儿童精神科门诊候诊期创造性艺术活动的医务社会工作实践——一项行动研究

Practice of Medical Social Work with Creative Arts Activities during the Waiting Period in Child Psychiatry Outpatient Clinics—An Action Research

摘要: 儿童精神科门诊不断增大的服务需求，患儿饱受候诊之苦，焦虑、恐惧、行为崩溃等问题频发，而候诊空间正是用于医务社会工作进行介入但是又未进行深入和系统开发的应用空间。研究采取行动研究的研究思路，通过在北京市儿童医院某精神科门诊候诊区的“微笑空间”中进行三轮“计划–行动–观察–反思”的行动回旋，对用创造艺术活动(如绘画、手工、音乐欣赏等活动)改善患儿候诊体验的服务进行了探索和检验，并以此为基础探讨了服务过程以及服务对象的相关动态过程和变化。研究结论如下：创造性艺术活动服务是能够帮助患儿转移对疾病的注意力、克服对候诊的焦虑和恐惧、为陪诊家长提供情绪舒缓空间的有效服务；分龄化设计活动内容、植入亲子互动和服务流程规范化为服务改善的重要因素；三轮的行动回旋让服务完成了从碎片化活动到简单规范化服务流程的转变。研究提炼了一个可操作的、适合儿童精神科门诊候诊场域的创造性艺术活动服务流程和实务操作要点，并为探索医务社会工作介入门诊场域的本土实务提供可供参考和借鉴的小样本实践案例。

Abstract: The ever-increasing service demand in child psychiatry outpatient clinics has led to children suffering greatly during the waiting period, with frequent issues such as anxiety, fear, and behavioral breakdowns. The waiting space, however, represents a “gap period” where medical social work interventions could be applied but have yet to be systematically developed. This study adopts the action research methodology, conducting three rounds of “plan-action-observation-reflection” spirals at the “Smile Space” in the waiting area of a child psychiatry outpatient clinic at a Beijing children’s hospital. It explores and evaluates services that utilize creative arts activities (such as drawing, handicrafts, music appreciation, etc.) to improve children’s waiting experience, and examines the dynamic processes and changes among both service providers and recipients. The findings are as follows: creative arts activities effectively help children divert their attention from illness, alleviate waiting anxiety and fear, and provide emotional respite space for accompanying parents. Age-differentiated activity design, integration of parent-child interaction, and standardization of service procedures are key factors for improving service effectiveness. Through three rounds of action spirals, the service evolved from fragmented activities to a preliminarily standardized service process. This study distills an operable service process and practical operational guidelines suitable for the child psychiatry outpatient waiting context, offering a small-sample practice case for the exploration of local practices in medical social work interventions within outpatient settings.