急診醫療團隊對急診社會工作者服務現況與角色期待之研究

本研究旨在瞭解全國急診社會工作服務現況，探討急診社會工作者與急診醫療團隊醫護人員對急診社會工作的服務現況與角色期待及兩者之間的差異情形。本研究以調查研究法，調查99家區域醫院以上醫療院所中之急診社會工作者、急診醫師、急診護理人員，共計回收62家、185份有效問卷（回收率46.6％），其中急診社會工作者有效樣本44份、急診醫師有效樣本86份、急診護理人員有效樣本55份。本研究以描述性統計、卡方檢定、T檢定、單因子變異數分析及相關分析等統計方法進行資料分析，得到以下幾項主要的結論與發現：一、現況大多數醫療院所均已於急診部門編制有急診社會工作者，由社工部門採以兼任方式任職，出勤時段已有延長至晚上22：00，或者以值班on call方式持續提供服務，多數醫院有提供會談室或諮詢室、PHS通訊設備。二、急診社會工作者與急診醫護人員較常透過個案照會、私下討論等接觸情境互動，較少透過晨會、家屬座談會等接觸情境互動；另外，急診社會工作者與急診醫護人員均常透過面對面、電話聯繫等溝通方式互動。三、急診醫師、急診護理人員與急診社會工作者在對急診社會工作「家庭問題、無家屬、路倒病人、遊民個案處遇」、「保護性個案處遇」、「自殺、酒癮病患及精神疾患者個案處遇」、「滯留急診病患輔導與主動關懷」、「器官捐贈勸募與移植」以及「重大災難個案處遇與家屬關懷」的服務內容上有顯著差異。四、急診社會工作者較期待扮演「倡導者」、「診斷者」、「諮詢者」及「聯繫者或資源提供者」的角色，急診醫護人員則較期待急診社會工作者扮演「協調者或調解者」、「倡導者」及「聯繫者或資源提供者」的角色。五、急診醫師、急診護理人員與急診社會工作者對未來急診社會工作者可扮演「行為改變者」、「協調或調解者」、「協助或問題解決者」、「行政者」及「研究者」的角色期待上有顯著差異。最後，根據研究結果對組織政策、機構管理者及急診社會工作者提出建議。

關鍵字

急診社會工作；團隊合作；角色期待

並列摘要

This research aims to understand emergency social work performance in Taiwan, and explores the phenomena and gap between emergency social work performance and emergency social worker's role expectation from perspectives of emergency medical team. The study conducts a questionnaire survey to 99 emergency teams which are belong to regional level hospital or higher level units. The members of emergency team are required to answer the questionnaire, including emergency social workers, emergency physicians, and nurses. There are 397 questionnaires delivered with valid 185 returns and the return rate are 46.6%. These 185 valid questionnaies come from 62 hospitals, including 44 emergency social workers, 86 emergency physicians, and 55 nurses. Descriptive statistic, chi-square tests, t tests, ANOVA, and correlation are employed in this research. Main results and discoveries are summarized below. First, most regional hospital or higher level units have already worked out social workers of emergency department, adopted and works as by the part-time job by social service department, attendance has already been lengthened to 22:00, or provide service continuously by way of on call on duty, most hospitals offer the meeting room or the consulting room, Personal Handy-phone System (PHS) communication support. Second, case consultation and private discussion are main approaches used by emergency social worker, emergency physician, and nursing staff to interact each other. On the hand, formal morning meeting and meeting with family are less where they collaborate. Furthermore, they tend to communicate either face to face or through a phone call. . Three, there are significant differences on performance of emergency services among emergency department. These emergency services include ‘family problems and homeless intervention’, ‘protection case’, ‘suicide or alcoholic abuse and mental illness casework’, ‘reach-out service of patient staying in emergency’, ’ case of organ donation and transplantation’, and ‘intervention of family with significant disaster’. Fourth, there are significant different role expectations between emergency social worker and the other team members. Emergency social workers expect themselves as the role of advocator, diagnostician, consultant, and resource connector or provider, while relatively emergency physicians, and nursing staff want emergency social workers to be the role of behavior changer, mediator or coordinator, administration and the researcher. Five, regarding the future role expectation of emergency social worker, there are also significant differences between emergency social worker, emergency physician, and nursing staff, as social workers are expected to be behavior changer, mediator or the coordinator, assistance or problem solver, administrative staff, and researcher in emergency department. Finally, suggestions for institution of organization, organization's administrator and emergency social worker are proposed according to the results of this study.