件、专业机构服务缺失等多方面影响，家庭照顾是智力障碍人士普遍选择。农村智力障碍人士家庭的老年照顾者作为弱势群体面临的压力问题被大众所忽视，这些高龄化的家庭照顾者在漫长的照顾生活中，受到来自照顾、经济、个人身心以及自我发展等方面的多重问题困扰，特别是在社会福利保障缺失的情况下，如若不能得到妥善处理，就会影响照顾者的身心健康和照顾质量，不利于社会的稳定。 本研究以重庆市长寿区A村为实践地点，运用访谈法、文献研究法等研究方法筛选A村符合双老一残家庭情况的老年照顾者进行走访收集到相关资料，对双老家庭的老年家庭照顾者的社会支持网络现状进行分析，发现农村地区老年照顾者面临着多重复合性因素风险，与城镇老年照顾者相比，农村老年照顾者对精神支持需求更强，经济来源更为缺乏，对“喘息”服务需求更强烈的特点。当前社会工作在介入家庭照顾者的研究中存在着服务干预缺少针对性、忽视地域性差异、服务过于粗放等问题使得家庭照顾者压力解决不够彻底。本次研究对农村双老智残家庭的照顾风险类型进行划分，选取一位比较典型的农村双老智残家庭老年家庭照顾者作为个案对象，并在此基础上运用个案管理模式，通过访谈法了解服务对象个人情况和社会支持网络问题，共同制定出服务计划和目标，全面开展个案介入服务，链接相关资源协助案主建立完善的社会支持网络，改变错误认知，舒缓焦虑情绪，减轻家庭照顾者压力。最后对介入问题进行了总结与反思，进一步验证社工介入方法在解决农村双老智力障碍人士家庭老年庭照顾者的照顾压力问题的作用，并提出相关建议，为以后社会工作介入类似家庭照顾者的社会支持网络构建提供参考。 关键词：双老智障家庭；老年家庭照顾者；社会支持 Abstract With the global aging trend since the 21st century, the elderly population has increased, as has the disabled group. People with intellectual disabilities need to be given long-term care due to their special disability problems, and due to physical deterioration, they are the first to enter the aging stage compared to other disabled groups. Affected by many aspects such as traditional family concepts, economic conditions, and lack of professional services, family care is a common choice for people with intellectual disabilities. As a disadvantaged group, the elderly caregivers of rural mentally handicapped families face pressure issues that are ignored by the general public. These elderly family caregivers have suffered from multiple aspects such as care, economics, personal physical and mental, and self-development in their long caring life. Problems are plagued, especially in the absence of social welfare security. If they cannot be properly handled, it will affect the physical and mental health and quality of care of caregivers, and is not conducive to social stability. In this study, village A in Changshou District, Chongqing City was used as the practice site, using interview methods, literature research methods and other research methods to screen the elderly caregivers in village A who met the situation of the twin-elderly and one-disabled family. An analysis of the status quo of the social support network of family caregivers found that elderly caregivers in rural areas are facing multiple risks of multiple factors. Compared with urban elderly caregivers, rural elderly caregivers have a stronger need for spiritual support and lack financial resources. The characteristic of stronger demand for "respite" services. In the current research on the intervention of family caregivers in social work, there are problems such as lack of pertinence in service intervention, ignorance of regional differences, and overextensive services, which make the pressure of family caregivers not solved thoroughly. This research divides the types of care risks in rural dual-elderly mentally disabled families, and selects a typical rural elderly family caregiver of dual-elderly mentally disabled families as the case object, and uses a case management model on this basis, through interviews. Understand the personal situation of the client and social support network problems, jointly formulate service plans and goals, carry out case intervention services in a comprehensive manner, link relevant resources to assist the client to establish a complete social support network, change misunderstandings, relieve anxiety, and reduce family care Pressure. Finally, I summarized and reflected on the intervention issues, and further verified the role of social work intervention methods in solving the caregiving pressure of the elderly caregivers in the families of the elderly with intellectual disabilities in rural areas, and put forward relevant suggestions for future social work interventions similar to family caregivers. Provide reference for the construction of social support network. Keywords: dual-elderly mentally handicapped families; elderly family caregivers; social support 目录 摘 要1 Abstract2 1研究背景6 2文献综述7 2.1基础概念界定7 2.1.2家庭照顾者7 2.1.3照顾者压力8 2.1.4双重老化一残家庭8 2.2相关文献梳理8 2.2.1智力障碍人士研究8 2.2.2双重老化智力障碍人士家庭照顾研究10 2.2.3家庭照顾者压力研究12 2.2.4智力障碍人士家庭照顾者社会支持研究13 2.2.5农村老年家庭照顾者研究15 2.3研究述评16 2.4研究意义17 2.4.1理论意义17 2.4.2现实意义18 3 研究设计18 3.1研究思路18 3.2理论基础19 3.2.1通用过程模式19 3.2.2理性情绪理论19 3.2.3社会支持网络理论20 3.3研究方法20 3.3.1资料收集方法20 3.3.2半结构式访谈法21 3.3.3观察法21 3.3.4个案研究法21 4农村老年照顾者非正式社会支持以及社工介入情况分析22 4.1 家庭和亲属支持力量弱小且不稳定23 4.2朋辈和邻里支持不到位24 4.3无力购买专业机构服务支持24 4.4家庭功能缺失25 4.5当前社会工作服务效应26 4.5.1推动和改善非正式社会支持26 4.5.2链接运用非正式社会支持资源27 4.5.3社会工作者自身参与的活动推动27 4.5.4搭建非正式社会支持平台27 5当前农村老残家庭照顾服务干预存的问题28 5.1未对老年家庭照顾者问题进行风险评估28 5.2城乡地域差异未能体现28 5.3农村社工服务内容有待提升29 6 双老智残家庭中老年照顾者的个案管理30 6.1个案管理对于老年家庭照顾者的适用性30 6.2个案选取30 6.3建立专业关系31 6.4服务对象基本资料梳理31 6.5老残家庭老年照顾者的困境现状分析32 6.5.1多重心理问题困扰33 6.5.2照料负担过重34 6.5.3经济负担过重35 6.5.4个人发展受限36 6.6量表前测36 7老年家庭照顾者个案工作介入服务过程39 7.1服务方案实施39 7.1.1确定服务目标40 7.2服务实施过程40 7.2.1心理压力疏导，改变非理性认知40 7.2.2老年家庭照顾者增能，增强社会融入力43 7.2.3 服务资源链接与协调，减轻部分压力45 7.2.4增加家庭成员联系，恢复家庭支持47 7.2.5建立邻里互助支持网，区域专业化志愿者培训49 7.3结案50 7.4服务评估50 7.4.1相关量表后测50 7.4.2目标实现程度50 7.4.3社工自评52 8研究总结和反思54 8.1总结54 8.1.1个案服务需体现针对性54 8.1.2运用系统和整体思维去解决家庭问题54 致谢57 附录：58 |
