父母反思功能：基礎概念與其在華人特殊健康照護需求兒童家庭中的文化應用

Parental Reflective Functioning: Conceptual Foundations and Cultural Applications in Chinese Families with Special Healthcare Needs

研究目的：父母反思功能是指父母理解自己與子女心智狀態的能力，現有研究多聚焦於個人主義文化。本文旨在探討其在華人特殊健康照護需求兒童家庭中的應用，並強調文化特性的考量與必要的調整。研究方法：回顧個體主義文化中關於特殊健康照護需求兒童家長的父母反思功能研究，並探討華人家庭觀與親職實踐，分析在華人家長中應用父母反思功能時，如何考量其文化中的親職信念。研究結果：雙元孝道模型區分兩種人倫關係：相互型（強調同理與尊重）與權威型（強調階層與服從）。探討以家庭為中心的照護與父母反思功能的文化差異時，需關注華人父母如何整合文化信念以促進親職福祉。父母反思功能在華人特殊健康照護需求兒童家庭的應用，亦需在理論、評估與介入層面進行調整，契合華人文化。研究結論：父母反思功能對特殊健康照護需求兒童的心理健康與華人照顧者福祉的影響，可能受到相互性孝道信念的調節。未來可進一步探討兒童健康差異如何影響華人父母的反思功能。

Purpose: Parental reflective functioning refers to parents’ability to understand their own and their children’s mental states. Studies have shown that higher parental reflective functioning positively affects the development of children with special healthcare needs, and reduces their risk of negative mental health outcomes over time. Additionally, it can decrease the risk of anxiety, depression, stress, and post-traumatic stress of parents caring for children with special healthcare needs. Research on this topic has primarily focused on parents from individualistic cultures; there is limited research on Chinese cultures, where family values and filial piety strongly influence parenting practices. The purpose of this topical review is to integrate and synthesize the literature, and to discuss cultural considerations in parental reflective functioning with a particular focus on parents of children with special healthcare needs within Chinese cultures. Methods: First, we reviewed studies on parental reflective functioning and its application for parents of children with special healthcare needs in individualistic cultures. Next, we provided an overview of how family values strongly influence parenting practices in Chinese families by focusing on Yeh and Bedford’s (2003) dual filial piety model, which highlights 2 types of renlun (human relations): reciprocal (emphasizing empathy and respect) and authoritarian (emphasizing hierarchy and obedience). Finally, we analyzed the ways in which these cultural norms interact with parental reflective functioning, and specified why this understanding is crucial for supporting Chinese families with children who have special healthcare needs. Results: We found that although the concept of parental reflective functioning is generally applicable to Chinese parents, adjustments in theory, assessment, and intervention are required to align with Chinese cultural beliefs and for the development of appropriate assessment tools and interventions. We discussed how individuals from Chinese cultures may practice parental reflective functioning in ways that both align with Chinese cultural beliefs and also promote caregiver well-being, and we identified specific ways that parental reflective functioning could be applied to Chinese children with special healthcare needs. Conclusion: We expect that the effectiveness of parental reflective functioning on the mental health outcomes of children with special healthcare needs and the promotion of caregiver well-being in Chinese contexts is likely to be moderated by the strength of parents’reciprocal filial piety beliefs. Future research should examine how differences in children’s conditions affect how parental reflective functioning is expressed and functions within Chinese families.