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探討職能治療運用教練於兒童及家庭介入成效：文獻回顧
Using Coaching in Occupational Therapy for Children and Family: A Literature Review
摘要
近十年來「教練」技術被認定為職能治療師的增能技巧之一。教練與訓練有著本質上的差異，更強調「優勢本位」及「促進自我決定」等要素；教練涵蓋的「成人學習理論」特性，使之廣泛被使用於早期療育領域中來增能家長。本文欲透過文獻回顧，探討職能治療師運用教練於兒童及家庭領域的介入方案、對象、情境及成效。作者使用PubMed、CINAHL 與PsycINFO資料庫搜尋文獻，鍵入關鍵字＂coach＂, ＂coach or coaching＂, with ＂occupational therapy or occupational therapist＂。納入條件為:（1）介入方案需以教練取向進行；（2）介入由職能治療師執行；（3）研究對象為18歲以下兒童、青少年或其家長；（4）原創研究，研究設計需包含前、後測並呈現介入的成效；及（5）十年內以英文發表之文獻（發表時間為2009年1月至2019年3月）。本文共收錄11篇文獻，包含1篇為隨機對照試驗、5篇為單組前後測研究，及5篇個案研究。介入對象包含自閉症、肢體障礙及非特定診斷兒童及青少年。本文依據運用教練之介入對象及方案可分類為（1）針對肢障青少年的環境為本位介入，（2）針對自閉症兒童的感覺為本位介入，及（3）職能表現教練。研究結果顯示教練可增進兒童或家長於自然情境中的個別化目標，並提高對職能表現的滿意度及親職自我勝任感，有潛力成為替代治療之一。但多數文獻證據等級不高，未來仍需更多等級高的研究。
並列摘要
Coaching has been formally adopted by the Canadian Association of Occupational Therapists as an enablement skill in 2007 and became a powerful tool for occupational therapists. This review of literature was conducted to investigate the populations, settings, and outcomes for which coaching has been used in children and families by occupational therapists. The databases of PubMed, CINAHL and PsycINFO were searched using the terms ＂coach＂, ＂coach or coaching＂, with ＂occupational therapy or occupational therapist＂. Inclusion criteria were: (1) the term coaching was used as an intervention; (2) the intervention was administered by occupational therapists; (3) research participants were under 18 years old with difficulties in occupational performance along with their parents; (4) studies investigated intervention efficacy using a pretest-posttest design; and (5) research was published in English between Jan. 2009 and Mar. 2019. Of 160 articles, 11 articles met the inclusion criteria. Among them, 1 was a randomized controlled trial, 5 were pretest-posttest quasi-experimental design studies, and 5 were case studies. The populations included children with Autism spectrum disorders (ASD), physical disability, and nonspecific diagnoses. Three categories of interventions which used coaching were identified in the reviewed articles: (1) environment-based interventions for physical disability, (2) sensory-based intervention for ASD, and (3) occupational performance coaching to enhance occupational performance in the areas of leisure, self-care, play and social skill. Coaching has the potential to become an occupational therapy intervention for improving clients' occupational performance in nature contexts, enhancing the parent efficacy, and reducing parental stress. However, future studies with high levels of evidence are warranted.