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計畫摘要
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【摘要】 臺中市自辦理早期療育服務至今，對於早期療育健康照顧體系（包括通報中心與社區資源中心）服務執行的成效評估，較為偏著實務供給層面與政策面的改善為主，尚未對服務提供者及服務使用者進行全面性的討論。本研究關注兒童發展通報中心及社區資源中心之服務概況及服務使用者的感受。本研究目的有四：
1. 檢視及探討2011-2014年臺中市兒童發展通報中心服務使用者接受服務狀況及服務滿意度。
2. 檢視及探討2011-2014年臺中市1-6區兒童發展社區資源中心服務使用者接受服務狀況及服務滿意度。
3. 評估兒童發展通報中心及兒童發展社區資源中心服務輸出狀況。
4. 針對研究發現，提出具體建議，以供本局未來規劃完善早期療育服務方案。
本研究結果顯示：
有關通報中心服務概況的討論，在文件分析顯示，各行政區域之六歲以下人口數和通報量呈高度相關，然而通報量進入個管系統之比例有相當程度的落差。若就量化及質化呈現通報中心和網絡資源單位互動樣態，即仍有相當數量的網絡單位未曾使用通報中心的服務；曾使用通報中心服務者，有七成以上是對於服務表示滿意，而且多數視服務具重要性。但是，自通報中心之社工人員服務經驗得知，提供社區服務才能發現潛在個案及第一線篩檢工作的困難。社工認為，通報中心的職責應著重在服務宣導，以及關懷拒絕接受服務之個案。
有關社資中心服務概況的討論，在文件分析呈現社資中心需提供涵蓋社區及家庭的多元服務項目；然而，第一至六區社資中心的服務使用者之特質具相當程度的差異（如族群、社經地位、照顧者特質及其家庭類型）。此一事態使得社工人員在提供服務時，必需著眼於社區資源及人口特質、服務使用者的偏好等。但是，如何明確呈現社資中心「合理的」服務項目、建立跨單位的合作等，是有待政府單位間的協調與釐清。值得注意的是，若就家庭特質討論服務成效及品質，「家庭內在資源」仍具其影響力，此顯見於主要照顧者之原生國籍、家庭經濟情形、教育程度、有無其他子女接受服務、子女的出生序等變項。
【Abstract】 This study focused on the service delivery about early intervention notification and referral center and community resource centers for children with developmental delay and explored the perception of service utilization. Four purposes of this study were as following below: 1, to discover service situation and satisfaction about the notification and referral center. And resource network in the field of social welfare, education and medicine were as research subjects. 2, to illustrate service utilization and satisfaction about community resource centers, zone 1 to 6. And families of children with developmental delays/ disabilities were as research subjects. 3, to evaluate the service delivery of the notification and referral center and community resource centers, zone 1 to 6. And governmental reporting was adopted as documentary data. 4, to offer suggestions about clinic works and service planning for Taichung City Government to map the early intervention program for children with developmental delays or disabilities.
The quantitative and qualitative data were collected by document analysis, questionnaire survey and focus group interview. There were two main results in this study.
Service overview of the children's early intervention notification and referral center. The population under the age of 6 and the reporting case-load were closely related in each administrative distraction, but the proportion of reporting case-load getting into the case management system was still not as expected. Meanwhile, lots of resource network had never used services from the reporting center. Over 70% resource network, who had used services from the reporting center, thought highly of service satisfaction. And social workers agreed that they should paid attention on public enlightenment and assisted the involuntary families who had children with developmental delays.
Service overview of community resource centers for children with developmental delay, zone 1 to 6. These centers offered multiple services for families and their communities. The characteristics of families in these six centers were quite different, such as socio-economic status and family types. Therefore, services, offered by social workers, should be reflected these special features. All government institutions should made sure reasonable service contents of community resource centers and created the cooperative platform for all professionals. This study also found out that service effectiveness contributed to family resources, and the main factors related to family resources were nationality of caregivers, family economy, educational status of caregivers, birth order of children. |
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