文化健康站服務中的文化照顧意涵：評鑑制度與照服員的對話

本文旨在透過檔案及質性資料分析方法，探究在現今部落文化健康站的照顧實務中，「文化照顧」的概念是如何被理解及實踐。我國原住民族部落照顧服務之推動，始於2007年於原鄉設置「部落老人日間關懷站」，初期依循「在地老化」及「社區照顧」之目標，透過老人日間關懷站的設置，彌補原鄉部落中老人照顧資源不足之問題。後於2014年轉型為「文化健康站」，期盼透過強調在照顧中體現部落的文化特殊性，以促使原住民族長者在部落照顧實踐的框架下，獲得有尊嚴的照顧服務。本文從2020年全國文化健康站評鑑績優的檔案資料中，歸納分析評鑑委員之評鑑意見是如何論述照顧服務的「文化」意涵，並透過對信義鄉文健站照服人員進行訪談，分析比對文健站評鑑制度和照服員在文化照顧經驗上的互補性與差異性。研究發現評鑑制度中與文化照顧相關的指標及意見，對促進文健站發展文化多樣性的照顧模式有助益。因此建議在普及性的評鑑指標下，未來評鑑制度應特別重視部落之文化主體性，增加文化元素與創新服務指標的佔比。另建議著重發展以部落長者為主體的服務照顧，鼓勵部落強化自身文化特色並且給予文健站彈性發揮的空間，如此方能發展出符合在地需求的文化照顧模式。

關鍵字

文化照顧；在地需求；文化主體性；文化健康站

並列摘要

This paper aims to explore how the concept of ＂cultural care＂ is interpreted and practiced in the current care practice of tribal cultural health stations through archival and qualitative data analysis methods. The promotion of tribal care services for Indigenous peoples in Taiwan began in 2007 with the establishment of ＂Tribal Day Care Stations for the Elderly＂ in the tribes. Initially, in line with the goals of ＂aging in place＂ and ＂community care＂, the establishment of day care stations for the elderly compensated for the insufficient resources to care system for the elderly in the tribes. Later, it was renamed and transformed into a ＂Cultural Health Station＂ in 2015 in the hope that by emphasizing the cultural specificity of the tribe in the care, the Indigenous elders can receive dignified care services within the framework of tribal care practices. This article summarizes and analyzes how the evaluation opinions addressed by the evaluation committee members present the ＂cultural＂ meaning of care services from the archives of the national cultural health station evaluation in 2020. This paper analyzes and compares the complementarity and difference of cultural care experience between the evaluation system of Cultural Health Station and the caregivers. The study found that the indicators and opinions related to cultural care in the evaluation system are helpful for promoting the development of culturally diverse care models in the cultural health stations. Therefore, it is suggested that under the universal evaluation index, the future evaluation system should pay special attention to the cultural subjectivity of tribes, and increase the proportion of cultural elements and innovative service indicators. Emphasis should be placed on the development of service and care with the subjectivity of tribal elders, encourage tribes to strengthen their own cultural characteristics and give the cultural and health station room to play flexibly, so as to develop a cultural care model that meets local needs.

並列關鍵字

Culture Care ； Long-term Care for Indigenous peoples ； Cultural Health Station ； Xinyi County

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