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降低情緒障礙青少年日間留院特教班曠課率之分析

Analysis of Decreasing the Absent Rate of Special Education Class for the Adolescents Caring in the Psychiatric Day Care Hospital

摘要


爲協助特殊教育學生,台北市教育局自八十七年度起規劃辦理多元型態教育設施,提供多樣性、支持性的支援服務;其中又以罹患精神疾病之青少年最為弱勢。因此成立情緒及行為問題專業支援團隊以協助各校輔導「嚴重情緒及行為問題經學校輔導無顯著成效」的特殊教育需求學生。青少年精神病患「來醫院上學」是近6~7年來台北榮總精神部經由精神復健結合特殊教育以輔導罹患精神疾病青少年,然其成效有賴於病患之出席率,經由各式醫護記錄、團隊討論及會談整理後,分析曠課率高之主要原因為:學員退縮及人際問題、家長教養態度、課程無聊或太深等。研究方法:本研究乃針對問題擬定改進方案來降低曠課率並評值其效果;執行期間為民國92年06月至93年05月,改進方案包含加強家長座談會、帶領治療性青少年人際互動團體、設立班級自治幹部、開放課程討論、每月定期舉行個別化教育計畫(IEP)會議及個案討論會、增加有趣之點數兌換獎勵品、改善治療性環境及各項治療活動、補救教學、社交技巧訓練,建立教室規則來降低學員之曠課率,能及早達成復健目標,回歸校園及社會。結果:在未執行本方案前青少年學員曠課率平均為27.1%,執行後曠課率降至13.5%,其改善率為50.18%。在學員出席率方面,經由執行過程及學員/家長共同努力參與,由實施前出席率70.9%提昇至81.6%,顯示此方案不但可降低曠課率,且請假人數並未因此增加,更因執行後有效提昇學員出席率,改善率達15.09%。此方案之推行,更獲得家長們許多正面回饋及支持,在精神復健專業中提供更多具服務品質之具體效益。

並列摘要


Background: For helping adolescent patients with serious mental illness, the Department of Psychiatry in Taipei-Veterans General Hospital (VGH) conducted an adolescent mental rehabilitation program since 1998. To meet the needs of patients, we provided the programs of psychiatric day care treatment, and supported special education under the collaboration with the Educational Department of Taipei City Government. The effectiveness of the rehabilitation will dependent vitally on patients' attendance in the program. However, there are many reasons related to patients’ mental illness and psychopathology will affect their attendance of the program. According to the clinical survey and data analysis, we found many reasons of their absence in the program, such as withdrawn personality, anxiety, depression, peer problems, difficult to get up earlier, boring or lesson’s difficulty, and parenting attitude etc. To increase their attendance, we combined several treatment strategies in this project. This project included the clarification and build up of the classroom regulations, behavioral therapy with point system and reinforcement, forum for curriculum plan, individualized educational plan, to increase communication with school and family and to enrich social skill training program, group psychotherapy as well as family therapy. We also encouraged the parents to prompt their children’s attendance in the day ward constantly. Method: The project is to evaluate the effectiveness of the attendance in the adolescent day care hospital. The absent rate and attendant rate were used for measuring the effectiveness of the project before the project were compared with those after the project. Result: The average absent rate without appropriate reason before the project was 27.1% which was decreased to 13.5% after enforcing this project. The improvement rate was 50.18%. In the meantime, the average attendant rate was also increased from 70.9% to 81.6% after the project. The improvement rate in attendance was 15.09%. Conclusion: Through the effort of the project team, the attendance of adolescent psychiatric patients can be improved under a well organized program. The role of nurses and teachers were the vital roles in the project, they spend much time on getting along with patients and also conducted many therapeutic and teaching program for the adolescent patients.

參考文獻


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被引用紀錄


張如杏(2007)。嚴重情緒障礙學生自我決策及其家庭參與在轉銜服務歷程之探討—以又一村情障班個案為例〔博士論文,國立臺灣師範大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0021-2910200810532121

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