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  • 學位論文

照顧好我們的照顧者: 我國照顧服務人員就業歷程及人力發展之探討

Take Care of Our Caregivers: Taiwan Caregivers’ Subjective Working Experience and Human Capital Development.

指導教授 : 周玟琪
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摘要


根據行政院主計處2010年提出的國人健康醫療報告中指出,當時已有47萬5千人需要各樣的長期照顧服務,居家服務是當中使用率最高的服務項目,在經建會的委託報告中也指出至2028年時,65歲以上的各級失能人口約占65歲以上人口數的10%,這當中我國陸續需要約三萬名的居家照顧服務員,與2012年統計結果居服員共計6,390人相較下有甚大差距。 本研究匯整過去照顧服務人力運用政策發現,我國在發展本國照顧服務人力的同時也需要限縮對外籍看護工的依賴,2006年開始的外籍看護工與本國照顧服務接軌方案,無法彌補及改變國人從1992年開始使用外籍看護工的習慣,以至於接軌方案推動後,外籍看護工人數並無顯著下降,而本國居服員人數也並未大幅提升。 在發展照顧服務人力上另一個困難在於,整合病患服務員(俗稱的醫院看護)和居家照顧服務員後稱為的照顧服務員,在職前訓練後選擇擔任病服員(約六成)大於選擇擔任居服員(約四成),造成居家照顧服務人力不足;過去政策檢討將其原由大多指向居服員薪資、勞動條件過低,使參訓學員不願投入,透過文獻回顧發現,居服員的教育訓練、職涯發展和工作滿足等因素也是值得深入討論。 本研究採用文獻分析法與半結構深入訪談法,一共訪談22名相關人員,包括8名居家照顧服務員,8名病患照顧員,2名曾擔任居服員後升任的居服督導,18位中有4位曾轉換不同服務模式;另外訪談2位提供居家服務的非營利組織單位主管,1位提供居家服務企業組織主管,1位政府地方長期照顧管理中心主管。透過分析受訪者資料可得知,照顧服務員訓後抉擇擔任居服員或是病服員大多先考慮家庭因素及個人特質,過去外界大多認為病患服務員薪資條件較佳,所以較多人選擇擔任病服員,但是實際上會先考慮子女及家庭照顧需求,再考量工作收入高低做選擇。在留任因素方面,受訪的居家照顧服務員認為對該工作感到認同,工作中得到同事、主管的支持與鼓勵,從工作中得到非物質的報酬及成就感讓她們願意留下;但缺乏被照顧者及其家屬和社會的尊重,專業不被肯定,缺乏職務轉換的職涯發展,工作造成身體的損害,是考慮離職的因素。 本研究認為應使用居家照顧服務員的專業及經歷,來建置基層居服人力職涯發展的途徑,認同居家照顧服務專業,才能夠吸引更多勞動力投入補足照顧人力不足的需求,培養並提升我國居家照顧人力素質,創造良好的工作品質,不只解決照顧需求,更能提升照顧品質。

並列摘要


According to the 2010 Directorate-General of Budget, Accounting and Statistics, Executive Yuan medical health report, there were 475 000 people in need of various long-term care services, in-home care services being the most frequently demanded service. Furthermore, a report from the Council for Economic Planning and Development estimates that in 2028, over 10 % of the population over the age of 65 will be in need of such care. Taiwan currently requires about 30 000 in-home caregivers, yet a 2012 statistic shows that there are currently only 6,390 in-home caregivers in service, revealing the scale of the disparity. This study compiled the past caregiver resource utilization policies and found that along with Taiwan’s development of native caregiver resources, there must also be a reduced dependence on foreign care workers. Though applications for foreign care workers or for Taiwanese care services have been integrated into one procedure since 2006, the reliance on foreign care workers has not diminished. Since the integration of the two applications, the number of foreign care workers has not decreased nor has the number of Taiwanese caregivers increased. A difficulty in developing caregiving resources is the shortage of in-home caregivers, since after pre-employment training most caregivers find employment in patient assistance not within in-home caregiving. The last policy review pointed to in-home caregivers’ salary and working condition being too low and unattractive. Research shows that the OJT(on the job training) of in-home caregivers, career development and satisfaction of working are also key issues that need to be re-evaluated. This study reviewed past literature and conducted half-structured interviews, a total of 22 interviews with relevant staff. The interviewees consisted of eight in-home caregivers, eight patient assistants, and two in-home service supervisors who were promoted from caregivers. Of the 18 caregivers interviewed, four had changed positions. Other interviewees include two section managers in nonprofit organizations who provide in-home services, one manager in business organizations who provide in-home service and one manager in government care service management centers. According to the analysis of data provided by interviewees, the main determining factors for caregivers in deciding between be in-home caregivers or patient escort services are firstly, personal family circumstances, and secondly, job descriptions and salaries. In the past, many assumed the salary of patient assistants was much better since most caregivers chose to that path. In fact, most caregivers first consider the situation of their children and family member, then consider salary. Retention factor are recognition of work, and support and encouragement from colleagues and managers. In-home caregivers who stay do so for non-material rewards and greater sense of achievement. However, poor treatment from patients, patients’ family members and society, unrecognized expertise, occupational injury are factors that promote resignation. This research believes that the field of in-home caregivers needs to be defined and developed based on the required caregivers’ expertise and experience. Clearly and systematically identifying the necessary characteristics and strengths of such caregivers will give them distinct advantages for future career development. Clearly defining potential career developments may draw more people into this career, thus solving the problem of caregiver shortage and promote better quality of care.

參考文獻


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被引用紀錄


黃娜惠(2016)。外籍家庭看護工相關政策法令之探討-以嘉義縣市為例-以嘉義縣市為例〔碩士論文,國立中正大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0033-2110201614063130

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