研究背景及目的：白血病是儿童期恶性肿瘤的最常见形式,其发病率可达 4/10 万,占 15 岁以下儿童肿瘤患者的 30%。在儿童白血病中，急性淋巴细胞白血病(ALL)占 78%，可见 白血病对儿童健康的影响之大。在我国，白血病是儿童最常见的恶性肿瘤。据调查显示， 我国每年约有 15000 例新发白血病儿童，其中 70%～80%为急性淋巴细胞白血病（Acute Lymphoblastic Leukemia，ALL）。 Wanqing Chen 等人调查了我国 2014 年癌症发病率，其 中不论是男性还是女性，0-14 岁的儿童中，癌症发病率位居第一位的是白血病。随着白血 病的治愈率越来越高（急性淋巴细胞白血病治愈率可达 90%），对白血病患儿及其照顾者的 日常服务提上日程。医务社会工作的发展，使得其在医院中的作用逐渐显现出来。至今， 国外医务社会工作发展已有百年历史，他们更加专业化、职业化，医务社会工作和已经成 为医院不可或缺的一部分，而我国医务社会工作在改革开放以后才有了一定的进展，2006 年专业性医院和医务社会工作迅猛发展（刘继同，2006）。 但是目前我国医务社会工作的发 展还处于初级阶段。R 医院自 2009 年建立社工部，为各个科室提供社工服务，其中儿科是 其主要服务的科室之一。在儿科病房住院的 90%是白血病患儿，他们是 R 医院医务社工主 要的服务对象。所以本文以 R 医院儿科的白血病患儿及其照顾者为研究对象，从医务社工 的角度探究白血病患儿及其照顾者的社会支持需求。一方面总结患儿及其照顾者的社会支 持需求，另一方面了解目前医务社工所提供的社会支持服务有哪些，对两者进行差异匹配 分析，从而为医务社工的实务提供一定的借鉴意义。 研究方法：本文采用了质性研究方法，运用访谈的方式收集资料。最终共访谈 22 名访 谈对象，其中诱导缓解期患儿照顾者 4 名，强化治疗期患儿照顾者 6 名，诱导缓解期白血 病患儿 4 名，强化治疗期白血病患儿 4 名，医务社工 4 名。资料分析与整理是根据扎根理 论的三级编码方式对收集的资料进行分析整理。 研究结果：1）白血病患儿及其照顾者在不同阶段的社会支持需求不同，同一阶段，他们的社会支持需求也有层次上的区别。诱导缓解期白血病患儿照顾者的社会支持需求主要 是信息支持需求，心理支持需求，网络支持需求和临终关怀的支持需求。其中信息支持需 求为主要需求。强化治疗期白血病患儿照顾者的社会支持需求是心理支持需求，信息支持 需求，实际支持需求，医疗资源支持需求，网络支持需求。其中实际支持需求为主要支持 需求。诱导缓解期白血病患儿的社会支持需求主要有心理支持需求，信息支持需求，网络 支持需求，和实际支持需求。其中心理支持需求是他们的主要需求。强化治疗期白血病患 儿的社会支持需求主要有心理支持需求，信息支持需求，网络支持需求，和信息支持需求。 网络支持是他们的主要需求。 2）社工所提供的社会支持相关服务与白血病患儿及其照顾者 的社会支持需求之间存在着较大的差异。医务社工提供社会支持服务针对不同的阶段也有 不同的服务，针对诱导缓解期的白血病患儿照顾者提供的社会支持服务有信息支持服务和 网络支持服务，针对强化治疗期照顾者提供的社会支持服务包括实际支持服务和网络支持 服务，针对诱导缓解期的白血病患儿，社工提供的社会支持服务主要有实际支持，针对强 化治疗期的白血病患儿提供的社会支持服务有网络支持服务和实际支持服务。从中可以看 出医务社工提供的社会支持服务基本上是以需求为导向的服务，但是社工所提供的社会支 持相关的服务与白血病患儿及其照顾者的社会支持需求之间存在着较大的差异，即社工提 供的社会支持服务只有小部分覆盖了服务对象的社会支持需求，这也就意味着医务社工针 对白血病患儿及其照顾者的社会支持服务任重而道远。 研究结论：1）白血病患儿及其照顾者的社会支持需求在 Cutrona 社会支持理论框架 基础上有所调整，并不完全重合。2）白血病患儿及其照顾者的社会支持需求在不同的阶段 各有不同，在同一阶段层次上也有区别。他们两个群体之间的社会支持需求也存在差别。3）医务社工的访谈发现社工提供的社会支持服务基本上是以需求为导向，且 白血病患儿及 其照顾者的社会支持服务与白血病患儿及其照顾者的社会支持需求之间存在着较大的差异。

Background and purpose: leukemia is the most common form of childhood malignancies, and its incidence can reach 4/10 million, accounting for 30% of children under 15 years of age. In childhood leukemia, 78% of acute lymphoblastic leukemia (ALL) accounts for the large impact of leukemia on children's health. Leukemia is the most common malignancy in children in China. According to the survey, there are about 15000 new cases of leukemia in China every year, of which 70% to 80% are acute lymphoblastic leukemia.(Acute). Lymphoblastic Leukemia, ALL). Wanqing Chen and others investigated the incidence of cancer in 2014 in our country, among both male and female, the first number of cancer of the 0-14 year old children is leukemia. As the cure rate of leukaemia is getting higher and higher (the cure rate of acute lymphoblastic leukemia can reach 90%), the daily service of children with leukemia and their caregivers is on the agenda. The development of medical social work has made it play a more and more important role in hospitals. So far, the development of medical social work in foreign countries has a history of more than one hundred years. They are more specialized and professional. Medical social work has become an indispensable part of the hospital. The medical social work in China has made some progress after the reform and opening up. In 2006, professional hospitals and medical social work developed rapidly (Liu). . But at present, the development of medical social work in China is still in its infancy. R hospital has established social work department since 2009 to provide social work services for various departments, among which pediatrics is one of its main services. 90% of the children in the pediatric ward are children with leukemia. They are the main clients of medical social workers in R hospital. Therefore, in this paper, children with leukemia in R hospital and their caregivers are studied. From the perspective of medical social workers, the social support needs of children with leukemia and their caregivers are explored. On the one hand, the social support needs of children and their caregivers are summarized, and on the other hand, I also study what is the social support service provided by medical social workers and the difference matching analysis between the two, so as to provide some reference for the practice of medical social workers. Research methods: This paper adopts qualitative research method and uses interviews to collect data. A total of 22 interviewees were interviewed, of which 4 were induced in remission period, 6 in the intensive treatment period, 4 in remission period leukemia, 4 in patients with leukemia in the treatment period and 4 in medical social workers. Data analysis and sorting are based on the three level coding method of grounded theory. Results: 1) the social support needs of children and their caregivers at different stages are different, and their social support needs are also different at the same stage. The social support needs of the caregivers of children with remission period leukemia are mainly information support demand, psychological support demand, network support demand and terminal care support demand. The demand for information support is the main requirement. The social support needs of the caregivers of children with leukemia in the treatment period are psychological support demand, information support demand, actual support demand, medical resources support demand, and network support demand. The actual support demand is the main support demand. The social support needs of children with leukemia during induction remission are mainly psychological support needs, information support needs, network support needs, and actual support needs. Among them, psychological support demand is their main demand. Social support needs of children with leukemia during intensive treatment are mainly psychological support needs, information support needs, network support needs, and information support needs. Network support is their main demand. 2) there is a big difference between social support related services provided by social workers and social support needs of children with leukemia and their caregivers. Social support services provided by medical social workers also have different services for different stages. The social support services provided for the caregivers of children with leukemia in remission period have information support services and network support services. The social support services provided for the treatment period include real support services and network support services. Social support services provided by social workers are mainly supported by social support services for children with leukemia in remission period. The social support services provided for children with leukemia in the intensive treatment period have network support services and practical support services. It can be seen that social support services provided by medical social workers are basically demand oriented services, but social support services provided by social workers are very different from the social support needs of children with leukemia and their caregivers, that is, social support services provided by social workers are only a small part of the service. Social support needs of clients, which means that medical social workers have a long way to go for social support services for children with leukemia and their caregivers. Conclusions: 1) the social support needs of children with leukemia and their caregivers are adjusted on the basis of Cutrona's social support theory. 2) the social support needs of children with leukemia and their caregivers differ from each other in different stages, and there are differences at the same level. There is also a difference in social support needs between the two groups. 3) interviews with medical social workers found that social support services provided by social workers are basically demand oriented, and there are significant differences between the social support services of children with leukemia and their caregivers and the social support needs of children with leukemia and their caregivers. a small part of the service. Social support needs of clients, which means that medical social workers have a long way to go for social support services for children with leukemia and their caregivers. Conclusions: 1) the social support needs of children with leukemia and their caregivers are adjusted on the basis of Cutrona's social support theory. 2) the social support needs of children with leukemia and their caregivers differ from each other in different stages, and there are differences at the same level. There is also a difference in social support needs between the two groups. 3) interviews with medical social workers found that social support services provided by social workers are basically demand oriented, and there are significant differences between the social support services of children with leukemia and their caregivers and the social support needs of children with leukemia and their caregivers.