戰後台灣的防癆保健員

Lay Home Visitors in Tuberculosis Control after World War Ⅱ in Taiwan

張淑卿(Shu-Ching Chang)

《近代中國婦女史研究》 14期 (2006/12) Pp. 89-123

https://doi.org/10.6352/mhwomen.200612.0089

摘要

結核病（以肺結核病爲主，俗稱肺癆、癆病）是戰後台灣最重要的傳染病之一。防癆保健員則是60年代中期以來台灣官方結核病防治工作中最基層的工作人員，此職務建置於1966年，由台灣省防癆局派駐在各鄉鎮衛生所執行防癆工作，至1989年改聘爲護理佐理員。本文以1966年至1989年爲研究斷限，除述及防癆員設置的歷史背景外，同時討論防癆員遴選之標準以及職場經驗。資料來源以官方報告、相關研究以及四位資深防癆員的深度訪談爲主，透過防癆員的選定、工作內容、同儕關係、與病患間的關係網絡等面向，探討其職場生涯及其困境。本文獲得的初步結論：（一）防癆員的選取富有傳統的性別意涵，認爲具有耐心、愛心、恆心的年輕女性最適合此項工作。（二）防癆員與輔導員之間，雖同爲女性，但只爲上下的從屬關係；而面對輔導醫師時，男醫師的性別與身分有助於處理不合作的病患；「工作目標數」，是防癆員工作上最大的壓力來源。（三）防癆員與衛生所公共衛生護士之問的摩擦，來自於身分的不同、工作分配的不平等以及對護理專業理解程度的差異。（四）在病患關係方面，尤其是面臨男性病患時，防癆員會特別注意到安全與性別問題。在病患管理方式、家庭訪視、衛生教育等方面，則彰顯出防癆員利用其工作權力，規訓與監控病患的身體。

關鍵字

防癆員 ； 結核病 ； 職業婦女 ； 戰復台灣

並列摘要

Since World War Ⅱ, tuberculosis (TB) has been one of the most serious of the contagious diseases in Taiwan. Thus ”lay home visitors” have been one of most basic official ways to control the disease since the mid-1960s. The position was established in 1966, and the visitors were assigned to the public health station in each village and town by the Taiwan Provincial Tuberculosis Control Bureau. In 1989, lay home visitors were promoted to be assistant nurses. This article studies the situation between 1966 and 1989. Besides discussing the historical background of the establishment of the lay home visitors program, it also discusses the selection standards and career experiences of the workers. The sources of this article are mainly official reports, relevant research, and in-depth interviews of four senior lay home visitors. The career and its difficulties are shown through the selection of lay home visitors, the nature of their work, relationships between colleagues and with patients, and so forth. The initial conclusions of this article are as follows: 1) The selection of lay home visitors is influenced by traditional gender expectations; young females with patience, love, and persistence are considered most suitable to this job. 2) Lay home visitors and public health nurses in tuberculosis control, although both female, maintain a status differential, while the gender of male physicians helps in handling uncooperative patients. ”Working Target Numbers” are the chief source of the lay home visitors' work stress. 3) Different status, unequal work allotments, and differences in the understanding of health care all cause conflict between lay home visitors and public health nurses in health stations. 4) Regarding relations with patients, lay home visitors pay special attention to safety and sexual problems, especially when faced with male patients. In terms of patient management methods, home visits, health education, and other aspects of the program, we can see how lay home visitors utilize their authority to regulate and monitor their patients' bodies.

並列關鍵字

lay home visitors in tuberculosis control ； tuberculosis ； career woman ； Taiwan after world war Ⅱ