Case Study范文-儿童健康需求个案研究。本文是一篇Social Work Essay 社会工作课程作业，主要内容是作者针对一个评估家庭中孩子健康需求的案例研究进行批判性分析。是一篇典型的留学生Case Study写作内容。对于刚到国外留学，或者第一次接触Case Study写作要求的学生来说，这是一篇可以解决“Case Study怎么写？”这一问题的参考范文，希望有所帮助。
Case Study范文
案例分析一个两岁女孩的双亲家庭。这家人是从另一个地区转移过来的。他们的女儿在31周时早产。她没有眼神交流，也没有主动发言。已获得在案例研究中使用信息的完全许可。我首先使用Orems护理模式来评估家庭的需求。然后是一个比较合适的家庭健康需求评估框架。
For the purpose of this essay I will write a critical analysis of a case study assessing the health needs of a child within a family. The case study is of a two parent family of a two year old girl. The family had transferred from another area. Their daughter was born prematurely at thirty one weeks. She didn’t offer eye contact and had no voluntary speech. Full permission has been obtained to use the information in the case study. I used firstly Orems nursing model to assess the family’s needs. Then a more appropriate framework Family Health Needs Assessment.
这种模式是一种行为模式。行为模型是基于马斯洛的人类需求层次。等级制度始于金字塔的底部，有着基本的需求，当这些需求得到满足时，人就会沿着金字塔向上发展，直到达到全部的潜能。Orem的模型是基于社会对客户自我照顾的需求。
The model is a behavioural model. Behavioural models are based on the hierarchy of human needs by Maslow (1993). The hierarchy starts at the bottom of a pyramid with essential needs, when these are met the person progresses up the pyramid until full potential is achieved (Maslow, 1993). Orem’s model is based on societies need for the client to be self caring (Henderson, 1990).
Orem的模型有一个自我照顾能力的连续体，其目的是沿着这个连续体移动到自我照顾或适应晚期或慢性病患者的自我照顾减少。
Orem’s (2001) model has a continuum of self care abilities, the aim being to move along this continuum to self care or adapt to a diminishing self care in terminal or chronic ill cases.
Orem指出，家庭和一个人生命中重要的其他人必须参与他们的自我照顾。这是一个将个人责任、预防和健康教育作为护理干预关键方面的模式
Orem (2001) states that the family and significant others in a person’s life must be involved in their self care. It is a model which values inpidual responsibility, prevention and health education as key aspects of nursing intervention (Aggleton and Chalmers 2000).
Orem列出了以下影响健康的关键因素：
Orem lists the following key factors that influence health;
1. Adequate intake of air water and food. 充分摄入空气、水和食物
2, Adequate excretion of waste. 充分排泄废物
3. A balance between activity and rest both mentally and physically. 身心活动与休息的平衡
4. Social interaction and solitude should be optimised. 优化社会交往和独处
5. The prevention or avoidance of hazards and danger. 预防或避免危害和危险
6. The feeling of being and behaving normally leading to stress reduction. 正常的感觉和行为导致压力减轻
通过能够在这些领域进行自我护理，人们满足了Orem所说的普遍自我护理需求。如果有疾病、伤害或疾病，个人在三个额外领域有自我照顾的需求（。这些被称为健康偏离自我保健需求。
By being able to carry out self care in these areas the person fulfils what Orem (2001) calls their Universal Self Care Demands. If there is illness injury or disease the inpidual has self care demands in three extra areas (Orem, 2001). These are known as the Health Deviation Self Care Demands.
i Structure.
ii. Functioning.
iii. Behaviour.
Orem采用从家庭评估开始的护理过程，以发现他们的个人问题，这些问题是根据自我护理缺陷定义的。Orem模型的第一阶段确定了个人对自我照顾的需求和实现自我照顾的能力。我评估了这个家庭，父母都在工作，爸爸是厨师，妈妈是养老院的看护，他们都由住在街对面的祖父母抚养。两人都很健康。两岁的女儿引起了她母亲的担忧，因为她不说话，很难用很少的眼神来引起她的注意。我用奥勒姆的清单问了六个活动中的每一个。所发现的问题与两岁的孩子在房间里踱来踱去、不说话、不眼神交流、一只手挨着另一只手拍打的行为有关。
Orem uses the Nursing Process starting with assessment of the family in order to discover their inpidual problems which are defined in terms of self care deficits (Orem, 2001). The first stage of Orem’s model identifies both the demands for and the ability to achieve, self care in an inpidual (Aggleton and Chalmers, 2000). I assessed the family the parents both worked dad is a chef and mum is a carer in a nursing home they are both supported by grandparents who lived across the street. Both were fit and well. The two year old daughter was causing her mother concern in that she was not speaking it was difficult to get her attention with very little eye contact. Using Orem’s list I asked questions about each of the six activities. The problems identified were related to the two year olds behaviour of pacing around the room not speaking no eye contact and slapping her hands one on top of the other.
在收集了信息之后，我不得不决定为什么会出现自理不足。这是很难使用奥雷姆的，其中指出，自我照顾赤字应与缺乏知识或技能，缺乏动机，以实现自我照顾。这些似乎不适用于由父母照顾的两岁孩子。但显然她的行为令人担忧。
After gathering information I had to decide why there was a self care deficit. This was difficult using Orem’s which states the self care deficit should be linked to a lack of knowledge or of skills to a lack of motivation to achieve self care (Aggleton and Chalmers, 2000). These don’t seem to apply to a two year old cared for by her parents. But clearly her behaviour was a cause for concern.
我现在已经完成了大量的文书工作，认识到的一个错误，在许多情况下，这导致护理模式成为“官僚杂务”。检查表方法和标准护理计划可以快速评估普遍的自我护理需求。
I had now completed a good deal of paperwork a fault recognised by Fawcett et al (2004) in many instances it has led to nursing models being a “bureaucratic chore” (Fawcett et al,2004). A checklist method and standard care plans would have allowed for a quick assessment of the Universal self care demands (Kitson, 2001).
下一阶段是计划和设定目标。每个客户的长期目标是恢复自我护理能力和自我护理需求之间的平衡。
The next stage is to plan and set goals (Salvage and Kershaw, 1990). The long term goal for each client would be the restoration of a balance between self care ability and self care needs (Salvage and Kershaw, 1990).
护理计划的实施可能涉及满足自我护理需求的活动。此外，家庭成员或重要的其他人可能会提供一些照顾。Orem（2001）已经确定了六种广泛的方式来帮助实施护理计划。
The implementation of the care plan may involve activities to meet self care demands (Pearson et al, 2004). In addition members of the family, or significant others, may provide some care. Orem (2001) has identified six broad ways in which assistance can be given to implement a care plan.
1.Doing for or acting for another
2.Guiding and directing another.
3.Providing physical support.
4.Providing psychological support.
5.Providing an environment which supports development.
6.Teaching another.
However each of these methods of helping requires compliance (Pearson et al 2004). Orem’s model demands that clients and their families are willing and able to adopt certain roles achieve self care (Aggleton and Chalmers 2000).
3) Evaluation
Orem (2001) has suggested that the evaluation of care given should be measured in terms of the clients or families performance of self care.
Using Orem we should set out goals in terms of what the family will achieve (Pearson et al, 2004). It was difficult to set goals babies who are born prematurely can suffer from learning difficulties and to investigate the two year olds behaviour was the goal.
Orem’s model didn’t seem to fit well with this families care.
The major problem with nursing models concerns the relationship with the clients of the service. These are of two kinds. The employer for most nurses in the UK, the employer is the Government. The Government has aims and objectives for its health care system which is to use evidence based practice which may conflict with a particular nursing model or philosophy (Mckenna et al, 2008). Orem’s model is over fifty years old and is not evidence based.
The problems mainly being centered on the daughter’s behavior the following framework was more appropriate for this family.
An evidence based framework The Family Health Needs Assessment was introduced into the health visiting service in 2003 and is based on the Framework for the Assessment of children in need and their families (Department of Health et al, 2000). The Assessment Framework was intended to help practitioners to become child-centered (Horwath, 2010). The aim being to do an assessment of the family’s health and parenting needs. A triangle is used as an illustration of the Framework the child being in the centre (Rose, 2009).
The three sides of the triangle represent the key factors that influence the Childs health; child developmental needs, parenting capacity and family health and environmental factors. Each one has sub headings specific to the main heading.
Child’s Development Needs
Health
Education
Emotional & Behavioral Development
Identity
Family & Social Relationships
Social Presentation
Self Care Skills
Parenting Capacity
Basic Care
Ensuring Safety
Emotional Warmth
Stimulation
Guidance & Boundaries
Stability
Family health
Family history & functioning
Wider family
Housing
Employment
Income
Family’s Social Integration
Community Resources
The aim of the initial Family Health Needs Assessment (FHNA) is to undertake a full
assessment of the family’s health and parenting needs. The impact of parenting
capacity, family health and environmental factors on the child’s health and well-being
is assessed to identify children and families who may require additional support to
achieve the 5 outcomes identified in Every Child Matters (2004).
Being healthy
Staying Safe
Enjoying and achieving
Making a positive Contribution
Achieving Economic well-being
There is research evidence to suggest that low birth weight and prematurity indicates a greater risk of not achieving the 5 outcomes identified in Every Child Matters (2004).
Then a family health plan can be developed to include the family’s needs as agreed in partnership with the parent/carer. How the family wishes to address these needs
An action plan which identifies specific interventions/support and who this will
be provided by as well as the date for review and a review of progress made against the action plan.
The assessment took some time I had to reword some of the questions for fear of giving offence. The assessment forms were lengthy and there was some duplication. Emotional warmth under parenting Capacity and Emotional and behavioral development under the heading Childs developmental Needs. I found it difficult to know what to include under some of the headings. In Calders study (2003) the practitioners found the heading for ‘the child’s developmental needs’ the most challenging of the three headings. A number got confused between ‘social presentation’ and ‘self-care skills’ and the majority struggled with assessing ‘identity’.
The task for practitioners is to specify what, in relation to health and development, the child is at risk of and how significant they consider this risk to be (Horwath, 2010).
The original Framework for the assessment of children in need and their Families has guidance and support materials which explain the risk of harm, reducing the Framework to ‘the Triangle’ and a set of descriptions separates the needs from the risk of harm. Which could lead to a loss of focus on the child and their needs (Platt, 2006).
Both parents in this case were happy to carry out the assessment some parents can be unco-operative or even hostile Brandon et al, (2009). This could also cause a lack of focus on the needs of children. Brandon et al, (2009) found that good parental engagement can also disguise risk of harm to a child.
It is important hear what children have to say (Archard and Skivenes, 2009). I did engage the two year old with my identity badge which she recognized the picture but in this case I wasn’t able to interview the child because of her understanding and limited speech. I was able to observe her though and record my observations. Brandon et al. (2009) describe the various ways in which professionals don’t include children in the assessment. These include young people and siblings and a failure to address the needs of children who chose not to or are unable to speak because of disability, trauma and fear (Brandon et al 2009).
Groups of children in need that are hard to assess included: disabled children; adolescents; children of different cultures and faiths; and children in asylum-seeking
and refugee families (Brandon et al, 2009). Another group of children that also
has been found to be difficult to assess are children in need from higher socioeconomic groups. These cases were found challenging by social workers because:
the parents were more aware of their rights (Brandon et al, 2009). Care must be given to recording accurately what the child says and managing that information,
especially if it is negative about the parents so not to expose the child to any more risk
Practitioners are responsible for gathering information and they also have to share the findings of the assessment with family members.
From the assessment I identified a problem under the heading Child Developmental Needs Health the two year old daughter was growing physically but was not developing speech and had limited eye contact. The family had just moved from another area. Their daughter had been born premature at 31 weeks and she had had follow up appointments at hospital now that they had moved the hospital was too far away.
The follow up at hospital was important for her developmental reviews. So the first identified need was to register at the Doctors and explain that she needs a referral to the hospital for a full pediatric review.
Speech was a problem in that she was making the occasional sound and not forming her words properly. I made the speech therapy referral and gained assurances that her parents would take her. We discussed taking her to a nursery to mix with other children. After talking it was decided so that mum could go too to join a mother and toddler group. So things moved swiftly we put a time scale on these three major things of three weeks. I arranged to visit again in two weeks.
Case Study范文在结尾部分指出如果是消极的父母，就不要让孩子暴露任何更多的风险 。从业人员负责收集信息，他们还必须与家庭成员分享评估结果。从Case Study范文发现了一个问题，题为“儿童发展需要健康”。两岁的女儿身体正在发育，但没有语言发育，眼神接触也有限。这家人刚从另一个地区搬来。他们的女儿在31周时就早产了，现在他们把医院搬到了太远的地方，她在医院有了后续的预约。在医院的随访对她的发展回顾很重要。因此，首先确定的需要是在医生那里登记，并解释说她需要转诊到医院进行全面的儿科检查。说话是个问题，因为她偶尔会发出声音，而且说话的形式不正确。我做了语言治疗转诊，得到了她父母会带她去的保证。我们商量着把她带到托儿所和其他孩子混在一起。经过交谈，决定让妈妈也去参加一个母婴小组。所以事情进展得很快，我们给这三件大事定了一个三周的时间尺度。我安排两周后再去。本站提供各国留学生论文Case Study写作指导服务，如有需要可咨询本平台。