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Intervention Review

Kinship care for the safety, permanency, and well-being of children removed from the home for maltreatment

  1. Marc Winokur1,*,
  2. Amy Holtan2,
  3. Deborah Valentine3

Editorial Group: Cochrane Developmental, Psychosocial and Learning Problems Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 20 FEB 2007

DOI: 10.1002/14651858.CD006546.pub2


How to Cite

Winokur M, Holtan A, Valentine D. Kinship care for the safety, permanency, and well-being of children removed from the home for maltreatment. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD006546. DOI: 10.1002/14651858.CD006546.pub2.

Author Information

  1. 1

    Colorado State University, Social Work Research Center / School of Social Work, Fort Collins, Colorado, USA

  2. 2

    Center for Child and Adolescent Mental Health, Faculty of Medicine, Department of Clinical Medicine, Tromsø, Norway

  3. 3

    Colorado State University, School of Social Work, Fort Collins, Colorado, USA

*Marc Winokur, Social Work Research Center / School of Social Work, Colorado State University, 110 Education, Fort Collins, Colorado, 80523, USA. marc.winokur@colostate.edu.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

SEARCH

This is not the most recent version of the article. View current version (31 JAN 2014)

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Every year a large number of children around the world are removed from their homes because they are maltreated. Child welfare agencies are responsible for placing these children in out-of-home settings that will facilitate their safety, permanency, and well-being. However, children in out-of-home placements typically display more educational, behavioral, and psychological problems than do their peers, although it is unclear whether this results from the placement itself, the maltreatment that precipitated it, or inadequacies in the child welfare system.

Objectives

To evaluate the effect of kinship care placement on the safety, permanency, and well-being of children removed from the home for maltreatment.

Search methods

The following databases were searched to Februrary 2007: CENTRAL, MEDLINE, C2- Specter, Sociological Abstracts, Social Work Abstracts, SSCI, Family and Society Studies Worldwide, ERIC, PsycINFO, ISI Proceedings, CINAHL, ASSIA, and Dissertation Abstracts International. Relevant social work journals and reference lists of published literature reviews were handsearched, and authors contacted.

Selection criteria

Randomized experimental and quasi-experimental studies, in which children removed from the home for maltreatment and subsequently placed in kinship foster care, were compared with children placed in non-kinship foster care on child welfare outcomes in the domains of well-being, permanency, or safety.

Data collection and analysis

Reviewers independently read the titles and abstracts identified in the search and selected appropriate studies. Reviewers assessed the eligibility of each study for the evidence base and then evaluated the methodological quality of the included studies. Lastly, outcome data were extracted and entered into REVMAN for meta-analysis with the results presented in written and graphical forms.

Main results

Sixty two quasi-experimental studies were included in this review. Data suggest that children in kinship foster care experience better behavioral development, mental health functioning, and placement stability than do children in non-kinship foster care. Although there was no difference on reunification rates, children in non-kinship foster care were more likely to be adopted while children in kinship foster care were more likely to be in guardianship. Lastly, children in non-kinship foster care were more likely to utilize mental health services.

Authors' conclusions

This review supports the practice of treating kinship care as a viable out-of-home placement option for children removed from the home for maltreatment. However, this conclusion is tempered by the pronounced methodological and design weaknesses of the included studies.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Kinship care for maltreated children

Child abuse and neglect are common problems across the world that result in negative consequences for children, families and communities. Children who have been abused or neglected are often removed from the home and placed in residential care or with other families, including foster families. Foster care was traditionally provided by people that social workers recruited from the community specifically to provide care for children whose parents could not look after them. Typically they were not related to the children placed with them, and did not know them before the placement was arranged. In recent years many societies have introduced policies that favour placing children who cannot live at home with other members of their family or with friends of the family. This is known as 'kinship care' or 'families and friends care'.  We do not know what type of out-of-home care (placement) is best for children. 

This review was designed to help find out if research studies could tell us which kind of placement is best. Sixty two studies met the methodological standards we considered acceptable. Wherever possible we combined the data from studies looking at the same outcome for children, in order to be more confident about what the research was telling us. Current best evidence suggests that children in kinship care may do better than children in traditional foster care in terms of their behavioral development, mental health functioning, and placement stability. Children in traditional foster care placements may do better with regard to achieving some permanency outcomes and accessing services they may need. Implications for practice and future research are discussed.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

親屬寄養 (Kinship care) 對於被帶離家的受虐孩童之安全性、穩定性及安適感之研究

每一年,世界上都有很多孩童因為受到虐待而被從家中帶離。兒童福利機構負責將這些孩童安置在家庭之外的地方,以促進他們的安全、穩定和安適感。然而,在家庭之外的安置場所的孩童,和同儕相較,通常有更多的教育、行為和心理的問題。目前我們仍不清楚,這些問題是因為安置本身造成的,還是被虐待所引發,或是兒童福利制度尚未完備的結果。

目標

評估親屬寄養對於被帶離家的受虐孩童,所提供的安全性、穩定性以及安適感之成效

搜尋策略

我們搜尋了以下的資料庫至2007年2月,包括ENTRAL, MEDLINE, C2Specter, Sociological Abstracts, Social Work Abstracts, SSCI, Family and Society Studies Worldwide, ERIC, PsycINFO, ISI Proceedings, CINAHL, ASSIA, and Dissertation Abstracts International。另外,也手工搜尋了相關的社會工作期刊和已刊登的回顧文獻所列的參考資料,並和作者聯繫。

選擇標準

針對因受虐而被帶離家後,安置在親屬寄養的孩童,和安置在非親屬寄養的孩童,在安適感、穩定性、安全性方面的兒童福利預後之比較,所進行的隨機和準實驗性研究。

資料收集與分析

作者群各自獨立閱讀篩選符合後的研究的題目及摘要。作者評估每項研究的實證素質,然後再評估收納的研究的方法學之品質。最後,作者擷取研究結果數據,以 REVMAN進行統合分析 (metaanalysis) ,結果以書面和圖形呈現。

主要結論

62個準實驗性研究納入本篇回顧。資料顯示,親屬寄養的孩童,相較於非親屬寄養的孩童,有較好的行為發展,心理健康功能,安置穩定性。雖然在回歸家庭的比率上沒有差異,安置在非親屬寄養的孩童比較可能被領養,而親屬寄養的孩童比較可能處在被監護的狀態。最後,安置在非親屬寄養的孩童比較可能使用心理健康服務。

作者結論

本篇回顧支持運用親屬寄養,作為受虐孩童被帶離家之後的家庭以外的安置選擇。然而,這個結論的有效度,受到收納研究中明顯的方法學以及設計上的弱點而減弱。

翻譯人

本摘要由成功大學附設醫院黃惠群翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

兒童虐待和忽視是全球性常見的問題,對孩童、家庭以及社區造成負面的後果。受到虐待或忽視的孩童常常被帶離開家,並且被安置在機構照顧,或是安置在其他家庭中,包括寄養家庭。傳統上,寄養家庭是由社工從社區招募,以提供照顧給父母本身無法照顧的孩童。他們通常和被安置的孩童沒有親屬關係,在安置前也不認識這個孩童。近年來,許多社會開始引入政策,傾向把無法留在家的孩童安置和其他的家庭成員或家族的朋友在一起生活。這就是所謂的'親屬寄養'或'家庭和朋友寄養'。我們不知道什麼類型的家庭以外的照顧(安置)是對孩童最好的。這次回顧的目的是要了解研究是否能告訴我們哪一種安置是最好的。62個研究符合我們認可的方法學標準。我們僅可能的結合各個研究的數據,來檢視相同的孩童的預後,用以對研究所描述的結論更有信心。當前最好的證據顯示,在親屬寄養的孩童,在其行為發展,心理健康功能,和安置穩定性,都較在傳統的寄養家庭的孩童表現較好。安置在傳統的寄養家庭的孩童,可能在達到某種永久性的預後和獲得需要的服務方面,有較佳的狀況。另外,此篇回顧也對臨床工作和未來研究的應用做探討。