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長照復能服務跨專業協作的現況與未來挑戰

Transdisciplinary collaboration in long-term care reablement: Current situation and future challenges

摘要


「復能」是以個案目標為導向,透過跨專業團隊介入將服務輸送至長照使用者居家及社區。臺灣於2016年導入復能服務,期望幫助使用者恢復執行日常生活的能力,復能跨專業連結現況值得被探討。本文依據霍爾四階段跨專業團隊理論模型,說明和分享新北市長照專業照顧人員跨專業個案研討課程設計經驗,並且針對跨專業協作狀況,提出實務分析和政策建議,包括:(1)長照復能專業人員角色定位從執行者轉為諮詢者、(2)強化個管人員和專業照顧人員對於長照復能個案連結機制、(3)在學與在職教育應重視跨專業協作能力培養。臺灣長照2.0導入復能服務,並視為居家照顧新典範模式,建議應改善跨專業實體對話環境,才能有效提升照顧品質整合。

關鍵字

復能 跨專業團隊 課程設計

並列摘要


Reablement is defined as a goal-oriented intervention using a transdisciplinary team approach in the home and surrounding community of long-term care service users. In 2016, Taiwan introduced reablement with the objective of helping service users regain the ability to perform daily activities. The current transdisciplinary team approach involving long-term care professionals' delivery of reablement services requires further understanding. This study demonstrated a sample of course design regarding a transdisciplinary case study of long-term care professionals in New Taipei City using Hall's four-phase transdisciplinary team-based model. Furthermore, we analyzed the practical aspects of transdisciplinary collaboration and provided policymaking recommendations to address the following issues: (1) the roles of long-term care professionals in reablement have changed from that of hands-on operators to hands-off consultants; (2) the mechanism for filling knowledge gaps between case managers and long-term care professionals in reablement services needs to be strengthened; and (3) the competence of transdisciplinary collaboration during in-school and in-service education needs to be addressed. Taiwan has implemented reablement as a new mode of home care service under the policy of Taiwan's Long-Term Care Plan Version 2.0. Improvements in the physical environment of communication among transdisciplinary professionals are required to facilitate the integration of quality care.

參考文獻


邱慈穎、陳雅美(2018).長照整合機制概述 . The overview of long term care integration mechanisms.長期照護雜誌,22(1),1-5。 https://doi.org/10.6317/ltc.201805_22(1). 0001
Birkeland, A., Tuntland, H., Forland, O., Jakobsen, F. F., & Langeland, E. (2017). Interdisciplinary collaboration in reablement - a qualitative study. Journal of Multidiscip Healthc, 10, 195-203. https://doi.org/10.2147/jmdh.s133417
Chiu, T. Y., Yu, H. W., Goto, R., Lai, W. L., Li, H. C., Tsai, E. T., & Chen, Y. M. (2019). From fragmentation toward integration: Apreliminary study of a new long-term care policy in a fast-aging country. BMC Geriatr, 19(1),159-169. https://doi.org/10.1186/s12 877-019-1172-5
Cochrane, A., Furlong, M., McGilloway, S., Molloy, D. W., Stevenson, M., & Donnelly, M. (2016). Time-limited home-care reablement services for maintaining and improving the functional independence of older adults. Cochrane Database Systematic Reviews, 10, Cd010825. https://doi.org/10.1002/14651858.CD010825.pub2
Hall, K. L., Vogel, A. L., Stipelman, B., Stokols, D., Morgan, G., & Gehlert, S. (2012). A four-phase model of transdisciplinary team-based research: goals, team processes, and strategies. Translational Behavioral Medicine, 2(4), 415-430. https://doi.org/10.1007/s13142-012-0167-y

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