本研究是以機構角度來探討社區照顧推展及資源整合狀況,採以質化研究中的深度訪談法,來瞭解社區照顧服務輸送體系中的相關人員,對社區照顧之認知及服務方案之推展看法,從而發現社區照顧及資源整合之問題。本研究共訪談25名相關人員,包括政府人員2名、機構工作人員14名、服務使用者6名,以及社區重要人士3名。至於本研究之重要發現則有三點: 一、機構推展社區照顧的優點為機構的財力較雄厚,能應付社區照顧財源不穩定的問題,且機構的照顧技巧及經驗也較豐富,但缺點則是機構的靈活度較低,而且民眾若認知不足便容易對機構產生誤解,認為機構只是想發掘更多機構照顧的個案,因此「融入社區」成為是機構落實社區照顧的首要條件,也是關乎其能否永續經營的重要關鍵點。 二、政府的經費支持是同時最被機構及社區所重視及依賴的,尤其多數社區不像機構還有其他的財源獲取管道,甚至有的社區重要人士更認定社區是無法自己生財的單位,因此表現出比機構更依賴政府提供經費補助的現象,而對機構的資源依賴程度則較低且被動。而政府則認為最好跟最多的資源都在社區,所以相當依賴社區,視其為推動社區照顧成功之關鍵。至於機構則同時依賴著政府及社區,希望一邊獲得政府經費的支持,一邊又能從社區中找到充足的照顧人力。 三、政府及社區對其本身在照顧資源的掌握及運用認知不足,故社區相當依賴政府資源,而政府則認為社區照顧是否成功的關鍵則在社區的資源開發及配合,呈現一種彼此覺得對方才是推展社區照顧的重要關鍵,但卻未體認到自己在社區照顧中亦扮演著相當重要的角色,反而機構是這三者當中最能清楚知道自己在社區照顧推展中所擁有的資源及角色定位,因此可以發現到目前整體的照顧資源整合不足,且相關單位的認知是有落差的。
This paper aims to analyze, from an institutional perspective, the development of community care and the conditions of resource integration. With the use of a qualitative in-depth interview method, this paper also attempts to understand how relative persons of community care service evaluate community care and the development of service programs. This study interviews a total of 25 relative persons, including 2 government officials, 14 institutional workers, 6 service users, and 3 vital persons from the community. This study has three major findings: First, community care, which developed by the institution, not only ensures enough capital to resolve financial problems but also guarantees professional caring techniques though it is not fully flexible. Without knowing much about the operating processes of the institution, clients tend to recognize institution as an experience-seeking organization. Thus, institution’s community participation would become premier principle of community care as well as the key factor as to whether it can last forever. Second, government subsidy is highly valued by both the institution and the community. Unlike the institution, which is superior in search of diverse financial supports, the community depends more on the government than on the institution for it is mainly sponsored by the government. The government presumes the community owns most and best resources so it relies much on the community reversely, whereas the institution seeks not only to receive subsidy from the government but also to get more human resources form the community. Finally, both the government and the community lack entire understanding regarding resource control and manipulation. Although the government and the community view each other as the pivot of developing community care, they ignore their importance in community care. Only the institution knows its orientation and recourses of developing community care, so it can find out the shortages of integrating caring resources as well as the cognition gap between relative units.