社區復健中心個案之服務使用經驗探討

An Investigation of Serviced Experiences of Clients in Community Rehabilitation Center

王怡婷(Yi-Ting Wang)

指導教授 ： 呂文賢

中山醫學大學/醫學科技學院/職能治療學系碩士班/碩士(2018年)

摘要

前言：老化是當今世界各先進國家所共同面臨的社會變遷狀況。近年來我國面臨人口快速老化及少子化的情形，與因慢性失能而衍生的照顧及復健問題，使國內急性醫療體系的健保制度無法滿足龐大需求。目前復健服務也逐漸由醫療體系進入社區與家庭，目的是減少醫療費用開銷及復健病人住院天數，亦能促進病人達到最大的功能獨立。然而目前針對社區式復健之相關研究並不多見，尤其針對使用者參與經驗之研究甚少。本研究主要目的：探究社區復健中心個案對於服務使用的經驗。

方法：本研究採立意取樣，邀請13位符合長期照顧服務之個案及家屬，採半結構式深度訪談與參與觀察進行資料收集。將於每次訪談後錄音檔或現場觀察札記轉譯為逐字稿並進行譯碼及研究發現彙整。資料飽和為收案樣本數之依據，並以主題分析法進行資料分析與彙整。

結果：本研究共呈現五個主題：（一）社區復健中心是個案也是家屬尋求的歸屬感；（二）社區復健中心提供照顧者實際解決照顧問題之服務；（三）將社區復健中心的參與納入生活常規；（四）多元化治療模式；（五）社區復健中心提供個案及照顧者共同參與之空間。

結論：本研究顯示社區復建中心不僅提供專業服務，更需要負責輔導家屬及教導照顧者技巧，並連結其他資源。本研究將有助於了解個案及家屬對社區復健中心之觀點，藉以協助社區復健中心擬定照護及服務方向，使得資源落實應用於失能者及家屬們的身上，提升服務品質與成效。

關鍵字

社區復健中心 ； 關懷據點 ； 長期照顧 ； 質性研究

並列摘要

Introduction: Ageing is the foremost social change that all developed countries are currently facing. In recent years, Taiwan has faced a rapidly aging population coupled with low birth rates. Derived care and rehabilitation issues have made it impossible for the country’s health care insurance system to meet and cope with the ever-increasing demand of patients seeking acute medical care. Currently, pre-rehabilitation services are gradually moving from a medical care oriented system to a community and family-oriented system, thereby reducing medical expenses, rehabilitating patients' hospitalization days, and promoting maximum functional independence for patients. The main purpose of this study was to explore the experience of community rehabilitation center cases in practical use.
Methods: This study employed purposive sampling to recruit thirteen qualified long-term care patients (case studies) and their families. Data were collected by semi-structured, detailed interviews and observation of clients’ engagement and participation in various activities. Each interview was either audio-recorded or transcribed verbatim on site for data decoding until the target sample sized was reached.
Results: Five findings of this study are: 1) Community care centers focus on offering clients and their families a sense of belonging; 2) Community care centers offer tool-kits for caregivers to solve problems based on each client’s situation, thus ensuring that the client receives the best level of care; 3) Clients incorporate the community care center into their daily routines; 4) Multifaceted care models and modules are provided, and 5) Community care centers provide clients and caregivers avenues or recourse for mutual participation in rehabilitation activities.
Conclusion: This study found that community care not only provides specialized service but also is tasked with linking critical social resources to coach and train family and caregivers in how to better provide care to patients. In addition, the findings of this research will help engage clients and family to better understand specialized care services and guidelines offered at community rehabilitation centers and help to improve the efficacy and quality of the care provided.

並列關鍵字

Community Rehabilitation Center ； Community Care Centre ； Long term Care ； Qualitative Research

參考文獻

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