偏鄉地區發展遲緩兒童早期療育利用經驗與障礙：主要照顧者觀點分析

Experiences and Barriers to the Utilization of Early Intervention for Children with Developmental Delays in Remote Area: An Analysis of Main Caregiver Perspectives

了解發展遲緩兒童早期療育服務需求與利用障礙，是保障弱勢兒童就醫權益的一大保障。本研究目的乃以主要照顧者的觀點，深入探討偏鄉地區發展遲緩兒童早期療育利用經驗與障礙。本研究採取質性半結構式的深度訪談進行資料收集，以三芝某幼兒園為個案研究場域，研究對象為12名發展遲緩兒童主要照顧者，訪談資料分析的方式，以質性資料分析原則，主要以內容分析法與主題分析法進行資料的整理與分析。研究結果發現主要照顧者對早期療育深感「城鄉落差、資源不足，無法滿足家長需求」，主要分析主題包括：資源匱乏以致於需赴外地就醫、資源分配不均、療育時間未能滿足需求等三面向；研究內文將根據此三大主題敘述次主題，以及描述受訪者所表達的早期療育利用經驗與障礙等。最後，本研究建議為提升三芝地區發展遲緩兒童利用早期療育服務的可近性，如何媒合常規性定點式服務的社區據點、充足的服務時段與頻率、以及充實專業人力及設備是未來努力的方向。

Understanding the needs and barriers to the utilization of early intervention for children with developmental delays is a major safeguard to protect the rights of disadvantaged children to health care. The purpose of this study was to examine the experiences and barriers on early intervention of children with developmental delays in remote areas from the perspective of primary caregivers. In this study, qualitative semi-structured indepth interviews were used to collect data, and a kindergarten in Sanzhi was used as the case study site, with 12 primary caregivers of children with developmental delays as the target group. The data analysis of the interviews was based on the principle of qualitative data analysis, and the data were mainly organized and analyzed using the content analysis method and the theme analysis method. The results of the study revealed that the primary caregivers were deeply concerned about the“urban-rural disparity, lack of resources, and inability to meet parents' needs”. The main themes of the analysis included: lack of resources, which resulted in the need to go abroad for medical treatment, unequal distribution of resources, and inability to meet the needs of the early intervention time; the text of the study will be based on the three themes to describe the sub-themes, as well as to describe the experiences of the early care utilization and barriers that the interviewees have expressed. Finally, this study suggests that in order to improve the accessibility of early intervention for children with developmental delays in the remote area, future efforts should be made to match the community locations of regular services, to provide adequate service hours and frequency, and to enrich professional manpower and equipment.