運用設計思考於國小身心障礙學童及家長口腔保健多元策略發展及介入成效

Abstract

本研究運用「設計思考」(Design Thinking)發展以國小身心障礙學童及家長為主之口腔保健策略，並評價介入後之成效。研究對象為新竹市某國小身心障礙資源班學童26名及其家長26名，研究方式依史丹佛設計學院所提出的設計思考五步驟實施。研究顯示：在「同理」及「定義」階段，發現26名身心障礙學童刷牙後仍有三成牙菌斑殘留、刷牙效果不佳，以及家長不熟悉潔牙技巧而無法落實督導式潔牙。在「發想」階段，7位專家小組透過腦力激盪，建構親子共學、簡化刷牙程序、製作衛教影片以及編寫潔牙口訣等解方。在「原型」階段，設計「貝式彩虹刷牙法」指導身心障礙學生刷牙，以及製作「督導式潔牙工具包」(含潔牙用具與工具書)幫助26名家長督導孩子，工具書中有3部影片、2張資訊圖、1組教學齒模等教材，同時規劃「護齒行動0123」活動建立親子共學等策略。在「測試」階段，發現介入後26名學生的牙菌斑指數平均從30.36%下降至7.82%，平均每週有4.17天能做到零含糖飲料、4.77天能每天使用一次牙線、6.9天能完成睡前刷牙兩分鐘。八成以上家長表示工具包、貝氏彩虹刷牙法、教學齒模及護齒0123活動皆有助於落實孩子刷牙，家長也因此學會貝氏刷牙法及牙線操作，並覺得最實用、最滿意的教材為彩虹教學齒模。本研究可提供未來身心障礙學生口腔保健教學及推動家長督導式潔牙之參考，亦適用於一般學童及家長。

This study used"Design Thinking" tools to develop oral health strategies for students with special needs and parents in a primary school, and evaluated the effectiveness of the intervention. The participants included 26 students with special needs and 26 parents in a primary school in Hsinchu City. The research method was implemented according to the five-step design thinking proposed by Stanford D. School. The results showed that in the "Empathize" and "Define" stages, 30% of the dental plaque remained among26 students, showing the effect of tooth brushing was poor. Parents did not know the correct method of tooth brushing, thus it was not feasible to implement supervised tooth-brushing. In the"Ideate" stage, the team of 7 experts proposed parent-child co-learning, simplified tooth-brushing procedures, and health education videos through brainstorming stage. In the "Prototype" stage, the expert team designed the "Bass rainbow method of brushing" to guide students how to brush their teeth, and provided "Supervised Toothbrushing toolkit" (including tooth-brushing tools and reference guide) to help 26 parents supervise their children. The reference guide contained teaching materials including 3 videos, 2 infographics, and 1 set of teaching tooth model. In addition,"Tooth Protection Action 0123" activity was conducted to establish parent-child learning strategies. In the "Test" stage, the results showed that after intervention the dental plaque index of 26 students dropped from 30.38% to 7.7%. Students achieved zero sugar-sweetened beverages on 4.17 days a week, used teeth floss once a day on 4.77 days a week, and brushed their teeth two minutes before going to bed on 6.9 days a week. More than 80% of parents agreed that the tool kits, the rainbow Bass method of brushing, tooth-brushing videos and"Tooth Protection Action 0123" activity were helpful for their children’s tooth-brushing, while the most satisfactory teaching material for parents was the rainbow Bass method of brushing. This study could provide a good reference for future oral health education for students with special needs and the promotion of supervised tooth-brushing for parents. The supervised tooth brushing toolkit could also suitable for general students and their parents.