社區整合型服務中心個案管理員工作壓力與因應策略之研究

為落實長照2.0在地老化政策目標，以社區為基礎之整合式服務體系，增進長照服務提供單位分布之密度，讓民眾獲得便利性且多元的服務，並推動社區整體照顧服務體系，因此由社區整合型服務中心落實個案管理，並依個案需求協調安排照顧服務資源，提供具彈性化以及連續性之服務，而社區整合服務中心提供服務之個案管理人員職責為銜接原有照顧管理人員之照顧管理及服務連結者的角色。本研究目的為探討社區整合型服務中心個案管理員的工作壓力與因應策略狀況。同時本研究是採用質性研究方法，是社會科學研究中最廣泛運用的收集資料方法之一，並且能協助研究者在研究發現中，歸納觀點並找出個案管理員的工作壓力、因應策略及留任意願狀況。為深入了解個案管理員的工作壓力與因應過程，又考量新進個案管理員對於多元複雜的長期照顧管理制度不熟悉，因此設定研究參與者之篩選條件為（一）現仍在執行個案管理員業務；（二）一年以上同職務工作經驗；（三）必須完成個案管理員進階課程；(四)願意分享內在經驗者。考量研究者個人的資源、預算與可能增加的訪談次數，樣本以可近性為主，研究場域選擇南投縣地區。本研究發現個案管理員須面對個人系統、實務系統、工作團隊系統和機構組織系統的工作壓力，與個案管理員因應策略之對應，並且依據研究發現提供建議:(一)問題取向因應策略，主動找到相關權責人員和尋求同儕的意見。(二)情緒取向因應策略，穩定自己的情緒並做適當的抒發。(三)折衷取向因應策略，透過自我反省及正向思考並且尋求組織內部主管支持或是外部單位尋求協助。關鍵字：個案管理員、工作壓力、因應策略、留任意願

關鍵字

個案管理員；工作壓力；因應策略；留任意願

並列摘要

In order to achieve the goal of localized aging under Long-Term Care 2.0, the community-based integrated service system will increase the density of long-term care service providers, allowing service recipients to receive convenient and diverse services, and promote the overall community care service system. The responsibilities of the case managers who provide services in the community integrated service center are to continue the care management initiated by the previous care managers and connect services, coordinate and arrange care service resources according to the needs of the service recipients, and provide flexible and continuous services. Case managers need to face different work pressures in the process of providing case management services. If these issues can be solved in terms of response strategies and other aspects, it would create a more satisfying work environment for case managers, enabling them to deliver higher quality services to the recipients. The purpose of this study is to explore the work stress and coping strategies of case managers at community integrated service centers. At the same time, this study adopts qualitative research methods, which is one of the most widely used data collection methods in social science research. It can help researchers summarize their opinions within the study and find out the work pressures, coping strategies and retention intentions of case managers. In order to gain a deeper understanding of the work pressure and coping process of case managers, and considering that new case managers are not familiar with the diverse and complex long-term care management system, the screening conditions for research participants were set as (1) Currently engaged in case manager duties; (2) More than one year of working experience in the same position; (3) Complete advanced case manager courses; (4) Those who are willing to share their personal experiences. Taking into account the researcher's personal resources, budget and the possible increase in the number of interviews, the sample was mainly based on accessibility, and the research site was selected in Nantou County area. This study found that case managers must face work pressures from personal systems, practice systems, work team systems, and institutional organizational systems, and that corresponding coping strategies. Based on the findings, the following recommendations are provided: (1) Processing to improve professional knowledge and Emotional stress relief courses provide case managers with support when facing work pressure and increase their willingness to stay. (2) Through the incentive mechanism, reduce the workload and increase staffing and set up enterprise employee assistance programs (EAPs). (3) Establish a long-term care policy inquiry platform and hold public hearings to make the policy open and transparent. Keywords: case manager, work pressure, coping strategies, retention intentions