COVID-19疫情爆發後長期照顧機構面臨之挑戰與IoT需求之探討

由於醫療技術發展快速，公共衛生環境不斷改善，人類的預期壽命不斷提高，國人的平均壽命皆創歷年新高，而我國已於1993年成為高齡化社會，2018年轉為高齡社會，推估將於2025年邁入超高齡社會，面對高齡社會帶來的退休潮、老人安養、勞動力減少與少子化的衝擊，需要大家共同來正視高齡照護的問題，然於2019年12月起中國湖北省武漢市發現不明原因肺炎群聚，此疫情隨後迅速在中國其他省市與世界各地擴散，從確診個案之流行病調查與實驗室檢測得知，藉由近距離飛沫、直接或間接接觸帶有病毒的口鼻分泌物、或無呼吸道防護下長時間與確診病人處於2公尺內之密閉空間裡，將增加人傳人之感染風險，因此，為避免直接接觸到疑似COVID-19個案帶有病毒之分泌物與預防其飛沫傳染，除了配戴口罩外，應避免出入人潮擁擠、空氣不流通的公共場所，並維持社交距離，而網際網路的技術發展與應用快速成長，已可將感測器與無線通訊晶片嵌入於食、衣、住、行、育、樂各方面的電子產品中或與其高度整合，此即所謂的物聯網，為減少與人接觸且維持社交距離的防疫政策下，藉此研究瞭解目前長照機構的照護服務現況、COVID-19疫情爆發後，所面臨之挑戰及探討因應COVID-19疫情並提升照護服務所需之IoT設備。為此，本研究內容歸屬於住宿式長照機構，採質性研究方法中的深度訪談法進行，並透過深度訪談3位機構負責人及4位照顧服務員，研究發現長照機構經營與相關設備購置、長照機構人力短缺、培育及管理、IoT推廣至長照機構照服員及IoT相關設備需求等4個面向問題，建議如後：(一)檢討長照資金來源；(二)強化長照人力發展與訓練；(三)提供高單價IoT相關照護設備承租模式；(四)建議長照機構每季或每半年排定IoT相關課程，針對在職員工實施在職教育，以推廣至直接使用設備之照服員；(五)依研究結果建議IoT可提升長照機構照護服務之設施。

關鍵字

長期照顧；嚴重特殊傳染性肺炎；物聯網；智慧照護

並列摘要

Due to the rapid development of medical technology, the continuous improvement of the public health environment, and the continuous improvement of human life expectancy, the average life expectancy of Taiwanese people has reached a record high. Taiwan has became an aging society in 1993 and will become a senior society in 2018. It is estimated that Taiwan will enter the super-aged era in 2025. Considering the impact of the retirement wave, the security of the elderly, the reduction of labor force and the declining birth rate brought by the elderly society , everyone has to face the problem of elderly care . However , December 2019 , Hubei Province, China Wuhan found unexplained cluster of pneumonia , this epidemic situation spread rapidly around the world in other Chinese provinces and cities. From epidemiological investigation and laboratory testing of confirmed cases, it will increase the risk of infection the people by close droplets, direct or indirect contact with the nasal and oral dischange with virus, staying with people confirmed infection without respiratory protection in confined space within 2 meters. Therefore, in order to avoid direct contact with The dischange and to prevent the droplet infection, we should avoid going into crowded and airless public places, and maintaining social distance in addition to wearing masks. Because of the rapid growth of Internet technology and application, sensors and wireless communication chips are embedded in or highly integrated with electronic products in food, clothing, housing, transportation, education, and entertainment . This is the so-called Internet of Things .To reduce the contact with people and maintain social distance policy, this research aims to understand the current service status of long-term care institutions , the challenges they face after the outbreak of the COVID-19 epidemic, and to explore the IoT devices needed to respond to the COVID-19 epidemic and improve care services. For this reason , with this research belongs to the long-term care institution. The in-depth interview method in the qualitative research method is adopted . Through in-depth interviews with 3 leaders of institution and 4 care assistants, the research found the long-term care institution and equipment purchases , the issues about the business and management manpower shortage, cultivation and management , extension of IoT to long-term care institutions and demand of IoT equipment , etc. 4 issue-oriented recommendations such as: ( 1 ) to review the sources of long-term care funds ; ( 2 ) strengthen development and training of manpower model ; ( 3 ) Provide a high-priced of renting IoT equipment; ( 4 ) Recommend long-term care institutions to IoT- related courses quarterly or half-yearly , to implement the on-the-job education schedule for in-service employees, and to promote to caregivers who directly use the equipment ; ( 5 ) Based on the research results, it is recommended that IoT can improve the facilities of long-term care institutions .