- 期刊
宅、急、變－以職能為焦點看COVID-19疫情期間有特殊需求兒童的家庭之調適
Observing Adaptation of Families of Children with Special Needs during the COVID-19 Pandemic: An Occupation-Based Perspective
摘要
2021年5月15日到7月27日，台灣政府宣佈嚴重特殊傳染性肺炎疫情達三級警戒。人們配合政策減少外出與非必要醫療，工作者調整為分流或居家上班，學校停課，公共場所、公園等休閒育樂場所皆關閉。人們被限制在家中，原本熟悉的生活常規、例行公事，個人的責任與角色、家庭分工都需要重新調整。特殊需求的孩子因其發展障礙影響生活參與，需要固定接受早期療育服務。然而，疫情期間家長無法帶孩子外出接受早期療育，孩子也停課；治療進展有停擺之虞外，孩子的生活安排與適應，更需要家長協助，整個家庭的生活受疫情影響甚鉅。但在逆境中仍有些家庭能逐漸展現韌性及自我調適的能力，創造新的日常、甚至是更好的家庭互動品質。本文為彙整北部地區三個早療醫療機構中，四位兒童職能治療師透過遠距關懷及陪伴32個早療家庭調適生活過程中之經驗，我們發現，家長與孩子「宅」在家，有失也有得，家長們在困境中主動發掘家庭可用資源，藉由調整作息、共同參與日常活動、善用手足等策略回復到穩定恆常，並覺察與領悟到日常活動的安排及實際的生活參與對孩子發展的重要性，進而被賦權與發展出韌性，這正是以職能為焦點的兒童職能治療所關注與推動的核心理念。
並列摘要
From May 15 to July 27, 2021, Taiwan announced a nationwide Level 3 epidemic alert due to a large-scale community outbreak of coronavirus disease 2019 (COVID-19). Social gatherings and access to medical services were restricted, business and public venues (including schools) were shut down, and many people were demanded to work from home. The imposed restrictions and home confinement forced people to readjust their daily routines, shift and change their roles and responsibilities in family. It even had great impact on families of children with special needs in many aspects: suspension of intervention services, the pressure of help their children adapt to the new daily living, and let alone the worries of the interruption of their children's development. As pediatric occupational therapists endeavored to support and empower the families we serve, the suspension of direct service also challenge us to play the role of accompanying and supporting the families of our clients through unconventional ways such as telecommunication. This article aims to delineate the authors' experiences and learnings on the adaptations of families of children with special needs during this period of the pandemic from an occupation-based perspective. We collected 32 interviews from families served in three hospitals with early intervention services in northern Taipei. We found that home confinement for parents and children has both negative and positive impacts. From an occupation-based perspective, families were able to gradually develop resilience and showed potential for adaptation along the time. The parents were able to actively integrate available resources. The adaptation strategies included schedule arrangement, shared engagement in daily activities, and facilitating sibling interactions, which further leading to empower the families and the reflection of the importance of their children's participation in daily routines. The shared experiences of these families echoed the core concept of 'occupational-based practice in occupational therapy.