臺灣博碩士論文加值系統

家庭角色在促進兒童發展與福祉上是家庭中心取向早期療育服務著重的焦點，而家庭中心實務以協同合作的夥伴關係及參與決策的增權過程則是對於增進主要照顧者的親職信心與效能感有正向影響。基於此，早期療育社會工作在服務有早期療育需求之家庭時，應落實家庭中心實務執行，可以促進主要照顧者親職效能感提升，支持兒童有正向發展的機會。故本研究之研究目的有三：（一）探討國內家庭中心取向早期療育服務的具體內涵，特別是主要照顧者所覺知的家庭支持與參與的內涵；（二）檢視兒童與家庭的特徵、服務介入的特徵、家庭中心實務感知對主要照顧者親職效能感之解釋；（三）研究成果希望能有助於未來發展提升家長親職效能感之家庭中心實務執行策略。
本研究採取量化之研究典範，以郵寄問卷調查為資料收集方式，研究對象為接受早期療育服務之主要照顧者，以立意取樣方式選取臺北市6個早期療育社區資源中心及12所臺北市政府社會局立案提供早期療育訓練的身心障礙福利機構進行抽樣，符合研究對象條件的共1,742個家庭。本次研究調查資料蒐集回收573份問卷，回收率達33.08％，有效問卷數為521份。
研究結果簡述如下：（一）兒童特徵與親職效能感無達顯著差異。（二）在家庭特徵方面，主要照顧者年齡較輕、已婚、教育程度較高以及愈多社會支持者有較好的親職效能感。（三）服務介入特徵中，專業人員面訪或電訪關心聯繫的頻率越高，則主要照顧者親職效能感會越高。（四）接受早期療育服務之主要照顧者的家庭中心實務感知與親職效能感有關，即以家庭中心的早期療育服務對於主要照顧者在親職照顧上實有助益。（五）在控制了兒童、家庭與服務介入特徵後，接受早期療育服務兒童其主要照顧者之家庭中心實務感知對親職效能感有顯著正向影響。立基於本次研究調查發現，研究者針對家庭中心取向早期療育服務、提升親職效能感以及未來研究方向等層面提出相關建議。

Family-centered early intervention services emphasized working with families as a key means to promote development and well-being for developmentally delayed children. Empirical evidence indicated that building collaborative partnership and promoting empowerment in working with families had a positive impact on primary caregivers'' parental confidence and efficacy. When providing services to families, early intervention workers should focus improving parenting efficacy of the primary caregivers in order to enhance children positive development. This study examined the relationship between perception of family-centered services and parenting efficacy among primary caregivers, when controlling for family characteristics and service use patterns.
This study used a quantitative research approach to examine the correlated relationship between service perception and parenting efficacy. Structured survey questionnaires were mailed to inquire primary caregivers about their using early intervention services at Taipei. This study purposively sampled 1,742 families from six early intervention community centers and twelve early intervention training institutions literally providing family centered services. Five hundred and seventy-three primary caregivers responded to the mailed questionnaires. The response rate was 33.08%, within an acceptable range. Among them, five hundred and twenty-one responses were valid for an further analysis.
Findings of the study were summarized as the followings. (1) Children’s characteristics were not significantly associated with parental efficacy of there primary caregivers. (2) The primary caregivers with younger age, higher education and more social support had better parenting efficacy. (3) In terms of the service use, more frequent face-to-face and telephone interview were associated with higher parental efficacy. (4) Primary caregivers’ perceptions of family- centered practice were significantly related to parenting self-efficacy. (5) While controlling the characteristics of the children, family and service use, primary caregivers’ perceptions of family-centered practice had a positive impact on the parenting self-efficacy. Implications for improving the perception of family-centered early intervention services and improving parenting efficacy were included.

口試委員審定書 i
謝 誌 iii
中文摘要 v
英文摘要 vi
目 錄 vii
表 次 ix
圖 次 x
第一章 緒論 1
第一節 研究背景 1
第二節 研究目的與問題 4
第二章 文獻探討 7
第一節 早期療育服務 7
第二節 家庭中心早期療育服務 17
第三節 親職效能感的理論基礎與相關研究 27
第三章 研究方法 35
第一節 研究典範選取 35
第二節 研究設計與假設 37
第三節 變項的定義與測量 39
第四節 研究對象與抽樣方法 49
第五節 資料蒐集 51
第六節 資料分析方法 53
第七節 研究倫理 54
第四章 研究結果 55
第一節 研究樣本之描述性統計分析 55
第二節 親職效能感與各自變項之相關性分析 65
第三節 親職效能感之多元迴歸分析 69
第五章 研究討論與建議 75
第一節 研究討論 75
第二節 研究限制 81
第三節 研究建議 83
後 記 88
參考文獻 90
中文書目 90
英文書目 93
附 錄 97
附錄一：家庭中心實務感知與親職效能感之關係調查問卷 97
附錄二：感謝函 104

參考文獻

中文書目

內政部兒童局（2000）。發展遲緩兒童早期療育工作手冊。臺北：財團法人中華民國發展遲緩兒童基金會。
內政部兒童局（2004）。發展遲緩兒童到宅服務實施計畫。臺中：內政部兒童局。
內政部兒童局（2007a）。歷年0-17歲兒童及少年單齡人口數概況。2008年12月1日取自：
http://www.cbi.gov.tw/CBI_2/
內政部兒童局（2007b）。發展遲緩兒童早期療育服務實施方案。臺中：內政部兒童局。
內政部兒童局（2007c）。發展遲緩兒童早期療育服務流程。2008年4月1日取自：http://www.cbi.gov.tw/CBI_2/internet/main/index.aspx
王天苗（1994）。心智發展障礙幼兒家庭狀況之調查。特殊教育研究學刊，10，119-141。
王天苗（1995）。心智障礙幼兒家庭支援實施成效及相關問題之研究。特殊教育研究學刊，12，75-103。
王天苗（1996）。臺灣地區心智障礙幼兒早期療育服務供需及相關之研究。特殊教育研究學刊，14，21-44。
臺北市政府社會局早期療育通報轉介中心（2008）臺北市早期療育服務成效與規
畫摘要報告。2008年12月1日取自：
http://www.eirrc.taipei.gov.tw/cgi-bin/SM_theme?page=48d1c45e
朱鳳英（2007）。臺北市早期療育服務社區照顧經驗。護理雜誌，54（5），18-22。
全國法規資料庫。2008年11月1日取自：http://law.moj.gov.tw/
呂翠夏（2002）。學前幼兒家庭之協同親職與其相關因素－婚姻關係、性別角色態度和父母自我效能。行政院國家科學委員會專題研究成果報告（報告編號：NSC-90-2413-H-024-021），未出版。
宋麗玉（2002）。社會工作理論－處遇模式與案例分析：社會支持網絡、壓力因應與社會支持網絡處遇，282-334。臺北市：洪葉。
周玟琪、葉琇姍譯（1995）。當代社會工作理論－批判的導論。臺北市：五南。
周月清（2001）。家庭社會工作－理論與方法。臺北市：五南。
林惠芳（1997）。早期療育服務模式介紹。發展遲緩兒童早期療育服務研討會會議實錄。臺北：臺北縣政府。
施怡庭（1998）。發展遲緩兒童家庭對兒童照顧需求之研究。私立東海大學社會工作研究所碩士論文，未出版，臺中市。
施教裕（2002）。社會工作理論－處遇模式與案例分析：系統理論觀點，216-247。臺北市：洪葉。
馬惠芬（2003）。男性眼光中父職參與、父職自我效能與親子關係滿意度之自我評估研究－新竹科學園區週邊幼兒員所調查之分析。私立天主教輔仁大學生活應用科學系碩士論文，未出版，臺北縣。
陳凱琳（2000）。影響發展遲緩幼兒家庭社會支持因素之研究。私立高雄醫學大學健康科學院行為科學研究所碩士論文，未出版，高雄市。
陳麗芬（2000）。公立托兒所推動早期療育相關服務堆發展遲緩兒童家庭之影響－以臺北市為例。私立中國文化大學兒童福利研究所碩士論文，未出版，臺北市。
陳向明（2002）。社會科學質的研究。臺北市，五南。
陳富美（2005）。親職效能感、教養行為與孩子生活適應之關係研究。輔導與諮商學報，27（1），47-64。
陳鳳珠（2007）。配偶親職支持、子女親職支持與母親親職效能感之關係研究。私立天主教輔仁大學兒童與家庭學系研究所碩士論文，未出版，臺北縣。
許昭瑜（2002）。「發展遲緩兒童家庭介入方案」之執行暨評估研究－以臺北市早期療育個案管理服務為例。私立東吳大學社會工作研究所碩士論文，未出版，臺北市。
許靜芳（2004）。不同社經地位之國小學童家長之父母效能感對家長參與的影響－以彰化縣為例。國立嘉義大學家庭教育研究所碩士論文，未出版，嘉義市。
許素彬（2008）。家長與個管員夥伴關係對早期療育服務成效之影響研究。臺大社會工作學刊，17，43-92。
張秀玉（2003）。早期療育社會工作。臺北市：楊智。
張秀玉（2007）。影響早期療育家庭使用資源之相關因素。社區發展季刊，120，223-251。
傅秀媚（2008）。本土早期療育對兒童及家庭照顧者之影響評估研究。內政部兒童局委託之專題研究成果報告。臺中：內政部兒童局。
黃凱霖（1995）。父母效能感、父母參與以及子女學業成就的關係。國立師範大學教育研究所碩士論文，未出版，臺北市。
黃淑文（2000）。早期療育服務季對心智障礙兒童家庭的影響。私立中國文化大學兒童福利研究所碩士論文，未出版，臺北市。
曾華源、張秀玉（2003）。外籍女性配偶子女發展遲緩高危險群可能性之研究－以進入早期療育通報轉介中心之個案為例。內政部兒童局委託之專題研究成果報告。臺中：內政部兒童局。
鄭麗珍（2002）。社會工作理論－處遇模式與案例分析：生態系統觀點，250-280。臺北：洪葉。
鄭麗珍（2008）。先進國家家庭支持性服務分析報告。內政部兒童局委託隻專題研究成果報告。臺中：內政部兒童局。
歐姿秀（1998）。福利服務介入對身心障礙幼兒家庭影響之研究－以臺北市伊甸社會福利基金會為例。私立中國文化大學兒童福利研究所碩士論文，臺北市。
簡春安、鄒平儀（2004）。社會工作研究法。臺北市，巨流。

英文書目

Allen, R.I.(1996). The Family-Centered Behavior Scales：A Report on the Validation Study. A System of Care for Children’s Mental Health：Expanding the Research Base. 9th Annual Research Conference.
Allen, R.I.,Petr, C.G.,& Brown,B.F.C.(1995). Family-Centered Behavior Scale and user’s manual. Lawernce,KS：The Beach Center on Families and Disability, The University of Kansas.
Allen, R.I.＆Petr, C.G. (1996). Toward Developing Standards and Measurements for Family- Centered Practice in Family Support Programs. In G. H. S. Singer, L.E. Powers, & A. L. Olsen (Eds.), Redefining family support: Innovations in public private partnerships, (pp. 57-84). Baltimore, MD: Paul H. Brookes.Bailey, D. B. (2001).
Bailey, B.D.,Bruder, M.B.,Hebbeler, K.,Carta, J.,Defosset, M.,Greenwood, C., Kahn, L.,MAllik,S., Markowitz, J.,Spiker, D.,Walker, D.＆Barton, L.(2006). Recommended Outcomes for Families of Young Children with Disabilities.Journal of Early Intervention,28(4),227-251.
Bailey, D.B.,Mcwillian, R.,Darkes, L.A.,Hebbeler, K.,Simeonsson, R.J.,Spiker, D.＆Wagner, M.(1998). Family outcomes in early intervention：a framework for program evaluation and efficacy research. Exceptional children,64(3),313-328.
Bailey, B.D., Hebbeler, K.,Spiker, D.＆Scarborough, A.(2005). Thirty-Six-Month Outcomes for Families of Children Who Have Disabilities and Participated in Early Intervention. Pediatrics, 116(6),1346-1352.
Bandura, A.(1986). Social Foundations of Thought and Action: A Social cognitive theory. Englewood Cliffs, NJ: prentice Hall.
Bandura, A.(1994). Self-efficacy. Encyclopedia of Human Behavior,4,71-81.
Bandura, A.(1997). Self-efficacy: The exercise of control. New York: Freeman.
Bandura, A.(1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84,191-215.
Bronfenbrenner, U.(1979). The ecology of human development. Cambridge, MA:Harvard University Press.
Coleman, P.K. & Karraler, K.H.(1998). Self-Efficacy and Parenting Quality：Findings and Future Applications. Developmental Review,18(1),47-85.
Cutrona, C.E.＆Troutuman, B.R.(1986). Social Support,Infant Temperament, and Parenting Self- Efficacy: A Mediational Model of Posrpartum Depression. Child Development,57,1057-1518.
Dempsey, I. & Keen, D.(2008). A Review of Processes and Outcomes in Family-Centered Services for Children With a Disability. Topics in Early Childhood Special Education.,28(1),42-52.
Dunst, C.J.(1999). Placing Parent Education in Conceptual and empirical context.Topics in Early Childhood Special Education,19,141-172.
Dunst, C. J.(2002). Family-Centered Practices: Birth Through High School. The journal of special education, 23(2),139-147.
Dunst,C.J.,& Dempasy,I.(2007). Family-Professional Partnerships and Parenting Competence, Confidence, and Enjoyment. International Journal of Disability, Development and Education, 54(3),305-318.
Dunst,C.J.,& Trivette,C.M.(1996). Empowerment,effective helpgiving practices and family- centered care. Pediatric Nursing,22,334-343.
Dunst, C.J.,＆Trivette, C.M.(Eds.).(1988). Enabling and Empowering Families:Principles and Guidelines for Practice.Cambridge, MA:Brookline.
Dunst, C.J.,Trivette, C.M.& Hamby, D.W.(1996). Measuring the helpgiving practices of human services program practitioners.Human Relations, 49,815-835.
＊Dunst, C.J.,Trivette, C.M.& Hamby, D.W.(2007). Meta-analysis of Family-Centered Helpgiving Practices Research. Mental retardation and developmental disabilities research reviews, 13,370-378.
Dunst,C.J.,Trivette,C.M.,Davis,M.,& Cornwell,J.C.(1994). Characteristics of Effective Help- Giving Practices.In Dunst, C.J.,＆Trivette, C.M.(Eds.), Supporting & Strengthening families. Methods, strategies, and outcomes(pp.171-186).Cambridge,MA.
Dyke, P.,Buttigieg, P., Blackmore, A.M.＆Ghose, A.(2006). Use of the Measure of Process of Care for families（MPOC-56）and service providers（MPOC-SP）to evaluate family-centered services in a paediatric disability setting. Child：Care, Health ＆ Development. 32(2),167-176.
Guimond, A.B., Wilcox, M.J.,＆Lamorey, S.G.(2008). The Early Intervention Parenting Self- Efficacy Scale(EIPSES). Journal of Early intervention，30(4),295-320.
Guralnick, M.J. (1997). Second-generation research in the field of early intervention. In M.J. Guralinck(Eds.),The effectiveness of early intervention（pp.3-20）. Baltimore,Maryland：Paul H. Brookes.
Hastings, R.P.＆Brown, T.(2002). Behavior Problems of Children With Autism, Parental Self- Efficacy, and Mental Health. American Journal on Mental Retardation ,107(3),222-232.
Hanson, M.J.& Lynch,E.W.(1995). Early Intervention-Implementing Child and Family Services for Infants and Toddlers Who Are at Risk or Disabled(2nd ed),Austin,TX:pro-ed Pub.Cb.
IDEA：2008年11月1日取自：http://www.supportforfamilies.org/resources.html
Johnston, C & Mash, E.J.(1989). A Measure of Parenting Satisfaction and Efficacy. Journal of Clinical Child Psychology,18(2),167-175.
Judge, S.L.(1997). Parental Perceptions of Help-Giving Practices and Control Appraisals in Early Intervention Programs. Topics in early childhood special education,17(4),457-476
Khouzam,M.,Chenouda, E.,& Naguib,G..(2003). A Family Partnership Model of Early Intervention. In Odom.,S.L., & Hanson, M.J.(Eds), Early intervention practices around the world, (pp.152-178).Paul H.Brookes Publishing Co.,Inc.
King, G.A., Rosenbaum, P.L.,& King, S.M.(1997). Evaluating family-centered service using a measure of parents’ perceptions.Child:Care,Health & Development.23(1),47-62.
King, S., Teplicky, R.,King, G. ＆ Rosenbaum, P.(2004). Family –Centered Services for Children With Cerebral Palsy and Their Families:A Review of the Literature. Seminars in Pediatric Neurology,11(1),78-86.
King, G.,Kertoy, M., King, S., Law, M.,Rosenbaum, P.＆Hurley, P.(2003). A Measure of Parents’ and Service Providers’ Beliefs About Participation in Family-Centered Services.Children’s Health Care,32(3),191-214.
Mahoney, G., & Bella, J.M.(1998). An examination of the effects of family- centered early intervention on child and family outcomes. Family child learning center,18(2),83-94.
Mahoney, G.,& Wiggers, B.(2007). The Role of Parents in Early Intervention: Implications for Social Work. Children & Schools,29(1),7-15.
McWilliam, R.A.,Snyder, P.,Harbin, G.L.,Porter, P.,＆Munn, D.(2000). Professions’ and Families’ Perceptions of Family-centered Practices in Infant-toddler Services. Early Education and Development,11(4),519-538.
Meisels, S.J., & Shonkoff, J.P.(2000). Early childhood intervention: A continuing evolution. In J. P. Shonkoff & S. J. Meisels(Eds.),Handbook of Early Childhood ntervention, (pp. 3-31). Cambridge:Cambridge University Press.
Murphy, D.L.,Lee, I.M., Turnbull, A.P.＆Turbiville, V.(1995). The Family-Centered Program Rating Scale:An Instrument for Program Evaluation and Change. Journal of early intervention, 19 (1),24-42.
Ngai Fei-Wan, Chan Sally Wai-Chi & Holroyd Eleanor.(2007). Translation and Validation of a Chinese Version of the Parenting Sense of Competence Scale in Chinese Mothers. Nursing Research,56(5), 348-354.
O’brien,M.,Dale,D.(1994). Family-centered services in the neonatal intensive care unit:A reivew of research. Journal of Early Intervention,18,78-90.
Odom., S.L.,＆Kaul, S.(2003). Early Intervention Themes and Variations from Around the World. In Odom.,S.L., & Hanson,M.J.(Eds), Early intervention practices around the world, (pp.334-346). Paul H.Brookes Publishing Co.,Inc.
Orsmond, G.I.(2005). Assessing Interpersonal and Family Distress and Threats to Confident Parenting in the Context of Early Intervention. In Guralnick,M.J.,The developmental systems approach to early intervention,(pp185-211). Paul H.Brookes Publishing Co.,Inc.
Petr, C.G.＆Allen, R.I.(1997). Family-Centered Professional Behavior:Frequency and Importance to Parents. Journal of emotional and behavioral disorders,5(4),196-204.
Rodrigue, J.R., Geffken, G.R.,Clark, J.E.＆Hunt, F.(1994). Parenting Satisfaction and Efficacy Among Caregivers of Children With Diabetes. Children’s Health Care. 23(3),181-191.
Rounds, K.A.(1991). Early Intervention Services for Very Young Children and Their Families Under P. L. 99-457. Child and Adolescent Social work.8(6),489-499.
Simeonsson, R.J.(1991). Primary, Second, and Tertiary Prevention in Early Intervention. Journal of Early Intervention,15,124-134.
Swick, K.J., & Hassell, T.(1990). Parental Efficacy and the Development of Social Competence in Young Children. Journal of Instructional Psychology.17(1),24-32.
Teti, D.M.,＆Gelfand, D.M.(1991). Behavioral Competence among Mothers of Infants in the First Year:The Mediational Role of Maternal Self-Efficacy.Child Development,62,918-929.
Trivette, C.M. & Dunst, C.J.(2004). Evaluating Family-Based Practices:Paretning Experiences Scale.Young Exceptional Children,7(3),12-19.
Trivette, C. M., Dunst, C.J., Boyd, K.＆Hamby, D.W.(1995). Family-Oriented Program Models, Helpgiving Practices, and Parental Control Appraisals.Exceptional Children,62(3),237-248.
Trute, B. & Hiebert-Murphy, D.(2007).The Implications of “ Working Alliance “ for the Measurement and evaluation of Family-centered Practice in Childhood Disability Services. Infants＆Young Children,20(2),109-119.
Turnbull,A.P., Turbiville,V., & Turnbull,H.R. (2000). Evokution of Family-Professional Partnerships: Collective Empowerment as the Model for the Early Twenty-First.Century.In J. P. Shonkoff & S. J. Meisels (Eds.), Handbook of Early Childhood Intervention, (pp. 631-650). Cambridge:Cambridge University Press.
Wehman,＆Therese.(1989). Family-Centered Early Intervention Services: F actors Contributing to Increased Parent Involvement and Participation. Focus on Autism & Other Developmental Disabilities, 13(2),80-87.