一個護理之家的民族誌研究

在面臨人口老化趨勢、疾病慢性化及老年身體逐漸退化等的衝擊，使得護理之家在長期照護機構這一環中，更彰顯其重要性，本研究以某護理之家為研究對象，以質性研究方法，以了解護理之家的運作、照顧者與被照顧者自我角色的交互關係，最後提出相應的發展與改善護理之家的運作的建議。研究發現個案護理之家在總體社會結構關係中扮演相當重要的功能，歸納觀點，包括：一、從家庭功能擴大成為社會依靠，重建社會結構之倫理關係；二、社會新結構關係的連結點與社區資源整合；三、社會防護網線的補漏，與共同承擔社會責任之關係。其次，研究發現當被照顧者從家庭照顧進入到社會照護機構，家屬必須和機構的照顧者建立共同合作關係，在此情況照顧者與被照顧者同時角色也進行轉換。家屬也必須與護理人員建立合作關係，共同參與及分享，形成互相尊重、合作與支援的夥伴關係。在照護機構中，照顧者與被照顧者的關係，又以護理人員與老人的關係最關鍵也最直接，其關係包括：情感的建立與移轉、生命陪伴的關係、關懷與調適。研究中的個案給未來政府整合社福機構發展的參考，提出一些看法：一、長期照護機構應發展在地老化的服務概念；二、發展社區多種類型的照護功能；三、機構應該有多元的老人活動與關懷服務；四、政府應介入規劃整合工作；五、志工培訓與資源整合。

關鍵字

護理之家；長期照護機構；護理人類學

並列摘要

Faced with impact of ageing population trend, the chronic disease and body gradual degeneration, the nursing home displays its importance in the long-term nursing institution. The study takes some nursing home as the research object to understand operation of the nursing home and interdependence of the caretaker and care recipient use the qualitative research method and finally present corresponding development and the suggestions for improving nursing home operation. The study finds that the case nursing home plays several quite important functions in the overall society structural relationship, including: 1. Expand from family function to social dependence and reconstruct ethical relationship of social structure. 2. The tie point of society new structural relationship and community resource integration. 3. Relationship of social protective net remedy and undertaking social responsibility together. Next, the study finds that when the care recipient enters from family care to social nursing institution, the family must establish mutual cooperation relationship with the institution caretaker, in which the caretaker and care recipient concurrently switch their roles. The family must also establish cooperation relationship with the nursing staff, participate together and share to form partnership relationship of mutual respect, cooperation and support. In the nursing institution, the relationship of the nursing staff and elder is the most critical and direct in the relationship of the caretaker and care recipient, including: establishment and transfer of emotion, relationship of the life companion, and concern and adaptation. The study case presents some views for reference that the government integrates social welfare institution development in the future: 1. The long-term nursing institution shall develop the enculturation service concept. 2. Develop many types of community nursing function. 3. The institution shall have the diversified elder activity and concern service. 4. The government shall intervene planning integration work. 5. Volunteer training and resource integration.