全日型生活照顧機構中身心障礙者自我決定經驗初探-中部某機構為例

本研究旨在探討全日型生活照顧機構中身心障礙者自我決定經驗，從全日型生活照顧機構中的服務使用者以及服務提供者的角度，了解機構服務提供者如何提供身心障礙住民自我決定的機會;身心障礙者在機構中自我決定經驗與感受;機構服務提供者對於身心障礙者自我決定的看法與其限制與困境。本研究採取質性研究作為研究方法，透過立意抽樣以及滾雪球為輔的取樣方式，找尋研究對象，並運用半結構式的深度訪談法，針對五位服務使用者以及六位服務提供者為受訪對象進行資料蒐集。本研究發現全日型生活照顧機構執行服務對象生活作息上的自我決定時，以集體式的規劃為主，在關照個別需求時有較大的限制，也會因為服務對象功能差異產生不對等的自我決定情形，因此大部分服務對象自我決定得由服務提供者替代決定。如果要滿足服務使用者的自我決定需求，應尋求支持決定取代替代決定使服務使用者的生活品質提升。要落實身心障礙者的人權，應從政府面、機構面、未來研究等方面思考並討論社會福利資源分配的議題，積極著手改善現有的限制。

關鍵字

全日型生活照顧機構；身心障礙者；自我決定

並列摘要

The purpose of this study was to explore the self-determination experience of people with disabilities in a full-time life care facility from the perspective of service users and service providers in a full-time life care organization; and to understand how the institutional service providers provide opportunities for people with physical and mental disabilities; and what the experiences and feelings of the people with physical and mental disabilities in the organization; and the institutional service providers' perceptions of the self-determination of the people with physical and mental disabilities and the providers’ limitations and dilemmas. This study adopts qualitative research as a research method, looking for research targets through sampling and snowball-assisted sampling methods, and using semi-structured in-depth interviews to interview five service users and six service providers for the data collection. This study finds that when a full-time life care institution performs self-determination on the life of the client, it is based on a group-way planning which has greater restrictions on individual needs, and it occurs unequal self-determination situation when the function of the client is different and therefore most of the self-determination of the service client is determined by the service provider. To meet the self-determination needs of service users, one should seek supportive-decision to replace the alternative-decision to improve the quality of life of the service users. To implement the human rights of people with physical and mental disabilities, we should consider and discuss issues of the social welfare resource allocations from the perspectives of the government, institutions, future researches and etc. to actively improve the existing limitations.