- 學位論文
巷弄長照站現況運作之研究–醫事C與據點C的比較
Research on the Current Operation of Tier C Long-Term Care Stations — To Compare Medical Related Stations C and Community Care Centers C
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摘要
目的：基於我國人口老化和家庭結構變遷，社會支持系統投入高齡照顧有其必要性。鑒於社區照顧關懷據點服務和長照1.0施政存在不足，政府意識到長照2.0應聚焦於社區初級預防，從根本減輕長照負擔。本研究以長照2.0社區整體照顧ABC模式之中的社區前端C級巷弄長照站為主要研究對象。目前巷弄長照站依背景區分成醫事C、據點C及文化健康站等類型，其中，據點C占最多，醫事C次之，因此，本研究針對醫事C與據點C探討其資源連結情形、運作問題，以及其長者收案特性與健康狀況。 方法：本研究以混合研究法進行，針對高雄市6處醫事C與6處據點C的長者特性與身心狀況資料進行描述性統計分析比較，並針對高雄市10位不同單位所設置之醫事C與據點C的主管與主要工作人員進行半結構式深度訪談，後續以紮根理論研究法進行運作分析與比較。 結果：醫事C與據點C因背景不同，致使場地獲得、人力來源、財務支持和服務內容等可用資源之連結情形存有不同，間接影響場地、人力及財務等資源的運用，以及服務呈現、治理現況的不同。目前，醫事C與據點C在運作上可能面臨人力流動、財源不足、多元化服務提供等運作挑戰。服務規劃上，醫事C強調身體健康，據點C則較為注重心理層面的健康，各自承辦人員對投入健康促進之充足性有不同程度的認知，然對於長者的健康維持性觀察卻一致獲得正向成果。目前，參與醫事C與據點C的個別長者族群特質，存有年齡、同住狀況、疾病史、獲得健康訊息途徑及健康狀況的不同。 結論：醫事C與據點C在資源連結及運作上，正面臨著場地使用、人力運用、財務支持以及服務競爭等方面的種種問題，同時，由於服務長者對象特質的不同，如何連結適當資源提供符合其照顧需求之服務，亦是需要持續面對的問題。未來，各界仍需要進一步地改善社區照顧的運作模式，促使巷弄長照站長者的照顧品質有所提升。
並列摘要
Objective: Based on the aging population and the change of family structure in Taiwan, it is necessary for the social support system to invest in elderly care. By recognizing deficiencies in community care base services and the governance of LTC (Long-Term Care) 1.0, the government acknowledges the need for LTC 2.0 to concentrate on primary prevention in the community, aiming to fundamentally alleviate the burden of long-term care. This study focuses on the primary research objects, which are the tier C long-term care stations situated at the community's front-end, within the ABC model of LTC 2.0 community overall care. Currently, these long-term care stations are categorized into medical related stations C, community care centers C, and cultural health stations based on their backgrounds, with community care centers C being the most prevalent, followed by medical related stations C. Consequently, the study investigates the resource linkage, operational challenges, as well as the characteristics and health status of the elderly in both medical related stations C and community care centers C. Methods: This study was conducted by mixed research method. The characteristics and physical and mental status of the elderly were compared by descriptive statistical analysis of the characteristics and the physical and mental status of the elderly in 6 medical related stations C and 6 community care centers C in Kaohsiung City. Semi-structured in-depth interviews were conducted with the supervisors and key staff of 10 medical related stations C and community care centers C in Kaohsiung City. Subsequent analysis involves using grounded theory to perform content analysis and conceptual comparisons. Results: Due to the different backgrounds of medical related stations C and community care centers C, the links between available resources such as site acquisition, manpower sources, financial support and service content are different, which indirectly affects the use of site, manpower and financial resources as well as the different status of service presentation and governance. At present, medical related stations C and community care centers C may face operational challenges such as manpower mobility, insufficient financial resources, and diversified service provisioning. In terms of service planning, medical related stations C emphasizes physical health, while community care centers C focuses more on psychological health. Their respective contractors have different degrees of awareness of the adequacy of investment in health promotion, but the observation of the health maintenance among the elderly has consistently achieved positive results. At present, the characteristics of individual elderly groups participating in medical related stations C and community care centers C are different in age, cohabitation status, medical history, access to health information and health status. Conclusion: Medical related stations C and community care centers C are facing various problems in terms of resource connection and operation, such as site utilization, manpower utilization, financial support and service competition. At the same time, due to the different characteristics of the elderly servants, the way to connect appropriate resources to provide services that meet their care needs is also a problem that needs to be faced continuously. In the future, there is still a need to further improve the operation mode of community care to improve the quality of care for the elderly around the blocks.
參考文獻
謝聖哲（2018）。從社區照顧關懷據點到巷弄長照站：挑戰與困境。台灣社區工作與社區研究學刊，8（1），1-34。https://doi.org/10.3966/222372402018040801001
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