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標題: | 照顧安排、家庭育兒環境與兒童早期發展 Care arrangement, family caregiving environment and early child development |
作者: | Chun-Li Wu 吳君黎 |
指導教授: | 江東亮(Tung-liang Chiang) |
關鍵字: | 兒童早期安排,家庭育兒環境,照顧安排,出生世代研究,臺灣, early child development,family caregiving environment,care arrangement,birth cohort study,Taiwan, |
出版年 : | 2009 |
學位: | 博士 |
摘要: | 背景與目的:確保每個兒童的早期健康發展,不僅在於保障兒童的健康人權,也為促進整體人口健康奠定基礎。台灣近幾十年來歷經快速的社會人口變遷,使得兒童照顧安排已從家庭決策提升成為公共政策的關注議題。而照顧安排與早期發展的關係雖然已有長久的研究歷史,但近來多以正式托育品質的影響為主軸,且鮮少討論到中間機轉。故本研究的目的為:(一)瞭解兒童早期發展是否因不同照顧安排類型而有差異;(二)檢視照顧安排是否會透過家庭育兒環境,影響兒童早期發展。
方法:本研究資料來自國民健康局出生通報和台灣出生世代研究先驅調查資料庫。該調查採兩階段分層隨機抽樣方法,取得2,048名具全國代表性的樣本,而本研究則以完成6、18及36個月三波訪問調查的1,543名幼兒為研究對象。根據樣本18個月以後的主要照顧者及分工型態,將照顧安排區分為僅由雙親照顧、共同照顧、其他非正式照顧和正式托育四種類型。依變項為36個月大的粗動作、精細動作、語言與溝通、認知和身邊處理社會能力五個發展量尺。家庭育兒環境的測量,則為一含包含情緒支持和認知刺激兩個面向、由受訪者自評的短式量表。 結果:整體而言,僅由雙親照顧的幼兒粗動作發展顯著最差,而正式托育的幼兒在精細動作、認知和身邊處理社會能力的發展狀況,皆又顯著高於僅由雙親照顧和其他非正式照顧的幼兒。但在控制樣本基本特性和家庭人口、社會經濟變項後,不同照顧安排類型的幼兒各類發展即無顯著差異。接著,利用Baron和Kenny (1986)檢驗中介作用的方法,發現照顧安排確實會透過家庭的情緒支持與認知刺激環境,影響兒童早期發展;尤其呈現於情緒支持環境,大都能顯著分別降低僅由雙親照顧和其他非正式照顧的幼兒在各面向的發展弱勢。惟此一照顧安排透過家庭育兒環境的中介作用微弱。 結論:雖然照顧安排會間接經由家庭育兒環境對兒童早期發展產生影響,但相對上較重要的是家庭對幼兒提供的情緒支持與認知刺激。政府應提供提升家庭育兒環境的方案政策,特別是針對社經弱勢的家庭。 Background and Objectives: Children growing up during a period of rapid demographic and social changes have drawn increasing policy attention. Care arrangement is one of the prior issues, particularly for its consequences on early child development. Recent research on the relationship of care arrangement and early child development has had a focus on the effects of formal child care; and meanwhile, relatively little has discussed the mechanism. This study aimed to: (1) describe the disparities in early child development by types of care arrangement; and (2) to examine the mediating role of family caregiving environment. Methods: The analysis was based on longitudinal data of the Taiwan Birth Cohort Pilot Study (TBCS-P). TBCS-P comprised a nationally representative sample of 2,048 babies born in 2003, and 1,543 who completed three waves of surveys at 6, 18 and 36 months old were included. According to the primary caregiver(s) at 24 and 36 months, care arrangement was divided into four types: exclusive parental care (35.7%), shared care by at least one parent and relatives (24.0%), non-parental care (8.9%), and child care (31.4%). The main outcome measure was parent-reported developmental status at 36 months old, including fine motor, gross motor, language, cognition, and social skills. Family caregiving environment was measured by a 14-item scale, comprising two domains: emotional support and cognitive stimulation. Results: Overall, exclusive parental care was related to the poorest development in gross motor. On the other hand, children of child care group performed significantly better in fine motor, cognitive and socioemotional development than exclusive parental and noo-parental care groups. However, after controlling for child’s characteristics and family sociodemographics, no significant differences were observed in all five areas of early child development by types of care arrangement. A mediating effect of family caregiving environment between care arrangement and developmental outcomes was confirmed using Baron & Kenny’s (1986) strategy of defining mediation. More concretely, higher scores of emotional support in the family were shown to mitigate the developmental disadvantages associated with exclusive parental and non-parental care. Conclusions: A supporting and stimulating family environment is critical to early child development, regardless of types of care arrangement. Public policy should be geared to foster family capacity to ensure all children a healthy start, particularly for socioeconomically disadvantaged groups. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/43190 |
全文授權: | 有償授權 |
顯示於系所單位: | 健康政策與管理研究所 |
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