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|Title:||Collisions between State Policies and Indigenous Cultures: Home Care in Indigenous Communities|
WANG, FRANK T. Y.
Indigenous peoples;Long-term care;Self-determination;Home care;Government policy
|Issue Date:||2018-03-27 11:39:55 (UTC+8)|
Purpose: The purpose of this study is to examine the interaction between culture and government health care policy by exploring how long-term care policy shapes home care practices in indigenous communities in Taiwan. We expect that the key to providing the best service is finding the flexibility to recognize indigenous cultures in government policies that are intended to be universal. Methods: We conducted ethnographic research (in-depth interviews and participant observation) in a home care program operated by an NGO in 8 indigenous communities in southern Taiwan. Participants included 10 administrators, 5 supervisors, 26 home care workers, and 43 clients. Results: The theme analysis showed that when the jurisdiction of long-term care policy shifted from the Council of Indigenous Affairs to the Ministry of the Interior, the definition of home care changed from care by community members to care by paid workers. When a co-payment system was implemented, clients began to see home care as a commodity, which resulted in a new understanding of home care workers, clients, and their relationship. The indigenous understanding of home care now tends to be problematized and portrayed as an individual problem, and so gets neglected. Conclusions: Long term care policy needs to recognize the different perceptions of indigenous peoples in contrast to Han people in order to make long-term care a process of de-colonization rather than a tool of assimilation. The provision of home care in indigenous communities needs modification. First, case managers should allow more autonomy for frontline workers in their care planning. Second, the one-on-one mode of care should have the possibility to adjust to a collective mode of care to suit the indigenous tradition of mutual sharing. Last, the cultural competence of NGOs working in indigenous communities needs to be fostered to encourage sensitivity to cultural differences in the understanding of managerial problems in home care.
|Relation:||中華心理衛生學刊, Vol.30, No.1 , 7-35|
|Appears in Collections:||[社會工作研究所 ] 期刊論文|
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