癌症兒童就學適應經驗探討

Abstract

背景： 隨著醫療進步，癌症兒童的五年存活率已提升至80%以上，顯示癌童就學議題越發重要，然而在台灣教育體制下，尚不清楚癌童就學經歷，以及其父母、教師的助學策略。 研究目的： 探討癌症兒童的就學經驗與適應歷程；探究父母與老師協助癌童就學的因應策略與角色責任。 研究方法： 本研究採現象學質性研究設計，訪談對象包含6至18歲癌童、及其主要照顧者（父母）與教師。資料以半結構式深度訪談蒐集，經Colaizzi（1978）七步驟進行分析，並透過三角檢證與同儕審查強化資料可信度與嚴謹性。 研究結果： 本研究從癌童、父母與教師三方視角出發，發現癌童的就學經驗主要展現在「找到班級歸屬感」、「逆境學習」以及「從失去中成長」的歷程中，逐步建立自信與自我認同。父母在協助孩子就學的過程中，著重於「保護孩子身體健康」、「協助適應團體生活」、「輔助孩子學習」、「建構彈性家庭」以因應照護與學習需求。教師則展現「保護癌童身體健康」、「協助適應校園生活」、「適性教學」的角色功能，「擁有一顆強心臟」則道出教師所需具備的心理承受力與專業彈性。 討論： 癌童在重返校園過程中，班級歸屬感的建立對其心理與學業復原至關重要。父母往往身兼倡議者與照顧者角色，需填補制度落差、主動連結資源。教師則在資訊斷層與缺乏訓練下仍展現高度同理心，彈性調整教學。整體而言，癌童的校園復歸需要教育、醫療與家庭三方攜手合作，方能降低其適應壓力並提升生活品質。 結論與建議： 癌症兒童的就學適應不僅是教育問題，更涉及醫療與社會支持系統的整合。建議臨床醫療人員應主動介入癌童返校前的準備工作，提供具體的衛教與就學指引，並與學校建立穩定的溝通管道。教育端應強化教師對癌症兒童的認識與因應能力，兼顧病童的健康限制與學習需求。政策制定層面亦應建立跨單位協作機制，推動在地且具文化適切性的本土返校照護模式，以支持癌童及其家庭穩定就學、逐步邁向正常化生活。

Background: With advances in medical treatment, the five-year survival rate for children with cancer has risen to over 80%, highlighting the increasing importance of addressing their school reintegration. However, under Taiwan’s current educational system, the school experiences of children with cancer and the support strategies employed by their parents and teachers remain insufficiently understood. Purpose: This study aims to explore the school experiences and adaptation processes of children with cancer, as well as to examine the coping strategies and role responsibilities of parents and teachers in supporting these children’s education. Methods: A phenomenological qualitative research design was adopted. Participants included children with cancer aged 6 to 18, their primary caregivers (parents), and school teachers. Data were collected through semi-structured in-depth interviews and analyzed using Colaizzi’s (1978) seven-step method. Credibility and rigor were enhanced through triangulation and peer review. Results: From the perspectives of children, parents, and teachers, the school adaptation experience of children with cancer revealed three key themes: “finding a sense of classroom belonging,” “learning through adversity,” and “growth through loss,” which together illustrated a gradual reconstruction of self-confidence and identity. Parents focused on “protecting their child’s physical health”, “helping them adjust to group life”, “support child’s learning”, and “building a flexible family structure” to cope with caregiving and educational needs. Teachers played key roles in “protecting students’ health,” “helping them adjust to school life,” and “individualized teaching.” The theme “having a strong heart” reflected the mental strength and flexibility teachers needed to support children with cancer. Discussion: Establishing a sense of classroom belonging is central to both the psychological and academic recovery of children with cancer. Parents often take on dual roles as advocates and caregivers, bridging systemic gaps and proactively seeking resources. Despite limited training and information, teachers showed strong empathy and adaptability in adjusting their teaching approaches. Overall, successful reintegration into school requires collaboration among educational, medical, and familial systems to reduce adjustment stress and improve quality of life. Conclusion and Recommendations: The educational adaptation of children with cancer is not solely an educational issue. It also involves the integration of healthcare and social support systems. It is recommended that healthcare professionals actively participate in school reintegration planning by providing tailored health education and return-to-school guidance, while establishing reliable communication with schools. On the educational side, teachers’ awareness and capacity to respond to the needs of children with cancer should be strengthened, ensuring a balance between health limitations and academic requirements. At the policy level, a cross-sector coordination mechanism should be established to promote culturally sensitive, locally tailored reintegration models that support children with cancer and their families in achieving stable schooling and normalized life transitions.