探討新型態「家庭式」替代性照顧的照顧經驗-以臺北市私立伯大尼兒少家園家父母之觀點為例

兒少替代性照顧服務的目的，是在家庭出現困境而不適合兒少居住與生活時提供替代性的照顧，但受限於替代性照顧在提供家庭式照顧上面臨人力、物力及資源的不足，多數兒少被安置於機構中而非接受以家庭環境為主的照顧，因而無法滿足家庭對於兒少的重要需求。在目前我國家外安置仍是以安置機構為主要場域且家庭式照顧服務量能不足的情況下，本研究以財團法人基督教臺北市私立伯大尼兒少家園在安置機構體制下所發展出的家父母服務方案為研究主體，探討身為替代性照顧者的家父母是如何在安置機構體系下提供家庭式照顧服務，以家父母的觀點的去瞭解照顧者對於家庭式照顧的想法，並進一步探索家父母提供家庭式照顧的歷程及當中所遇到的困難或阻礙。此研究採取質性研究設計，訪談六位在伯大尼兒少家園擔任家父母至少一年以上且未有擔任其他行政職的家父母為受訪者，以半結構的深度訪談法及研究者觀察參與法行資料蒐集，並透過主題分析法以畢恆達（2000）的「家」的概念： house（住屋）、family（家庭）、 home（家）作為分析架構來瞭解家父母提供「家庭式」照顧的過程與經驗。本研究結果發現，在house（住屋）的部分，伯大尼兒少家園於2020年完工的家園在硬體方面相當完善，但因仍在安置體下故須定期配合政府的考察、整體自由度相對較低。在family（家庭）的部分，家父母會透過家父母的稱謂、家庭規範及日常生活習慣建立等方式營造家的感覺；至於家庭關係的部分，兒少與家父母彼此間的行為與態度會影響雙方如何看待親子關係，另男性照顧者的出現讓兒少瞭解父職、母職間在照顧與工作上的差異；不同性別兒少共同安置則可以學習與不同異性相處，手足安置也能產生學習及榜樣的效果；家庭功能也透過家務分工、教育與社會化、家庭決策與溝通、休閒活動及宗教信仰等有所發揮。在home（家）的部分，兒少能對於小家產生歸屬感與安全感，對於家父母來說也能感受到有家的感覺，但同時也因為工作性質、照顧責任等現實考量而有所差異。另外，在研究過程中家父母也面臨困境，包含家父母在「工作」及「父母」兩個角色間不斷轉換、家父母的休假制度與真實家庭情境的落差、照顧上的經濟需求增加以及家父母在親職教養與管教的限制與兩難。綜合以上，根據研究發現提出研究建議。實務面，應定期提供照顧者的教育訓練與照顧支持、增加家父母與其他替代性照顧者間的交流與互動性、以及家父母專業知能的提升與配套措施；政策面，則建議建立屬於家父母的規範與制度，並提供工作時的誘因與保障；研究面，因為貫時性研究而無法瞭解家父母方案對於安置兒少未來離院甚至是長大成人後的影響，同時也建議未來研究可納入兒少或其他管理職、社工的觀察。

關鍵字

替代性照顧；家庭式照顧；替代性照顧者；機構安置

並列摘要

The purpose of alternative care is to provide vulnerable children with alternative child care when families are in difficult circumstances and not suitable for children. Although it is known that a family is important to children, most foster children are placed in residential care instead of family-based care due to the lack resources in providing family-like care in the child welfare system. This study focuses on perceptions of alternative caregivers at the Bethany Children’s Home, explores how caregivers provide family-like care within a residential out-of-home care environment, and understands caregivers’ challenges in caring for foster children. This study is based on a qualitative research design, incorporating interviews with six caregivers who have worked at the Bethany Children’s Home for at least one year without holding administrative positions and the researcher’s observations of foster children and caregivers’ interactions in their homes. Data analysis was conducted through thematic analysis, using the concept of house, home, and family, to understand how the Bethany Children’s Home’s new caring program works in real situations. The findings indicate that, in terms of house, the apartment complex built in 2020 is well-equipped in terms of hardware. However, due to the out-of-home care environment, caregivers must regularly comply with government inspections and experience a relatively low degree of freedom. In terms of family, caregivers create a sense of home through the parental titles, family norms, and daily routines. Regarding family relationships, the behaviors and attitudes of both foster children and caregivers influence how they perceive their relationship with each other. Additionally, the presence of male caregivers helps children to understand the differences between maternal and paternal caregiving roles. Regarding sibling relationships, mixed-gender placements help children to learn how to interact the opposite sex, while siblings also serve as role models and sources of learning. Family functions manifest in various ways, including the division of household chores, education and socialization, family decision-making and communication, recreational activities, and religious beliefs. In terms of home, children develop a sense of belonging and security, while caregivers also experience a feeling of home. However, differences arise due to the nature of their work, caregiving responsibilities, and other practical considerations. Despite these positive aspects, challenges remain, including caregivers’ concerns about constantly shifting between the roles of ”employee“ and ”parent,” increased financial demands, and dilemmas in parenting, discipline, and caregiving. Based on the research findings, this study provides practical, policy, and research recommendations. For practical implication, it suggests providing regular training and caregiving support for caregivers, fostering communication and collaboration between caregivers and other alternative care providers, and enhancing caregivers’ professional knowledge and skills. For policy implication, the recommends specific regulations and systems for the new type of out-of-home caregivers, while offering incentives and protections to support them in their work. For research implication, future research should examine the long-term impact of the home-parent program on child development, including their experiences into adulthood. It is also recommended to incorporate observations of children as well as insights from management personnel and social workers to gain a more comprehensive understanding.