Yuan brought us together: Teachers' experiences in working with adolescent cancer survivors for successful middle school reentry

國中教師服務癌癒後 學生返校的經驗

Purpose: With the advancement of medical technology and effective treatment protocols, many children diagnosed as having cancer can return to school during or after their treatment cycles. However, childhood cancer survivors face numerous physical, socioemotional, and academic challenges on returning to school. Recent studies on school reentry of childhood cancer survivors in Taiwan have mostly been conducted by nursing professionals, who have approached the children's school reentry issues from a medical perspective. Although these nursing researchers recommend multidisciplinary collaboration for serving children with cancer after they return to school, they seldom include teachers' perspectives and approaches in which they could be involved in their research. To understand children's back-to-school experiences and design a successful school reentry program for childhood cancer survivors, it is essential to exploreteachers' relevant attitudes and experiences in this regard. Methods: By focusing on childhood cancer survivors' overall well-being on return to school, this qualitative study adopts a phenomenological approach to explore three middle school homeroom teachers' perceptions and experiences working with students. Specifically,each of the participants reflected upon one of their students who were diagnosed as having leukemiaor osteosarcoma in Grade 7, received treatment for 2 years, and officially returned to school for Grade 9. Two of these teachers also served as their students' bedside instruction teachers. The research data were collected through 1–2-hour-long semistructured in-depth interviews conducted at the time and place convenient to the participants. With the participants' consent, the interviews were audio-recorded and transcribed verbatim. The data were then analyzed using thematic analysis to transform teachers' concrete daily experiences to several abstract concepts informing their experiences. These concepts were represented by the themes introduced in the findings. Results/Findings: Thematic analysis of the in-depth interviews revealed teachers' deep sympathy for the students and their mothers, their Yuanspecific cultural beliefs concerning teacher–student relationships, and their creative and flexible ways of maintaining constant and close interactions with students and their mothers and connecting hospitalized students with their classmates. The connections among teachers, adolescent cancer survivors, their peers, their mothers, and other school personnel bridged the otherwise separate entities of school, hospital, and home. Additionally, it created a virtual learning community that offered more learning opportunities for all involved than these settings combined. Teachers reported undergoing a transformation in the process themselves as their understanding about life and death and the meaning of school attendance changed along the way. Conclusions/Implications: The implications of this study comprise encouraging the school teachers of students diagnosed as having cancer to serve as bedside instructors whenever possible, increasing classroom teachers' and bedside instruction teachers' knowledge on childhood cancer and the ramifications of cancer treatment, taking advantage of bedside instructor's official bridging role in ensuring home–school communication and interactions through formal and informal channels, and utilizing real-time or on-demand online instruction and communication programs for hospitalized students.
癌癒後兒童返校繼續學業時可能面臨不少挑戰。目前臺灣癌癒後兒童返校方面的研究者大多為護理人員，比較缺少教師方面的角度和參與。從癌癒後兒童的福祉出發，本質性研究以現象學研究派典來探究三位國中教師服務三位癌癒後兒童（一位教師各服務一位學生）的觀點及實際經驗。他們的學生七年級時分別被診斷為骨癌或血癌，經過兩年治療，於九年級返校。本研究以深度訪談方式蒐集研究資料，訪談時間為1—2小時。訪談錄音檔的逐字稿經過主題分析，得到以下結果：教師和學生及家長建立深刻正面關係，以「緣」看待師生關係，擔任學生的床邊教學教師，以極具創意及彈性的做法來增進在校同儕和住院學生間的互動，促進並動員班級、全校、社區的支持及資源整合。教師扮演的橋樑功能將學校、家長（母親）、醫院連接起來創造了一個虛擬卻意義深遠的學習社群。雖然學生學習的時間空間並不相同，教師和學生的學習比在各別學習環境中學習機會更為豐富多元。為了讓學生順利返校，除了鼓勵學科教師擔任床邊教學教師外，原本擔任床邊教學／在家教育的特教教師更應該提升兒童癌症相關知能並擔任學校、家長、及醫院間的橋梁。另外，建議利用網際網絡及技術，開發適合課程平台，讓無法返校學習的學生能在線上和班上同學一起學習及互動。