研究生: |
郭色嬌 |
---|---|
論文名稱: |
特教教師參與學生情緒行為問題使用藥物治療之研究 |
指導教授: | 洪儷瑜 |
學位類別: |
碩士 Master |
系所名稱: |
特殊教育學系 Department of Special Education |
論文出版年: | 2005 |
畢業學年度: | 93 |
語文別: | 中文 |
論文頁數: | 125 |
中文關鍵詞: | 特教學生 、情緒與行為問題 、藥物治療 |
英文關鍵詞: | exceptional students, emotional and behavioral problems, pharmacotherapy |
論文種類: | 學術論文 |
相關次數: | 點閱:519 下載:56 |
分享至: |
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
摘 要
本研究旨在探討國小特教教師參與學生情緒行為問題使用藥物治療行為及其藥物治療相關知識,並探討教師之藥物治療相關知識在不同基本變項、參與經驗上之差異。本研究選取台北市200位特教教師為研究對象,以自編之「藥物治療參與經驗」、「藥物治療相關知識」量表為工具,採用問卷調查方式收集資料。回收樣本共178份,回收率89%。以百分比、t檢定、單因子變異數分析做統計考驗。茲將本研究之主要發現歸納如下︰
一、特教教師參與學生藥物治療行為
(一)經驗背景
有80.7%的台北市國小特教教師有參與經驗,這些教師中,有89.4 %認為每年大約有1-2位學生因為情緒行為問題而接受藥物治療。有95 %的研究對象認為學生接受藥物治療與教師的特教工作有關係。
(二)參與情形
教師最經常參與的項目是主動了解學生使用藥物的效果及副作用;和家長討論、評估學生的情緒行為是否應該轉介醫療單位;和家長討論藥物治療的成效;以及留意學生的情緒行為變化,作為教學及輔導的參考。教師很少或從未參與的項目是持有家長托付的藥袋(包)說明或醫師指示的注意事項;和醫師討論藥物治療成效及要求家長簽寫同意書,表示同意教師督導管理學生用藥。
(三)參與學生藥物治療之困難問題
五至七成的教師認為參與學生藥物治療最多也是最重要的困難問題有︰家長排斥或害怕孩子使用藥物治療情緒行為問題;特教教師藥物治療專業知識不夠;學生情緒行為問題複雜,不易判斷因果關係,選用處理策略;家長通常不願意讓別人知道孩子正在看精神科。最少也是最不重要的困難問題是︰教師無法取得醫院相關訊息,所以無從轉介;學校並非醫療單位,應以教育工作為主。
二、特教教師之藥物治療相關知識
本研究發現台北市國小特教教師之「藥物治療相關知識」全量表平均通過率為79%,其中「行為及藥效評估知識」平均通過率90%,「情緒行為問題與藥物治療的關係」是78%,「藥物相關知識」是69%。此外,特教教師之藥物治療相關知識在其年資、學歷、特教專業訓練、相關專業訓練及參與經驗上,並無顯著差異。
根據上述結果綜合討論後,研究者對國小特教教師、特教行政單位及未來研究者提出建議並說明研究限制。
Abstract
This study intended to find out and discussed how elementary school special education teachers participated in the pharmacotherapy of exceptional students with emotional and behavioral problems. This study surveyed individual teachers’ knowledge in pharmacotherapy, and investigated the relationship between the teachers’ knowledge and their training, educational background, and duration of teaching experience. Two hundreds special education teachers were randomly selected from Taipei elementary schools as the subjects of mail list. The received surveys were 178 copies and the rate of receiving is 89%. Two questionnaires measuring pharmacotherapy knowledge were designed to collect information for this study. "The experience of
participation in pharmacotherapy" and "Related knowledge in pharmacotherapy". The percentage, t-test and one-way analysis of variance were used for statistical analysis. The major findings of this study were summarized as follow:
1.Special education teachers’ participation in pharmacotherapy
of students
(1) Experience of pharmacotherapy participation
There were 80.7% of Taipei elementary school special education teachers who had participated in pharmacotherapy of students. Of these teachers, 89.4% had worked with one to two students who do received pharmacotherapy because of emotional and behavioral problems. 95% of teachers concluded that pharmacotherapy of students was closely related to teachers’ work in special education.
(2) Participation
The tasks teachers participated the most frequently include: finding the effectiveness and side effects of medication for students; discussing with parents and assessing students’ emotional and behavioral state, so as to determine appropriate referral to medical facilities; discussing the effectiveness of medications with parents; and monitoring students’ emotional and behavioral change for reference in teaching and counseling.There were tasks teachers seldom or never participated in, including: keeping students’ medication and dispensing directions, keeping doctors’ instructions in areas needed special attention, discussing effectiveness of medicine with doctors, and requesting written consent from parents authorizing teachers to monitor and dispense medication to students.
(3) The difficulties experienced by special education teachers
when they participated in pharmacotherapy of students
Fifty to seventy percent of teachers encountered difficulties when they participated in pharmacotherapy of students .The most
frequent and most serious problems were that parents rejected medical recommendations or parents feared side effects from pharmacotherapy of emotional and behavioral problems. Special education teachers did not have profound professional knowledge in pharmacotherapy. Teachers lacked causal understanding of students’ emotional and behavioral problems, due to their complexity, which then leads to difficulty developing effective management strategies. In addition, parents were usually reluctant to reveal that their child was seeing a psychiatrist, so the teachers lacked important information. The least frequent and least serious difficulties include: teachers not being able to obtain related information about treatment facilities and lacking referral practice. Teachers and school administrators regarded education as their main responsibility and schools were not designed or equipped to be treatment facilities.
2. Special education teachers’ related knowledge in
Pharmacotherapy
This study found that special education teachers in Taipei elementary schools answered the questions correctly in "Related knowledge in pharmacotherapy" with an average of 79%. Within this particular questionnaire, 90% of teachers obtained the correct response for the items "The knowledge in behavior assessment and medication effect", 78% obtained the correct response for the items" The relationship between emotional and behavioral problem and pharmacotherapy", and 69% obtained the correct response for the items "Related knowledge in medication". In addition, this study found that teachers’ related knowledge in pharmacotherapy appeared no significant difference among the various years of the teachers and their educational background, professional training in special education, related professional training, and experience of participation in pharmacotherapy.
3. Conclusion and limitations
Based on the conclusions, some recommendations were made to elementary school special education teachers, school administrators, and other researchers who want to conduct related studies in the future. This researcher also pointed out and explained the limitations in this study.
參考文獻
一、中文部分
王惠珀(2003)︰藥師是現代的智慧型媽媽。台灣大學醫學院及社會科學院後SARS社會反省研討會論文。行政院衛生署。
丘彥南、宋維村(1999)︰兒童精神疾病的治療。李明濱主編,實用精神醫學,283-293。國立台灣大學醫學院。
江漢光、謝遠達、劉文健(民83a)︰三環類抗憂鬱藥物之神經與中樞副作用。國防醫學,19卷,2期,150-153。
江漢光、謝遠達、劉文健(民83b)︰人格違常症之藥物治療近觀。醫學繼續教育,4卷,2期,188-194。
江漢光、徐偉雄、夏一新(民84)︰自傷行為的檢討。國防醫學,20卷,2期,159-163。
江漢光(民85)︰罹患精神疾病青少年之個案輔導。教師天地,80期,38-42。
回德仁、陳智德(民91)︰藥物治療監測與用藥安全。藥學雜誌,18卷,3期,8-15。
孔繁鐘,孔繁錦編譯(民91)。DSM-Ⅳ精神疾病診斷手冊。台北。合記。
何善欣(民89)我愛小麻煩。台北︰平安文化。
李欣南、李貫棠、周璟玲(民91)︰精神病患常見之藥物疑慮-以高雄榮總精神科日間病房病患暨家屬藥物衛教為例,藥學雜誌,18卷2期,106-113。
李明濱、吳佳璇、李信謙、謝明憲、許彥森(1999)︰自我測驗。李明濱主編,實用精神醫學,395-510。國立台灣大學醫學院。
林式榖(民88)︰精神藥物手冊。台北︰合記。
林寶貴(民83)︰語言障礙與矯治。台北︰五南。
林信男(民88)︰藥物及其他生物學療法。載於李明濱主編,實用精神醫學,227-245。國立台灣大學醫學院。
林信男(民83)︰精神科物理及藥物治療。台北︰水牛出版社。
洪儷瑜(民87)︰ADHD學生的教育與輔導。台北︰心理出版社。
洪儷瑜(民89)︰嚴重情緒障礙學生鑑定原則鑑定標準說明。張蓓莉主編,身心障礙及資賦優異學生鑑定原則鑑定標準說明手冊,94-95。國立台灣師範大學特殊教育學系。
洪儷瑜、張郁雯、丘彥南、蔡明富(民90)︰注意力缺陷過動症學生學校輔導手冊。國立台灣師範大學特殊教育學系。
吳家珍(民84)︰社區中情感性障礙患者的藥物遵從行為與健康信念之相關關係。高學醫學院護理研究所碩士論文,未出版。
鈕文英(民90)︰身心障礙者行為問題處理︰正向行為支持取向。台北︰心理出版社。
周美玲(民90)︰台北縣市國小校護對過動兒知識、態度與行為之探討。國立陽明大學社區護理研究所碩士論文,未出版。
施顯烇(民87)情緒與行為問題︰兒童與青少年所面臨與呈現的挑戰。台北︰五南出版社。
姚惠馨(民91)︰國小教師對注意力缺陷過動症之歸因與因應策略之探討。國立師範大學特殊教育研究所碩士論文,未出版。
翁菁菁、高淑芬、宋維村(1999)︰兒童精神疾病的評估。李明濱主編,實用精神醫學,81-86。國立台灣大學醫學院.
郭為藩(民81)特殊兒童心理與教育。台北︰文景。
張英鵬(民88)︰教師與家長對ADHD藥物使用應有的正思。特教園丁,15卷,1期,38-44。
張正芬(民88)︰自閉症兒童問題行為之探討。特殊教育學刊,17,253-273。
張芳全(民89)主編︰教育法規。台北︰師大書苑。
陳俊欽(民92)︰幫他走過精神障礙。台北︰張老師文化。
陳俊欽(民93)︰憂鬱與憂鬱症。台北︰健康文化。
陳長安(民89)︰常用藥物治療手冊。台北︰全國藥品年鑑雜誌社。
陳雪萍(民86)︰精神科急性病房將出院病患對其疾病與藥物認知的探討。國立台灣大學護理研究所碩士論文,未出版.
教育部編(民91)特殊教育法規選輯。教育部特殊教育工作小組。
國立台灣師範大學特殊教育中心編(民89)中華民國特殊教育法規彙編。台北市︰國立台灣師範大學特殊教育中心。
曹純瓊(民87)自閉症兒與教育治療。台北︰心理出版社。
黃瑞媛(民89)︰服用非傳統抗精神病藥物之精神分裂症病患對藥物的態度及其相關因素探討。國立台灣大學護理研究所碩士論文,未出版。
曾雯綺(民79)︰出院精神分裂病人遵從藥物治療行為之探討。國防醫學院護理研究所碩士論文,未出版。
楊坤堂(民89)︰情緒障礙與行為異常。台北︰五南。
賴銘次(民89)特殊兒童異常行為之診斷與治療。台北︰心理出版社。
盧安琪(90)過動兒教師壓力知覺與因應策略之探討。東吳大學社會工作學系碩士論文,未出版。
顏瑞隆(民91)自閉症兒童行為問題家庭介入方案實施探究。國立高雄師範大學特殊教育學系碩士論文,未出版。
聶華明(民90)台北市工職學校嚴重情緒障礙學生的特殊教育現況調查研究。國立高雄師範大學工業教育學系碩士論文,未出版。
二、英文部分
Gadow, K. D. (1977). Psychotropic and antiepileptic drug treatment in early childhood special education. Final report.
Hannah, C., &Dale, C.,呂偉白、林志堅、任麗華、邱滿英譯(民91)︰六個朋友︰認識六大身心障礙類別。台北︰洪葉文化。
Kauffman, J.M.(2001). Characteristics of emotional and behavior disorders of children and youth(5thed). New York︰Macmillan Publishing Co.
Lewis,R. & Robert O. F.,楊聰財譯(民92)︰當代精神醫學的診斷與治療。台北︰合記。
Patricia L. Owen,廣梅芳譯(民91)︰憂鬱心靈地圖。台北︰張老師文化。
Reid, R., John, w., Stanley, F., & Gregg, w. (1993). Who are the children with attention deficit-hyperactivity disorder? A school-baseed survey. Journal of Special education, 28,117-137.
Singh, N. N. (1990). Teacher perceptions of psychotropic medication for students with serious emotional disturbance. Journal of Special education, 24,283-317.
Singh, N. N. (2001). Biological factors. In Kauffman, J. M. Characteristics of emotional and behavior disorders of children and youth(5thed). New York︰Macmillan Publishing Co.
Steven, R. F.(2002). The New Medical Model:
Interdisciplinary Treatment and the Limits of Behaviorism. Behavior Disorders,27(2),168-178.
Steven, R. F.(2003). Parting reflections on education of children with emotional or behavioral disorders. Behavior Disorders,28(3),198-201.