長照機構照顧服務員服務現況與專業培訓接軌之探討

Discussion on the current situation of long-term care nurse aide and the connection with professional training

鄧玉蓮(DENG,YULIAN)

指導教授 ： 王亦凡

國立臺北商業大學/管理學院/企業管理系研究所/碩士(2019年)

摘要

台灣目前面臨生育率逐年降低的窘況，再加上國人平均餘命隨著醫療科技的發達而延長，健康平均餘命也因著公共衛生的普及與生活水準的提升而增加，故在嚴峻的少子化危機與高齡化的雙重考驗下，政府開始逐步推動長期照顧十年計畫，那高齡化直接的需求就是長期照顧的發展，當中照顧服務員培訓就是不可或缺的一環。於是政府也開始長照2.0的長征旅程。

然而照顧服務員的專業技能訓練內容除了認識營養與膳食、人體結構與功能、了解被照顧者基本的生理需求、疾病的症兆認識與處理、以及急症處理外，照顧服務員丙級技術士之項目亦只增加了生活照顧、身體照顧和緊急級意外事件處理的訓練。這些專業培訓內容的培訓只能滿足老人及失能者基本的需求，對於更廣泛被照顧者的心理需求和照顧服務員自我情緒的調適，這方面並無法獲得專業的培養與訓練，往往都是由照顧服務員在邊做邊摸索中學習，面對自身的情緒照顧與安撫被照顧的躁動、不安與其他心裡情緒將是選擇忽視，再不就是束手無策。

所以，本研究發現在台灣現今長期照顧的龐大需求背景下，藉由看到長期照顧服務員於長期照顧服務中所面臨到的專業培訓內容不足。包括被照顧者突如其來的心理不安，因為恐懼產生的躁動，可能身體不適所帶來的悲傷情緒，以及照顧服務員自身於照顧服務中所產生的經驗不足，面對各種突發狀況諸如團隊默契、個案更替、家屬溝通..等的多元情緒調節，及面對被照顧者往生的悲傷處理，都是無法有足夠的專業培訓內容足以解決。那麼這些都再再凸顯出長期照顧服務員在學習了基本的照顧技巧與專業護理後，並且順利通過目前的考核制度卻仍無法在照顧服務的崗位上提供被照顧者完善的服務，這與照顧服務員專業的培訓內容有著無法完全接軌的落差。因此，本研究希望藉此探討照顧服務員的專業培訓內容與其照顧服務中所面臨的所需，尤其給予個案心理衛生方面的關懷、支持、陪伴技巧。

關鍵字

長期照護 ； 照顧服務員 ； 專業培訓內容 ； 教育訓練 ； 情感規則

並列摘要

In Taiwan, we are facing the predicament of declining fertility rates year by year. With the Taiwanese average life span prolonged by the development of medical technology, life expectancy has increased due to the popularization of sanitation and the improvement of living standards. As a result, under the trial of sub-replacement fertility crisis and population ageing, the government has gradually promoted the plan of long-term care for a decade. The development of long-term care responds accordingly to the aging of population, and nurse aide training is an indispensable part.

As the nurse aide, they needs to be trained professionally to get acquainted with nutrition and diet, body structure and function, the basic physiological needs of the cared person, signs of disease understanding and treatment, and emergency treatment. However, the level C certified technician for care attendant just get additional training in life care, body care and handling emergencies and accidents. These professional trainings can only meet the basic needs of the elderly and the disabled. In regard to the deeper mental demands of the cared recipient and self-regulation of technician for caring service, nurse aide usually learn by doing, not by professional training or cultivating. They will choose to do nothing or hide their feeling and emotion when confronted with restless patient.

Consequently, this research revealed that in the context of the large demand for long-term care in Taiwan today, we can see the insufficiency of nurse aide’s professional knowledge when practicing long-term care service. Those insufficiency include whether nurse aide can handle the patient’s sudden panic, restless induced by fear, and sadness caused by physical discomfort. In addition, they don’t have enough professional skills and experiences in confronting emergency situations, such as the adjustment of multiple emotions like team chemistry, case replacement, communication with patient’s family member, and how to deal with the sadness when patient passed away. Those examples indicate that despite the long-term care attendants have successfully learned the basic and professional care and nursing skills and passed the examination system, they are still unable to provide the patients with comprehensive and perfect services, which means there has a gap within the professional training content of nurse aide. Therefore, this study was designed to discuss the professional training content of nurse aide and the demands in long-term care, especially laying emphasis on giving them care, support, and companionship skills.

並列關鍵字

long-term care ； nurse aide ； Professional Capability ； education and training ； feeling rule

參考文獻

中文文獻：

丁茹喬(2015）。照顧中的互惠：失智老人日間照顧中心照顧服務員的情緒勞動，國

立臺灣大學社會科學院社會工作學系碩士論文。

內政統計通報 (2012) 一○一年第十一週內政統計通報(100 年底我國老人長期照

顧及安養機構概況) 。