跨專業團隊合作照護中醫務社會工作角色之研究

本研究目的主要了解瞭解醫療團隊成員對跨專業團隊照護及醫務社會工作者的專業認知及瞭解程度，並分析醫務社會工作者在團隊中發展專業的阻礙因素，最後瞭解團隊成員對醫務社會工作者的期待。本研究採用質性研究方法，透過半結構式訪談十二位參與誇專業團隊照護成員，研究發現如下：一、跨專業團隊運作現況及其困境跨專業團隊照護仍有進步空間：團隊運作深受私人情誼與個人特質影響，而且專業霸權及本位主義仍然存在現今的醫療環境，因而阻礙了跨專業團隊照護的發展，雖然評鑑制度已有所要求，但礙於評鑑規劃與現實脫節而出現形式主義。二、醫務社會工作者參與跨專業團隊照護之現況與阻礙雖然醫務社會工作者專業能力已逐漸受到肯定，但就整體而言，目前跨專業團隊合作照護中的其他團隊成員對於醫務社會工作者認知仍顯不足，主要是因為醫務社會工作者角色及功能明確性仍顯不夠，在團隊合作時，出現不少與其他團隊成員角色重疊之現象，再加上醫務社會工作者缺乏基礎醫學知識，因此在跨專業團隊合作照護時容易被忽略。此外，醫務社會工作者人力無法負荷所有工作且流動性大，因此與團隊間缺乏合作默契，必須藉由更多的正向合作經驗累積才能增加能見度。基於上述研究之發現，對政策制度包括評鑑與教育面、醫院管理及跨專業團隊合作照護實務工作提出具體建議，供臨床實務工作者參考以建構更人性化的跨專業團隊合作照護模式。

關鍵字

醫務社會工作者；跨專業團隊合作照護；團隊工作

並列摘要

The main purpose of this study is to explore the professional recognition and the degree of understanding medical team members have of interprofessional practice and medical social workers, further analyze the obstructive factors that medical social workers have when developing their professional skills in a team, and eventually understand the expectations that team members have for medical social workers. In this study, the qualitative research method was used and 12 health care professionals who had been participated in interprofessional practice were interviewed through semi-structured interviews, and the research results are listed as follows: 1. The current status and difficulties of the operation of interprofessional practice: Interprofessional practice still has room for improvement for the development of interprofessional practice has been hindered not only because the team operation is rather easy to be affected by private relationships and personal traits, but also because the professional hegemony and sectionalism still exist in today’s health care environment. Although the evaluation system has been implemented, the disconnection between the evaluation planning and the reality only results in formalism. 2. The current status and obstacles of medical social workers in participating in interprofessional practice: The professional capacity of medical social workers has gradually been recognized; however, on the whole, other team members involved in the interprofessional practice still has little awareness of medical social workers. Mostly it is because of the uncertain role and functions of medical social workers, and this tends to cause the overlapping problem for the roles of team members. Moreover, the lack of basic medical knowledge often has medical social workers overlooked in the interprofessional practice. In addition, the manpower of medical social workers is insufficient to cover all the work, and the significant turnover rate among medical social workers results in a poor cooperative teamwork, which needs more positive experience of cooperation to increase the visibility and the necessity of the role of medical social workers. Based on the above research results, this study has provided specific recommendations for the policies and systems of evaluation and education, hospital management and interprofessional practice, hoping to be used as a reference for clinical practitioners to construct a more humane model for interprofessional practice.