因應零拒絕以及就近入學原則，一些需管灌、氣切照護或醫療設備之極重度多重障礙學生開始就讀住家附近的小學。本研究探討國小特教班教師教育這些學生的困擾及需求，邀請五位國小特教班教師進行三次焦點團體訪談，以質性資料歸納分析，同儕檢證編碼一致性達83%－100%，並以參與者檢核與省思札記確保研究信賴度。研究發現教師面對這些學生有五項困擾：（1）學生密集的醫療照護需求，教師須時刻注意學生身體狀況而無法喘息；（2）學生先天功能受限且反應微弱，教師難以切入課程，產生教學無力感；（3）行政單位支援有限且環境規劃不全，學生學習活動受限；（4）專業團隊服務頻率低且建議不合用，教師無法即時獲得諮詢協助；（5）親師對於照護及教養理念有落差，溝通與合作關係受阻。此外，教師有以下需求：（1）改善班級設備及編擬極重度多重障礙領域之教材與書籍；（2）規劃照護實作研習及極重度多重障礙課程進修管道；（3）行政單位積極地支援與分擔照護責任，建立密切合作關係；（4）提升專業團隊服務內容，建置醫療巡迴團隊。最後針對研究結果提出實務及未來研究建議。

This study aims to understand the teaching challenges and needs of special education teachers when they educate the students with multiple/severe disabilities and complex health care needs at self-contained classrooms in elementary schools. Participants were five self-contained special education teachers in New Taipei City. Qualitative data were collected via focus group interviews, and analyzed using inductive coding approach. The consistency in coding between the researcher and peer reviewer are 83-100%. The results are as follows: A. The challenges as below: (1) The system of the schools could not provide professional health and medical care to the students. (2) The students have poor academic performance, so the teachers will feel frustrated in this kind of ineffective teaching. (3) The current administrative system could not provide health and medical care supports properly to the teachers. (4) The service hours of the collaborative teams could only provide rough solutions to the students. (5) Many parents overprotect their children that caused a number of conflicts between parents and teachers. B. The needs as below: (1) The government provides additional funding to improve equipment and compile books providing instruction on how to educate the students with multiple and severe disabilities. (2) Increase more opportunities for teachers to pursue further knowledge about teaching and caring the students. (3) The school administration actively shoulder the responsibility of caring the students together with the teachers. (4) The government should establish professional medical collaborative teams.