台灣社福機構執行綠色照護之探討

A Study of Implementing Green Care in Taiwan Welfare Institutions

陳宗億(Tsung-Yi Chen)

指導教授 ： 陳惠美

國立臺灣大學/生物資源暨農學院/園藝暨景觀學系/碩士(2016年)

https://doi.org/10.6342/NTU201602739

摘要

台灣的弱勢族群人數逐年攀升，有庇護安置、生心理治療等需求，而歐美國家照護機構常運用綠色照護(Green Care)的概念，將園藝植物、動物等自然元素，融合健康照護理念。協助生心理或社會條件缺損的國民增加日常活動與社交互動，增進生心理健康，提升生活品質，相當適合台灣社福機構運用，故綠色照護在台灣社福機構逐漸萌芽發展。然而，過去研究多個別探討綠色照護對某一類個案所帶來的效益。較少以執行的社福機構為研究對象，探討其執行綠色照護的成果與困境。此外，農場是國外照護機構常見的綠色照護的場域，近年來台灣社福機構也開始應用，但過去研究也較少探討社福機構農場的運作模式，因此本研究的目的為1)了解台灣社福機構執行綠色照護的現況；2)比較有農場與無農場的綠色照護、產生的效益以及可能面對的困難；3)探討社福機構農場執行綠色照護的操作、管理方式以及困境應對作為；4)比較不同模式的綠色照護農場之規劃管理差別。
研究分兩階段進行，階段一，從新聞電子資料庫收集社福機構執行綠色照護的相關新聞，採用內容分析法，針對機構類型、綠色照護產生的效益與執行困境，分別建構分類類目歸納整理。階段二根據相關文獻與階段一的研究結果發現，台灣執行綠色照護的社福機構以身心障礙福利機構最多，且為了提供服務對象健康照護與保障其公平參與社會、經濟的權利，有較多運用農場活動提供健康照護，發展農事工作提供就業的機會。因此進一步挑選有農場的身心障礙福利機構為研究對象，針對機構成立農場的背景、農場綠色照護營運規畫、和農場成果效益，進行個案機構深入訪談與比較。
研究結果顯示，綠色照護對受照顧者的效益，主要以「改善情緒壓力」、「改善身體機能」和「增加交流互動」為主，此外，有農場與無農場的綠色照護個人效益主要差別在「重返社會接觸」、「增進工作能力」和「獲得就業機會」。呼應受訪的身心障礙福利機構成立農場的動機，是為「增加活動空間」和「提供工作機會」，且認為「穩定情緒」、「增強體能」、「增加智識與工作能力」和「融入社會」是照護農場給服務對象的主要成效；而綠色照護對社福機構本身的效益主要是由有農場的機構獲得，其中「促進自給自足」和「獲得營收回饋」為主要效益，受訪機構則進一步指出「無毒飲食」、「增加員工福利」、「增強機構照護形象」和「作為募款的基礎」是農場帶給機構的效益；而「提供休閒遊憩」、「維護生態」是照護農場常見的社會與環境效益。
社福機構執行綠色照護的困境以「資金不足不穩」和「個案能力限制」的案例較多，而有農場的受訪機構指出，法規政策方面的困境包括私法人不得持有農地，農地農用政策，影響機構建置適合服務對象的農場環境空間，以及農業部門只補助一般農民的天災損失。財務困境方面，機構可與其他團體合作，資源共享降低營運成本，或發展有經濟規模事項、產品做市場區隔和穩定的市場售價來增加營收。人力規劃方面，機構會提供教保員農牧園藝知識培訓，且鼓勵一般農場工作者加強照護知識增加綠色照護的專業度。面對服務對象參與綠色照護的問題，農場活動的執行要領為「適性分組」、「切割工作流程」、「設計輔具」、「成果反饋」，並且透過工作內容調度與適當懲罰，解決服務對象生心理狀況異常和行為偏差問題，也會擬定緊急事件處理規則，做好預防措施降低因能力不足造成的安全風險。最後研究建議政府有條件放寬農業政策對社福機構的限制。機構可多元化綠色照護活動，但需要輔以一項具規模經濟的農業事項主力生產。此外機構應鼓勵人員參與台灣各類綠色照護相關協會的培訓與認證，並將綠色照護目標融入服務對象個別化服務計畫之中。最後，台灣社福機構應在審視組織的資源與能力後，再決定是否自行經營農場，承擔經營責任以增加服務對象與機構的健康與工作效益。在缺乏資源的情況下也可考慮與休閒農場或一般農場進行合作，同樣可以讓服務對象享受綠色照護的效益。

關鍵字

社福機構 ； 綠色照護 ； 照護農場 ； 成效與困境 ； 管理

並列摘要

The number of the disadvantaged prople in Taiwan is rising by year. They all have the demand of the resettlement of asylum, and the demand of care for both physical and mental problem. European countries and America usually provide “Green Care” to these vulnerable groups, which utilize horticultural plant and animal elements etc. combine with health care concepts, to increase their daily activities, social contct opportunities and keep them healthy. It is very suitable for social welfare organization in Taiwan. There has been little research about Green Care concerned social welfare organizations as their research objects, to understand how social welfare organizations implement Green Care and what achievement they obtain and what difficulties they encounter in Green Care process. Most researches are about the benefits brought from green care in different individual cases. Besides, farms are often used to provide green care by Care facilities in foreign countries. There are more and more applications in Taiwan as well. However, there are only little research about the mode of care farm operation. Therefore, the purposes of this research are as follow. First, to find out the green care situation of social welfare organization in Taiwan. Second, to understand the benefits and the potential difficulties comparing the organization with farm to organization without farm. Third, to go into the green care management strategy and the means to plight of social welfare organization. Fourth, to know the difference of green care operation management comparing different mode of Green Care farm.
This research include two studies. Study one is collecting the news of green care social welfare organization and use content analysis on different social welfare organization、beneficial result and potential problem to build up different category. Study two is according to the result of study one and related references. It turns out that disabled persons’ organization has more opportunities using farm activities to give health care and develop farm work in order to protect them the right to participate in society and economic fairly. Therefore, I choose disabled persons’ organization with farm as my study object to interview deeply and compare different cases from the background of setting up farm, the operation of green care farm, the outcome of the farm.
The result shows that the most mentioned effects are improvement of mental stress, physical function and more social contact chance. Furthermore, Green Care with farm has personal effect on returning to society, improvement of work ability, access to jobs opportunities more. Above individual benefits could respond to the outcome of second study that the motivation of disabled persons’ organization setting up farm is to increase activities space and provide job opportunities. In addition, most interviewed organizations attribute stable emotion, better physical function, improvement of intellecture and working ability and participation in society are to Green Care farm.On the other hand, Green Care has two effects for organization itself, operation benefit and finance benefit, usually mentioned by those news of social welfare organizations with farm. The self-sufficient operation and revenue feedback are the main benefit results. Furthermore, providing leisure and recreation activities and maintain environment ecology are common social and environment benefits from care farm.
When it comes to the plights of social welfare organization implementing green care, lots of news are relate to Green Care with farm, referring to cases dealing with insufficient funds and ability constrains. Organizations in study two point out that constrains on legislation farmland policy. First, private social welfare organization can’t have the property of farmland. Second, organizations are very hard to build suitable farm environment to service objects because the policy of farmland only for agriculture use. Third, when disaster happens, social welfare organization can’t get financial subsidy due to the beneficiary is for normal farmer not for social welfare organizations. To deal with the financial plight the organization can cooperate with others, which will decrease the operation cost, or focusing on project having economic scale to make market segmentation and make the products price stable, these manner may help organization increase their revenue. As for the human resource plight, the organization will train staffs how to gardening and encourage them to improve care knowledge and skill of Green Care so that they can make up the lack of green care profession. Last but not least, the key manners for excuating Green Care are devided service objects several groups according to their physicial and mental condition、dividing workflow、design assisted tool、achievement feedback. The solutions to solve the plight that people participating in green care, are dispatching work which can solve the problem of mental and behavior, however, sometimes the suitable punishment also solutions as well. In addition, the organization will give rules to emergency for the purpose of precaution. According to the result, researcher suggests that the government shold conditionally lift the restriction of agricultural regulations. Organizations could diversify Green Care activities but still need at least one item as major production. Besides organization should encourage staff to participate training course or certification by various Taiwan Green Care associations, and design individual goal of Green Care. Finally, social welfare organizations should investigate what resource and capability they have. Organizations can consider managing a farm by themselves. Undertake the responsibility to raise the benefits for service objects or their own. However, there still are other choices that organizations can also consider to cooperate with leisure farm or private farm so that they don’t need to worry about the lack of resource.

並列關鍵字

social welfare organization ； green care ； care farm ； benefits and difficulties ； management

參考文獻

4. 王俊雄 (2011)。休閒農場成立庇護農場可行性之研究。未出版之碩士論文，國立屏東科技大學農企業管理所，屏東。

17. 吳佳晏(2012)。園藝治療對癌症患者生活品質之效益。未出版之碩士論文，台灣大學園藝研究所，台北。

18. 巫潞琳(2012)。運用園藝治療活動在亞斯伯格兒童之個案研究。未出版之碩士論文，台灣大學園藝研究所，台北。

22. 李翠玲(2010)。園藝治療與療癒庭園對特殊學生課程設計與校園環境建置之意涵與運用。國小特殊教育，(49)，33-40。

11. 江珮儀(2004)。應用寵物治療於護理之家之經驗分享。長期照護雜誌，8(2)，118-124。