第十五屆 家長對於身心障礙兒童接受以家庭為中心復健服務過程之感受

家長對於身心障礙兒童接受以家庭為中心復健服務過程之感受

Parental perceptions for the process of family-centered rehabilitation services in children with disabilities

康琳茹¹  黃靄雯¹  許妍晞¹  陳嘉玲¹

Lin-Ju Kang¹  Ai-Wen Hwang¹  Yen-Hsi Hsu¹  Chia-Ling Chen¹

¹長庚大學醫學院早期療育研究所

¹ Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan

Background and Purpose：

Family-centered service (FCS) has long been recognized as the ‘best-practice’ for providing rehabilitation services to children with disabilities. Research shows that FCS can enhance children’s development, decrease parenting stress, promote emotional wellness, and increase parental satisfaction to services. Though the family-centered concept has been considered as relevant in pediatric rehabilitation, there is a lack of evidence regarding its implementation in Taiwan. The purpose of this preliminary study was to investigate that to what extent FCS was being practiced, and to explore factors influencing parental perception of FCS.

Methods:

This cross-sectional study includes a total of 100 parents/caregivers whose child had a primary condition associated with physical disability (n=75) or autistic spectrum disorder (ASD, n=25), with children’s ages ranging from 2 to 11 years (69 boys and 31 girls). Parents completed the Measure of Processes of Care-20 (MPOC-20), a self-report questionnaire about their perceptions of one primary institution in that their child receives rehabilitation services. Each item is rated on a 7-point Likert rating scale (1 = not at all, 7 = to a very great extent). Descriptive statistics for the five MPOC domains were calculated, and the scores for the five MPOC domains were compared using Multivariate ANOVA (MANOVA) against the independent variables of child age group, sex, disability condition, and setting of receiving rehabilitation services.

Results:

Parents’ perceptions of FCS provision were the highest for the ‘Respectful and Supportive Care’ domain (M=4.93, SD=1.27) and the lowest for ‘Providing General Information’ domain (M=3.67, SD=1.66). Significant differences in the five MPOC domain scores were found in relation to setting of rehabilitation services (p<0.001), with developmental center (n=12) being the highest, followed by school (n=37), and hospitals or clinics (n=51) being the lowest. No significant differences (p>0.05) were identified between preschool and school-aged children, between boys and girls, and between children with physical disabilities and ASD.

Conclusion:

The study provides an initial understanding from parents’ perspectives on how well the FCS is being implemented in pediatric rehabilitation services. Our results indicate the need to further address the demand for providing general information that meets family needs for their children. Results on the differences of FCS provision based on setting of rehabilitation services should be interpreted with caution given and unequal representation of children who received services from each setting.

Keywords: Family-centered services, pediatric rehabilitation, children, disability