服務使用者與提供者間的凝視：彰化縣早期療育服務系統的參與式行動研究

本研究聚焦於彰化縣內的早期療育服務使用者經驗涵容，以修正該地區的服務系統。採用參與式行動研究方法，旨在分析利害關係人，包括早期療育服務專業人員與使用者的需求，評估服務系統運作情況以及衡量服務輸送與需求之間的差距，進行參與式服務系統設計。研究採用多階段策略。首先，研究者收集並分析早期療育服務工作人員的現行服務系統資料。隨後，在第二階段進行服務提供者與服務使用者間彼此需求缺口辨識，並對早期療育服務工作人員和服務使用者進行焦點團體訪談。根據這些交互建構的服務系統發展行動歷程，調整和修訂彰化縣早期療育服務系統，確保其符合最適實踐模型。研究發現彰化縣早期療育服務系統面臨多項挑戰，包括服務使用者在使用該服務系統時所遇到的困境，如行政端的單一窗口，非等同實質跨系統資源的連結落實，有通報轉介但沒有資源轉化之實，形成服務系統的重複進案和跨專業團隊的意見缺乏整合等現象。透過多方利害關係人參與式服務設計，產生彼此更深入洞悉在地脈絡中早期療育服務系統的實際運作情況，以針對當前政策環境下的最適服務實踐進行調整。研究發現透過採取參與式途徑，具有提升早療服務的對服務使用者視角的涵容，賦權實踐其在服務歷程中的結構優勢維繫。

This study targets early intervention service users in Changhua County to enhance the local service system. Employing the "Participatory Action Research" in Early Intervention Services in Changhua County approach, it aims to assess stakeholder needs, including professionals and users, evaluate system operations, and gauge the gap between service delivery and demand. Through system revisions, the goal is to better cater to user needs. The research follows a multi-stage approach. Initially, data on the current service system are collected and analyzed from early intervention personnel. Subsequently, effectiveness and demand gap identification are conducted, followed by focus group interviews with service personnel and users. Continuous adjustments are made based on this interactive process to ensure alignment with best practices. The study reveals challenges faced by the early intervention service system, including administrative-centric structures and lack of integration among multidisciplinary teams. Through participatory service design, a deeper understanding of system operations is gained, facilitating adjustments to provide suitable services within the current policy framework. This actualizes the empowerment approach in enhancing the structural advantages of early intervention services.