偏鄉地區照顧者對發展遲緩兒童早期療育整合服務識能之研究

The Exploratory Study on Caregivers’Awareness of Integrated Early Intervention for Children with Developmental Delay in Remote Area

偏鄉地區因交通不便與療育資源缺乏，發展遲緩兒童利用早期療育常有顯著限制。本研究以新北市三芝區為研究場域，主要研究目的乃探討該地區主要照顧者對發展遲緩兒童整合性早期療育之識能情形，以作為未來界定該地區發展遲緩兒童早期療育整合服務的需求參考。本研究利用質性半結構式的深度訪談進行資料收集，主要研究工具為質性訪談大綱，研究地點以三芝區某幼兒園為收案場域，符合收案條件之發展遲緩兒童的主要照顧者共計十二人，包含三位男性，九位女性為訪談對象。個案訪談時間平均約40-50分鐘，訪談過程以全程錄音紀錄，再以逐字稿方式呈現訪談資料，並以內容分析法與主題分析法進行資料的整理與分析。透過訪談資料內容歸納，發現主要照顧者對整合性早期療育識能普遍面臨知識不足和期望落差，歸納主題分別為：(1)早期療育知識來源侷限；(2)對早期療育態度多元；以及(3)對早期療育認知與經驗落差大。透過主題建構，再以次主題歸納受訪者之相關訪談紀錄分析於論文內文。最後本研究建議偏鄉地區應加強早期療育多元宣導，提升主要照顧者早期療育識能，以有效利用相關療育服務。此外，因地制宜的遠距視訊療育課程應可發展，以符合偏鄉地區民眾之需求，消弭健康的不平等。

Due to the inconvenience of transportation and the lack of medical resources in remote areas, the utilization of early childhood intervention for children with developmental delays is often significantly limited. In this study, Sanzhi District in New Taipei City was used as the research site, and the main purpose of the study was to investigate the knowledge of the primary caregivers of children with developmental delays in this area, so as to define the demand for integrated early intervention for children with developmental delays in this area in the future. This study utilized qualitative semistructured in-depth interviews for data collection, and the main research instrument was the qualitative interview outline. The study site was a kindergarten in Sanzhi District, and there were twelve primary caregivers of children with developmental delays who met the criteria for case intake, including three males and nine females as the interview subjects. The interviews lasted about 40-50 minutes on average, and were audio-recorded and presented verbatim, with data organized and analyzed by content analysis and thematic analysis. Through summarizing the interview data, it was found that the primary caregivers generally faced insufficient knowledge and expectation gap in integrative early intervention, and the themes were summarized as: (1) limited sources of knowledge on early care; (2) diversified attitudes towards early care; and (3) large gap between knowledge and experience on early intervention. Through the construction of themes, the interview records of the respondents were summarized and analyzed in the paper. Finally, this study suggests that in remote areas, we should strengthen the promotion of diversified early intervention and enhance the primary caregivers' knowledge of early care so that they can effectively utilize the relevant care services. In addition, on-line early intervention programs should be developed to meet the needs of the people in the remote areas and to eliminate health inequalities.