探討接受返校照護模式癌症兒童之學校生活適應

School Reentry Care Model for Children with Cancer

10.6880/TJON.202106_21(1).03

沈芸伊(Yun-Yi Shen)；林沛欣(Pei-Hsin, Lin)；陳映筑(Ying-Chu Chen)；高綺吟(Chi-Yin Kao)；黃美智(Mei-Chih Huang)

癌症兒童 ； 返校醫療照護模式 ； 校園適應 ； Cancer children ； School reentry care model ； school-life adaptation

腫瘤護理雜誌

21卷1期（2021 / 06 / 01）

29 - 44

繁體中文

背景：返校讓癌症兒童學習新知及進行社會化活動，南部某醫學中心近年發展出癌症病童返校醫療照護模式，由醫療端協助病童家庭與校方做返校準備，共召開數十位病童之返校會議，並進行返校後一個月內之追蹤，多數獲得正向回饋。目的：本研究旨在探討接受返校照護模式之癌症病童的長期校園適應情況。方法：邀請2016－2017年曾參與返校會議後成功返回學校之癌症病童及其家長共20組，進行半結構式訪談，以內容分析法歸納、分類並數量化訪談資料，藉以呈現病童之校園適應狀況。結果：病童於返校1.5至3年後逐漸適應，並持續執行自我保護措施，家長與校方仍保持聯繫；雖自述同儕與校方提供足夠之社會支持，仍有八成病童提出與同儕相處之負面經驗。病童以10分量尺自評課業滿意度為5.7分，校園生活滿意度達8.5分。結論／實務應用：病童接受返校照護後可具備自我照護能力，在同儕、家長及校方給予足夠支持下，呈現良好之校園適應，並給予返校照護高度評價。

Background: School reentry is part of the recovery program for children with cancer to get back into normal routine, of which education plays a key role. A medical center in southern Taiwan has developed a school reentry care model for children with cancer. Through more than a dozen of school reentry meetings with the parents and school staff in a month's long follow-up by the pediatric oncology team, the assessment of the reentry program was mostly positive. Purpose: This study aimed to evaluate the school-life adaptation of children with cancer under the school reentry care model. Methods: The children and their parents, who had participated in the school reentry care meeting during 2017-2018, were invited to join this research. Twenty pairs of the participants were interviewed, and the data were inducted, categorized and quantified via content analysis. Result: The children became well-adjusted gradually after returning to school for 1.5 to 3 years and could adhere to their self-care protection rules which they had learned during the school-reentry meetings. Parents were in constant contact with the schools. Using a 10-point self-evaluation scale, the children with cancer rated an average of 5.7 points for the satisfaction on their academic performance, and 8.5 points for their school life satisfaction. Although the schools and peers provided plenty of social support, eighty percent of the children with cancer expressed negative experience toward the interaction with their classmates. Conclusions / Implications: All the children with cancer kept up their self-care ability. They adapted well with the support from the peers, parents and schools. They returned to school successfully and also gave excellent reviews to the school reentry program.

1. 吳麗敏(2016)。兒童癌症存活者的健康問題和照護。源遠護理，10(2)，12-19。
   連結：
2. Capurso, M.,Dennis, J. L.(2017).Key Educational factors in the education of students with a medical condition.Support for Learning,32(2),158-179.
3. Helms, A. S.,Schmiegelow, K.,Brok, J.,Johansen, C.,Thorsteinsson, T.,Simovska,V.,Larsen, H. B.(2016).Facilitation of school re-entry and peer acceptance of children with cancer: A review and meta-analysis of intervention studies.European Journal of Cancer Care,25(1),170-179.
4. Hinton, D.,Kirk, S.(2015).Teachers’ perspectives of supporting pupils with long term health conditions in mainstream schools: a narrative review of the literature.Health and Social Care in the Community,23(2),107-120.
5. Irwin, M. K.,Elam, M. P.,Merianos, A. L.(2015).Coordination of care between health and education systems for patients with a hematologic or oncologic diagnosis: A time study analysis.Journal of Pediatric Nursing,30(1),244-253.
6. Katz, E. R.,Varm, J. W.,Rubenstein, C. L.,Blew, A.,Hubert, N.(1992).Teacher, parent, and child evaluative ratings of a school reintegration intervention for children with newly diagnosed cancer.Children’s Health Care,21(2),69-75.
7. Lähteenmäki, P. M.,Huostila, J.,Hinkka, S.,Salmi, T. T.(2002).Childhood cancer patients at school.European Journal of Cancer,38(9),1227-1240.
8. Lee, J. A.,Lee, J. M.,Park, H. J.,Park, M.,Park, B. K.,Ju, H. Y.,Kim, J. Y.,Park, S. K.,Lee, Y. H.,Shim, Y. J.,Kim, H. S.,Park, K. D.,Lim, Y. J.,Chueh, H. W.,Park, J. K.,Kim, S. K.,Choi, H. S.,Ahn, H. S.,Hah, J. O.,Lee, M. J.(2020).Korean parents’ perceptions of the challenges and needs on school re-entry during or after childhood and adolescent cancer: A multi-institutional survey by Korean society of pediatric hematology and oncology.Korean Journal of Pediatrics,63(4),141-145.
9. Lum, A.,Donnan, B.,Wakefield, C. E.,Fardell, J. E.,Marshall, G. M.(2017).Establishing Australian school re-entry service guidelines for children diagnosed with cancer.Journal of Paediatrics and Child Health,53(6),529-533.
10. McLoone, J. K.,Wakefield, C. E.,Cohn, R. J.(2013).Childhood cancer survivors’ school (re) entry: Australian parents’ perceptions.European Journal of Cancer Care,22(4),484-492.
11. Paré-Blagoev, E. J.,Ruble, K.,Bryant, C.,Jacobson, L.(2019).Schooling in survivorship: Understanding caregiver challenges when survivors return to school.Psycho Oncology,28(4),847-853.
12. Park, M.,Park, H. J.,Lee, J. M.,Ju, H. Y.,Park, B. K.,Yu, E. S.,Yang, H. K.,Kim, J. Y.,Park, S. K.,Lee, Y. H.,Shim, Y. J.,Kim, H. S.,Lee, J. A.,Lim, Y. J.,Cheuh, H. W.,Park, J. K.,Lee, M. J.,Kim, S. K.,Choi, H. S.,Shin, H. Y.(2018).School performance of childhood cancer survivors in Korea: A multi-institutional study on behalf of the Korean Society of Pediatric Hematology and Oncology.Psycho Oncology,27(9),2257-2264.
13. Ruble, K.,Paré Blagoev, J.,Cooper, S.,Martin, A.,Jacobson, L. A.(2018).Parent perspectives on oncology team communication regarding neurocognitive impacts of cancer therapy and school reentry.Pediatric Blood and Cancer,27427.
14. Schilling, E. J.,Getch, Y. Q.(2018).School reentry services for students with chronic health conditions: An examination of regional practices.Psychology in the Schools,55(9),1027-1040.
15. Soejima, T.,Sato, I.,Takita, J.,Koh, K.,Maeda, M.,Ida, K.,Kamibeppu, K.(2015).Support for school reentry and relationships between children with cancer, peers, and teachers.Pediatrics International,57(6),1101-1107.
16. Thompson, A. L.,Christiansen, H. L.,Elam, M.,Hoag, J.,Irwin, M. K.,Pao, M.,Voll, M.,Noll, R. B.,Kelly, K. P.(2015).Academic continuity and school reentry support as a standard of care in pediatric oncology.Pediatric Blood and Cancer,62(5),805-817.
17. Tremolada, M.,Taverna, L.,Bonichini, S.,Basso, G.,Pillon, M.(2017).Self-esteem and academic difficulties in preadolescents and adolescents healed from paediatric leukaemia.Cancer,9(6),55.
18. West, A. M.,Denzer, A. Q.,Wildman, B. G.,Anhalt, K.(2013).Teacher perception of burden and willingness to accommodate children with chronic health conditions.Advances in School Mental Health Promotion,6(1),35-50.
19. Wu, L. M.,Chin, C. C.,Chen, C. H.,Lai, F. C.,Tseng, Y. Y.(2011).Development and valida-tion of the paediatric cancer coping scale.Journal of Advanced Nursing,67(5),1142-1151.
20. Yi, J.,Kim, M. A.,Hong, J. S.,Akter, J.(2016).Childhood cancer survivors’ experiences in school re-entry in South Korea: Focusing on academic problems and peer victimization.Children and Youth Services Review,67,263-269.
21. 台灣兒童癌症基金會（2019）．2018年度報告。http://www.ccfroc.org.tw
22. 呂香瑩(2014)。國立成功大學。
23. 徐獻洲,黃美智(2011)。文化適切性照護—協助一位新移民母親之癌症學童返回校園。護理雜誌，58(3)，85-89。
24. 梁淑媛,莊宇慧,吳淑芳(2012)。內容分析技巧在護理質性資料之初步應用。護理雜誌，59(5)，84-90。
25. 陳文菁(2011)。國立成功大學。
26. 陳姿菁,方恩真（編）(2017)。成大醫院癌症兒童返校照護模式。中華民國兒童癌症基金會會訊，138，4-7。
27. 黃美智(2003)。正常化—慢性疾病兒童之家庭處理型態。護理雜誌，50(2)，61-64。

1. (2023)。兒童癌症學生的求學路－床邊教學家長的經驗。特殊教育季刊，166，39-51。