智能障礙者在三種服務模式之工作能力比較分析

智能障礙者離開學校後會依工作能力及生活自立能力接受適合的服務模式，台灣的輕度及中度智能障礙者以安置於社區日間作業設施（簡稱小作所）或進入庇護工場、支持性就業服務為大宗，其中小作所屬於部分負擔型的社會福利服務，而庇護工場與支持性就業屬於賺取薪資的就業權益維護服務，這三者形成一個連續性與階段性的服務體系，無論身心障礙者離校後進入哪一種服務類型，最終目標是身心障礙者能向上轉銜，最終進入競爭性職場穩定就業。然目前各階段的轉入與轉出之轉銜除了對「工作技能」有較明確的標準外，在「生活技能」與「工作行為」方面並未有明確的標準，過往研究中也鮮少關注到三種服務模式智能障礙者工作能力中生活技能與工作行為的差異性，可能造成目前各服務模式間的轉銜情況不佳。本研究的目的是探討三種服務模式的智能障礙者在「生活技能」和「工作行為」兩項能力表現的差異。徵求宜蘭縣、基隆市在小作所、庇護性就業、支持性就業的智能障礙者各20、17、17位，研究工具分別為智能障礙者自陳量表「身心障礙學生獨立成人生活轉銜技能量表」及專業服務人員客觀填寫的「工作行為衡量表」以蒐集資料，也收集了人口學基本資料。以多變量共變數分析探討三個服務模式的智能障礙者在替排除年齡及障礙程度後，三組服務模式個案在生活技能及工作行為表現差異情形。本研究也透過訪談專業人員以深入了解影響三種服務模式安置的關鍵指標，以及現階段智能障礙者未適性安置的原因。研究結果發現三種服務模式的智能障礙者生活技能表現確實有差異；工作行為表現上除了一般行為外則無顯著差異。安置模式同時受到個人及環境因素的影響，關鍵影響因素包括：個人工作態度、工作動機及動力、接受服務意願、認知判斷與工作認知能力、生活自理能力、獨立作業能力、交通自理能力、個人溝通與應對、工作技能及產能、家庭支持度及家庭狀況。智能障礙者未適性安置原因則包括個人對自我瞭解程度不足、缺乏就業準備度、人際互動問題、提前老化問題及各項環境因素：專業人員問題、家屬問題、資源不足問題、各種服務模式功能未清楚劃分。因此，就業準備除了關注個人的工作能力外，提升職業重建單位的服務品質、提升家人的支持度、落實就業轉銜機制、輔導成立庇護工場以及提升個案健康管理能力皆是政府單位未來對身心障礙者各階段轉銜服務應規劃的政策方向。

關鍵字

智能障礙者；工作能力；三種服務模式

並列摘要

Persons with intellectual disabilities receive a suitable service model according to their work ability and ability to live independently after leaving school. Persons with mild and moderately intellectual disability in Taiwan might be placed in Day-to-day facilities (referred to as small offices), sheltered workshops or supported employment services, of which the small offices belong to partially-burdened social welfare services, while sheltered workshops and supported employment are wage-earning employment rights maintenance services. The three service models form a continuous and staged service system, regardless of the type of service that people with disabilities will enter after leaving school, and the ultimate goal is that people with disabilities can move up their ranks and eventually enter a competitive workplace for stable employment. However, in addition to the clearer standards for "work skills", " independent living skills " and " work behaviors" was found to affect work performance of persons with intellectual disability and they might transfer-in or transfer-out depending on the those two performance. There have been few previous studies concerned the differences in independent living skills and working behaviors among persons with intellectual disabilities in the three service models, which may result in poor transition results. The purpose of this study was to explore the differences in " independent living skills " and "work behaviors" among persons with intellectual disabilities in the three service models. 20 participants in Day-to-day facilities, 17 in sheltered workshops and 17 in supported employment were recruited. Their independent living skills were measured with Scale for Independent Adult Life Transfer of Students with Disabilities (a self-report measurement) and work behavior were measured with Work Behavior Measurement Scale (measured by professional service personnel). Demographic data, such as sex, age, severity of disability, were collected. A multivariate covariate analysis was used to explore the differences in independent living skills and work behavior performance of the subjects in three service models after excluding the age and the degree of disablity. This study also conducted interviews with vocational rehabilitation professionals to gain an in-depth understanding of the key indicators affecting the placement of the three service models and the reasons for the improper placement of the target population at this stage. The results found that there are indeed differences in the independent living skills of the persons with intellectual disabilities in the three service models. There is no significant difference in work behavior except for general behavior. The placement model is also affected by personal and environmental factors. The key influencing factors include: personal work attitude, motivation to work, willingness to use services, judgment and cognitive ability, self-care ability, independent working ability, ability to use public transportation, communication skills , work skills and productivity, family support and family status. Reasons for the inappropriate placement of persons with intellectual disabilities include insufficient self-understanding, lack of readiness for employment, interpersonal interaction, premature aging, and environmental factors such as: professional problems, family problems, insufficient resources, and the functions of various service models are not clearly divided. Therefore, in addition to paying attention to the individual’s work skills, prevocational preparation, improving the service quality of vocational rehabilitation professionals, increasing family support, implementing the transition mechanism, establishment of sheltered workshops, and improving the health management capabilities of cases are all government units’ future challenges to disability management. The policy direction should be planned for each stage of transfer service.