台灣小兒職能治療與自覺執業能力之評量

A Survey of Clinical Practice of Pediatric Occupational Therapy and Therapists' Self-perceived Competence in Taiwan

小兒職能治療服務領域的拓展與成長，使轉介至小兒職能治療的個案種類及年齡層有明顯的變化。然而有關臨床上小兒職能治療常見之個案種類、評估與治療時所採用的理論架構、以及治療師的評估和治療能力之自我評量等相關文獻資料皆付諸闕如。本研究目的乃為了解台灣小兒職能治療服務對象的診斷種類，常用的治療理論架構，以及小兒職能治療師評估和治療能力的自我評量和自我成長需求。本調查研究以郵寄問卷的方式，調查台灣地區之小兒職能治療師，共寄發103個單位，包含303名治療師，共回收205份問卷（回收率68%），有效問卷197份。此份調查於2000年6月至8月執行。結果顯示，臨床上常見的個案種類為發展遲緩（43.1%）；治療師最常在初評後3-6個月內執行再評（47.8%）；結束療程方面，最多比例的治療師（30.6%）在一年至兩年內停止治療計劃；最常用的理論架構則是感覺統合理論（90.2%）；在自我評量方面，對評估與治療個案的能力感到滿意的是感覺統合障礙，而感到不滿意的則是高危險新生兒、自閉症及過動兒；學歷或年資與自我評量或建議課程著重理論或臨床的相關性均未達到顯著的差異性。研究結果不僅可以瞭解國內小兒職能治療臨床現況，更有助於職能治療系所教師瞭解臨床之需，以修訂課程。亦可作為舉辦繼續教育的參考，使已在執業的治療師有機會再提昇服務個案所需之相關評估與治療能力。

The aim of this study was to gather descriptive data on the clinical practice of pediatric occupational therapy (OT) including the variety of referred clients, the theories or frame of reference most often used, and therapists’self-perceived competence and continuing education needs for improving professional competence. A survey conducted between August and October of 2000 was used to collect data. Of the 303 surveys sent, 205 were returned (a 68% response rate). Therapists who reported one pediatric case or less fortnightly were excluded from the study, leaving 197 questionnaires. The results indicated that the most common problem identified as the reason for referral was developmental delay (43.1%). Most occupational therapists conducted reevaluation within 3 to 6 months after the initial evaluation (47.8%) and discharged their clients within 1 to 2 years after the initial treatment (30.6%). Sensory integration theory is the most frequently used frame of reference (90.2%). Regarding the self-perceived competency, most therapists felt satisfied with their competence in evaluating and treating children with sensory integration dysfunction. High-risk neonate, children with autism, and children with hyperactivity were the three clinical populations that therapists felt least satisfied with their competency in evaluation and treatment. In summary, the findings of this study not only provide the information about the current status of pediatric OT in Taiwan but also help the educators to revise the curriculum or continuing education courses according to the need of practicians.