新冠肺炎疫情下的社會工作：初探公共衛生治理政策對於醫務社會工作之影響

近年來新冠肺炎疫情肆虐，我國施行公共衛生治理政策加以隔阻新冠肺炎所致的高度傳染力，中央流行疫情指揮中心並於民國110年5月28日全國升級為三級警戒。為了探究公共衛生治理政策對於醫務社會工作的影響，本研究透過質性研究方法，並採取立意取樣之方式進行深度訪談，並採訪7位醫務社工師，梳理社工實務上的抗疫經驗與個案工作所面臨的困境。本研究發現，新冠肺炎疫情帶來的影響，病人及案家層面，包含經濟受到嚴重打擊、照顧人力安排產生阻滯、醫療決策及共識產生限制、人道探視及防疫制度之倫理兩難、社區照顧資源的不連貫性；社工師層面，包含預估形式的改變、悲憫疲憊的耗能增幅、公衛治理政策與安置制度之磨合；醫院制度層面，包含分艙制度致跨科部溝通協調需求增加、志工人力管理等。研究結果：疫情加劇的失業問題、補助審查標準專案化、社區安置照顧政策議題、醫療院所防疫措施的影響、社工部門的應對調整。研究建議：社會安全網的再定義、後疫情時間的醫務社會工作的倫理及資源分配正義，供未來醫務社會工作邁向後疫情時代的參考。

關鍵字

新冠肺炎；公共衛生治理；醫務社會工作

並列摘要

Due to the severe pandemic of COVID-19 in resent years, the government has adopted several public health governance policies to prevent from spreading the highly-contagious COVID-19. Furthermore, the Central Epidemic Command Center has implemented the nationwide Level 3 Alert for COVID-19 on May 28, 2021. In order to examine the impact of COVID-19 on the practice of medical social work, the study conducts in-depth interviews with medical social workers based on qualitative research approach. In this study, we interviewed seven medical social workers to profile the difficulties in clinical practice. The research found that the impacts of COVID-19. First, the problems patients and their family faced are severe financial deficits due to the pandemic, the living arrangement for the families in need of care , the restriction of medical decision making and consensus, the dilemma between humanity visit and isolation policy, and the inconsistency of community care resources. Second, on the problems social workers faced include the constantly changing assessment methodology, piled up compassion fatigue, the conflict between health administer policy and placement system. Lastly for the hospital system, the difficulties are increasing demand of trans-department communication about cross-cabin system and loading management of volunteer resources. Research results indicated that the increasing unemployment problem in pandemic era, reformulation of the standard of subsidy examination, community placement and care issues, the impact of anti-virus policies in hospitals, and the ethical adjustment regarding responses from social work department. Research suggestions include the redefinition of social safety network, the clarification of medical social work ethics, and the justice of medical resources distribution in post-pandemic era for the future medical work.

並列關鍵字

COVID-19 ； Public Health Governance ； medical social work

參考文獻

Robert,K.(2020).Risk factors and effects of the morbus: COVID-19 through thebiopsychosocial model and ecological systems approach to social work practice. SocialWork in Publc Health,36(2),98-117.https://doi.org/10.1080/19371918.2020.1859035.

行政院主計總處（2021）。中華民國統計資訊網主計總處統計專區。網址：https://www.stat.gov.tw/np.asp?ctNode=452