對一位腦性麻痺兒童和其家庭進行以家庭為中心之團隊協力問題解決過程

A Family-Centered Collaborative Problem-Solving Process for a Child with Cerebral Palsy and the Family

劉文瑜(Wen-Yu Liu) ； 潘懿玲(Yi-Ling Pan) ； 蘇慧菁(Hui-Ching Su) ； 洪若華(Jo-Hua Hung) ； 廖華芳(Hua-Fang Liao) ； 黃暄雅(Shiuan-Ya Huang) ； 楊建志(Jian-Zhi Yang) ； 孫世恆(Shih-Heng Sun) ； 莊育芬(Yu-Fen Chuan)

《物理治療》 40卷1期 (2015/03) Pp. 18-26

https://doi.org/10.6215/FJPT.PTS1416820642

摘要

背景和目的：以家庭為中心服務（family-centered services）模式是兒童復健及早期介入（early intervention）中極為重要的一環。本個案報告描述如何以團隊協力問題解決模式（Collaborative Problem Solving Model）執行以家庭為中心服務。個案描述：個案為一名月齡45個月，診斷為腦性麻痺（cerebral palsy）的男童。介入：家長參與一個家長增能訓練活動。此訓練活動旨在培養家長對其特殊需求兒童問題解決的能力。利用小組合作的方式，成員以團隊協力問題解決模式和國際健康功能與身心障礙分類系統—兒童及青少年版架構進行討論。以小組討論紀錄、家庭成效問卷（Family Outcomes Survey, FOS）、以及ICF-CY三到六歲問卷（ICF-CY Questionnaire, 3-6 years）做為初步結果。成效：小組討論的紀錄顯示討論的內容跨越ICF-CY中的15個章節（68%），且能依據個案家庭的需要提出以環境面向介入的策略。個案家長對於家長增能訓練課程非常滿意。並在FOS及ICF-CY問卷有觀察到前後的改變。討論與結論：對該位腦性麻痺兒童及其家庭，在以ICF-CY為基礎架構下進行以家庭為中心之團隊協力問題解決是可行的。未來研究需探討此訓練活動的長期成效。

關鍵字

腦性麻痺 ； 以家庭為中心 ； 問題解決 ； 國際健康功能與身心障礙分類系統—兒童及青少年版（ICF-CY）

並列摘要

Backgrounds and Purposes: Family-centered services (FCS) are considered an important part of pediatric rehabilitation and early intervention. This case report described how to use the Collaborative Problem-Solving Model to implement FCS. Case Description: The targeted child was a 45-month-old boy with cerebral palsy. Intervention: Both parents participated in the parental empowerment training session. This training aimed to equip parents with problem-solving abilities for their children with special needs. Working as a team, members used the Collaborative Problem-Solving Model and the International Classification of Functioning, Disability and Health: Children and Youth (ICF-CY) framework to solve their concerns and problems under the guidance of a facilitator specialized in early intervention. The written records from group discussions, the Family Outcomes Survey (FOS), and ICF-CY Questionnaire were used to present the preliminary outcomes. Outcomes: According to the final written report, 15 (68%) chapters of the ICF-CY were considered during the discussions. The final strategies for intervention were implemented in the child's natural environment. The targeted parents were very satisfied with this parental empowerment training. The changes of pre-post scores in the FOS and ICF- CY Questionnaire were noted. Discussion and Conclusion: A family-centered collaborative problem-solving process based on the ICF-CY framework for a child with CP and his family is feasible. Future studies are warranted to explore the long-term outcomes of this training.

並列關鍵字

Cerebral palsy ； Family-centered ； Problem-solving ； ICF-CY